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CARE OF TERMINALLY ILL PATIENTS,
LOSS AND GRIEF PROCESS
MS.POOJA SEN
NURSING LECTURER (MHN)
TERMINOLOGY
CARE - feeling or showing concern for
or kindness to others.
TERMINALLY ILL- having a disease or
illness that cannot be cured, and that is
expected to result in death in a short time
TERMINOLOGY
DEATH -the end of the life of a person
or organism.
DYING- on the point of death.
TERMINOLOGY
AUTOPSY - an examination of a body after
death to determine the cause of death or the
character and extent of changes produced by
disease. called also necropsy.
BIOPSY- A biopsy is a procedure to
remove a piece of tissue or a sample of cells
from your body so that it can be tested in a
laboratory.
TERMINOLOGY
LOSS - The fact or process of losing something or someone.
TERMINOLOGY
GRIEF- Grief is the natural emotional response to the loss of someone close, such as a
family member or friend. grief can also occur after a serious illness, a divorce or other
significant losses. grief often involves intense sadness, and sometimes feelings of shock or
even denial and anger.
TERMINOLOGY
BEREAVEMENT - Bereavement is the experience of losing someone important to us. It's
characterized by grief, which is the process and the range of emotions we go through when
we experience a loss. ( It is the starting stage of grief)
TERMINOLOGY
MOURNING – A reaction activated by a person to
assist in overcoming a great personal loss.
Mourning is an expression of grief or a time of
grieving that follows a loved one's death or other
serious loss. To begin to feel or show sadness for
someone who has died :
EX. - To begin the ritual observances accompanying
a death (such as the wearing of WHITE - she went
into mourning for her dead husband)
TERMINOLOGY
PALLATIVE CARE - Palliative care is specialized medical care for people living with a
serious illness, such as cancer . Patients in palliative care may receive medical care for their
symptoms, or palliative care, along with treatment intended to cure their serious illness.
TERMINOLOGY
HOSPICE CARE -Hospice care focuses on the care, comfort, and quality of life of a
person with a serious illness who is approaching the end of life. At some point, it may not be
possible to cure a serious illness, or a patient may choose not to undergo certain treatments.
TERMINOLOGY
LAST OFFICE -The last offices, or laying out, is the procedures performed, usually by a
nurse, to the body of a dead person shortly after death has been confirmed.
TERMINOLOGY
RIGOR MORTIS – (Latin: rigor
"stiffness", and mortis "of death")
Rigor mortis is a postmortem change resulting in
the stiffening of the body muscles due to
chemical changes.
Rigor mortis appears approximately 2 hours after
death in the muscles of the face, progresses to the
limbs over the next few hours, completing
between 6 to 8 hours after death. Rigor mortis
then stays for another 12 hours (till 24 hours after
death) and then disappears.
TERMINOLOGY
EMBALMING - Embalming is a process that uses chemicals to preserve a body after
death. It helps delay the decomposition that begins in the hours and days after death.
TERMINOLOGY
EUTHANASIA – An easy or painless death, or the
intentional ending of the life of a person suffering
from an incurable or painful disease at his or her
request , Also called MERCY KILLING.
Aruna Ramchandra Shanbaug (1 June 1948 – 18 May 2015),
was an Indian nurse who was at the center of attention in a
court case on euthanasia after spending over 41 years in a
vegetative state because of sexual assault.
ACCORDING TO ARTICLE 21-
Active euthanasia is illegal in India.
Passive euthanasia is legal under strict guidelines. For this,
patients must give consent through a living will. ( 7 March
2018 Supreme court of India)
TERMINOLOGY
Active euthanasia: Killing a patient by active means, for example,
injecting a patient with a lethal dose of a drug, sometimes called
“aggressive” euthanasia.
Passive euthanasia: Intentionally letting a patient die by
withholding artificial life support such as a ventilator or feeding tube.
CARE OF TERMINALLY ILL
PATIENTS
TERMINAL ILLNESS
• Terminal Illness Is A Medical Term Used To Describe A Disease That Cannot
Be Cured Or Adequately Treated And That Is Reasonably Expected To
Result In The Death Of The Patient With In A Short Period Of Time .
• A Terminal Illness Is A Disease Or Condition That Is Incurable And
Expected To Lead To The Death Of The Patient, Typically Within A
Relatively Short Period—often Defined As Six Months Or Less—if The
Illness Runs Its Natural Course.
Examples Include Advanced Stages Of Cancer, End-stage Heart Failure
IMPACT OF PATIENTS
Many Patients Realize With Out Being Told That They Are
Suffering From Terminal Illness, Nonverbal Often Pickup
This Knowledge From Nonverbal Communication By & By
Their Health Care Professionals. Patients Must Be Allowed
To Go Through The Stage Of Grieving Process And To
Make Decisions About Their Care, They Must Be Supported
In Their Decision Making. Competent Patients Have The
Right To Consent & Refuse Any All Indicated Medical
Treatment Even Life Sustaining Treatment And Should Be
Made Aware Of This Right.
IMPACT OF FAMILY
The Family & Significant Others Of Terminally Ill
Patients Should Be Encouraged To Participate In
Planning The Patients Care. Health Care Personnel
Should Be Available To Discuss The Patient's
Condition With The Family Members And Should
Support And Care As The Family Begins The
Grieving Process. The Family May Want To Make
Arrangement With The Patients For Funeral Or
Memorial Services.
AIMS OF CARE OF TERMINALLY ILL
PATIENTS
 To Improve The Patients & Family Quality Of
Life.
 To Provide Prioritized Care & Symptoms
Management .
 To Provide Care Of Multiple Dimension Of The
Illness Experience For Both Patients & Families.
Promoting Self Care & Self Esteem.
AIMS OF CARE OF TERMINALLY ILL
PATIENTS
 meeting clients need.
 prepare for and mange life closure & the
dying process.
Coping with loss & grief during the illness
& bereavement.
LOSS & TYPES
DEFINITION
♠The fact or process of losing something or someone.
♠Loss is an inevitable (which can not be avoid) part of life, loss is an
actual and symbolic (sure to happen) situation in which something
that is valued is changed or no longer available or gone.
TYPES
♠Maturational Loss
♠Actual Loss
♠Perceived Loss
♠Sudden Loss
♠Predictable Loss
♠Physical Loss
♠Physiological Loss
♠Anticipatory Loss
♠ MATURATIONAL LOSS – A maturational loss is a form of necessary loss which is normally
expected occur during the life cycle.
Ex. Death of spouse due to old age.
♠ACTUAL LOSS – Actual loss is when something valuable is lost or damaged
unexpectedly.
.Ex. – If you buy a toy and it breaks.
♠PERCEIVED LOSS – A perceived loss is a loss that is not necessarily seen or felt by
others. loss occurs when a Divorce, property, Job termination .
♠SUDDEN LOSS - sudden loss or shocking losses due to event like crime, accident, suicide .
♠PREDICTABLE LOSS / ANTICIPATORY LOSS - Predictable loss occurs due to terminal illness
sometime allow more time to prepare for loss.
♠PHYSICAL LOSS – Loss of part or aspect of the body, such as loss of an extremely in an
accident, burn.
♠PHYSIOLOGICAL LOSS - Emotional loss such as women feeling inadequately after
menopause.
GRIEF ,TYPES & STAGES
♠Grief is a subjective state of emotional, physical & social response to
the loss.
♠Grief is a series of intense physical, psychological response that
occurs following loss.
♠Grief is the subjective feeling participated by the death of loved one.
DEFINITION
TYPES
1. Normal / Common Grief
2. Anticipatory Grief
3. Complicated Grief
4. Absent Grief
5. Delayed Grief
6. Exaggerated grief
TYPES
1. NORMAL / COMMON GRIEF -
• Normal or common grief begins soon after a loss and symptoms go away over the
time.
• Normal grief usually includes some common emotional reaction shock, denial
occurring immediately after death if death is unexpected.
• Normal or common grief occur in 50 Percentage – 80 Percentage of person begin
soon after a loss.
TYPES
2. ANTICIPATORY GRIEF -
• Anticipatory grief has been defined as feeling of grief or loss that are felt
before the loss actually happens.
• Individuals are able to complete unfinished work with the dying patient or
person. (express feeling ,spend quality time ,practice forgiveness ask them
about funeral wishes)
TYPES
3. COMPLICATED GRIEF -
It is defined as lack of adapting to the loss of loved one that persistent for more
than one year in adult & more than 6 month in child.
• Minimal grief – a grief pattern in which the person has no, or only a few signs
of distress or problems that occur.
• Chronic grief – a grief pattern in which symptoms of common grief last for a
much longer time than usual , these symptoms are a lot like ones occurs with
major depression or PTSD.
TYPES
4. ABSENT GRIEF -
The kind of grief in which the person affected blocks their feelings they try to
act as nothing happening.
5. DELAYED GRIEF –
Delayed grief is a reaction to loss which occurs at present, but emotional
responses are not felt or expressed at same time.
Some time its associated to PTSD . ( Disaster , Accident)
TYPES
6. EXAGGREATED GRIEF -
• A person with exaggerated grief response self destructive or maladaptive
behaviors.
• Person may experience nightmares, suicidal thought or cope up with loss through
Substance abuse or using drugs.
TERMINOLOGIES,GRIEF PROCESS AND LOSS AMD ITS TYPES .pptx
introduction
• The five stages of grief model was developed
by Elisabeth Kübler-Ross, and became famous
after she published her book On Death and
Dying in 1969.
• Elisabeth Kübler-Ross (July 8, 1926 – August
24, 2004) was a Swiss-American psychiatrist, a
pioneer in near-death studies, and author of the
internationally best-selling book,
On Death and Dying (1969), where she first
discussed her theory of the five stages of grief,
also known as Kübler-Ross the " model".
1. DENIAL – Refusal to believe the loss has occurred.
Acts as a defense mechanism to give you a chance to
understand the news.
EX. – THIS CANT’T BE HAPPENING TO ME, IT IS
TRUE? HE/SHE REALLY GONE ?
2. ANGER – Experiencing anger after the loss, may
blame themselves or others.
EX. WHY ME ? IT IS NOT FAIR…..
3. BARGAINING – Making promises to change if the loss is
returned to them , Often accompanied by guilt.
EX. IF ONLY I WOULD HAVE OR MAKR THIS GO AWAY
I WILL…….. OR TAKE ME INSTEAD……….
4. DEPPRESION – Feeling od sadness, regret, fear, loneliness,
loss of interest.
EX. THERE IS NO HOPE OR I JUST WANT TO BE ALONE .
5. ACCEPTANCE – Accepting the reality that the loved one is
physically gone and that this new reality is permanent .
EX. MY LIFE WILL NEVER BE THE SAME BUT I AM AT
PEACE WITH WHAT HAS HAPPENED.
TERMINOLOGIES,GRIEF PROCESS AND LOSS AMD ITS TYPES .pptx

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TERMINOLOGIES,GRIEF PROCESS AND LOSS AMD ITS TYPES .pptx

  • 1. CARE OF TERMINALLY ILL PATIENTS, LOSS AND GRIEF PROCESS MS.POOJA SEN NURSING LECTURER (MHN)
  • 2. TERMINOLOGY CARE - feeling or showing concern for or kindness to others. TERMINALLY ILL- having a disease or illness that cannot be cured, and that is expected to result in death in a short time
  • 3. TERMINOLOGY DEATH -the end of the life of a person or organism. DYING- on the point of death.
  • 4. TERMINOLOGY AUTOPSY - an examination of a body after death to determine the cause of death or the character and extent of changes produced by disease. called also necropsy. BIOPSY- A biopsy is a procedure to remove a piece of tissue or a sample of cells from your body so that it can be tested in a laboratory.
  • 5. TERMINOLOGY LOSS - The fact or process of losing something or someone.
  • 6. TERMINOLOGY GRIEF- Grief is the natural emotional response to the loss of someone close, such as a family member or friend. grief can also occur after a serious illness, a divorce or other significant losses. grief often involves intense sadness, and sometimes feelings of shock or even denial and anger.
  • 7. TERMINOLOGY BEREAVEMENT - Bereavement is the experience of losing someone important to us. It's characterized by grief, which is the process and the range of emotions we go through when we experience a loss. ( It is the starting stage of grief)
  • 8. TERMINOLOGY MOURNING – A reaction activated by a person to assist in overcoming a great personal loss. Mourning is an expression of grief or a time of grieving that follows a loved one's death or other serious loss. To begin to feel or show sadness for someone who has died : EX. - To begin the ritual observances accompanying a death (such as the wearing of WHITE - she went into mourning for her dead husband)
  • 9. TERMINOLOGY PALLATIVE CARE - Palliative care is specialized medical care for people living with a serious illness, such as cancer . Patients in palliative care may receive medical care for their symptoms, or palliative care, along with treatment intended to cure their serious illness.
  • 10. TERMINOLOGY HOSPICE CARE -Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life. At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments.
  • 11. TERMINOLOGY LAST OFFICE -The last offices, or laying out, is the procedures performed, usually by a nurse, to the body of a dead person shortly after death has been confirmed.
  • 12. TERMINOLOGY RIGOR MORTIS – (Latin: rigor "stiffness", and mortis "of death") Rigor mortis is a postmortem change resulting in the stiffening of the body muscles due to chemical changes. Rigor mortis appears approximately 2 hours after death in the muscles of the face, progresses to the limbs over the next few hours, completing between 6 to 8 hours after death. Rigor mortis then stays for another 12 hours (till 24 hours after death) and then disappears.
  • 13. TERMINOLOGY EMBALMING - Embalming is a process that uses chemicals to preserve a body after death. It helps delay the decomposition that begins in the hours and days after death.
  • 14. TERMINOLOGY EUTHANASIA – An easy or painless death, or the intentional ending of the life of a person suffering from an incurable or painful disease at his or her request , Also called MERCY KILLING. Aruna Ramchandra Shanbaug (1 June 1948 – 18 May 2015), was an Indian nurse who was at the center of attention in a court case on euthanasia after spending over 41 years in a vegetative state because of sexual assault. ACCORDING TO ARTICLE 21- Active euthanasia is illegal in India. Passive euthanasia is legal under strict guidelines. For this, patients must give consent through a living will. ( 7 March 2018 Supreme court of India)
  • 15. TERMINOLOGY Active euthanasia: Killing a patient by active means, for example, injecting a patient with a lethal dose of a drug, sometimes called “aggressive” euthanasia. Passive euthanasia: Intentionally letting a patient die by withholding artificial life support such as a ventilator or feeding tube.
  • 16. CARE OF TERMINALLY ILL PATIENTS
  • 17. TERMINAL ILLNESS • Terminal Illness Is A Medical Term Used To Describe A Disease That Cannot Be Cured Or Adequately Treated And That Is Reasonably Expected To Result In The Death Of The Patient With In A Short Period Of Time . • A Terminal Illness Is A Disease Or Condition That Is Incurable And Expected To Lead To The Death Of The Patient, Typically Within A Relatively Short Period—often Defined As Six Months Or Less—if The Illness Runs Its Natural Course. Examples Include Advanced Stages Of Cancer, End-stage Heart Failure
  • 18. IMPACT OF PATIENTS Many Patients Realize With Out Being Told That They Are Suffering From Terminal Illness, Nonverbal Often Pickup This Knowledge From Nonverbal Communication By & By Their Health Care Professionals. Patients Must Be Allowed To Go Through The Stage Of Grieving Process And To Make Decisions About Their Care, They Must Be Supported In Their Decision Making. Competent Patients Have The Right To Consent & Refuse Any All Indicated Medical Treatment Even Life Sustaining Treatment And Should Be Made Aware Of This Right.
  • 19. IMPACT OF FAMILY The Family & Significant Others Of Terminally Ill Patients Should Be Encouraged To Participate In Planning The Patients Care. Health Care Personnel Should Be Available To Discuss The Patient's Condition With The Family Members And Should Support And Care As The Family Begins The Grieving Process. The Family May Want To Make Arrangement With The Patients For Funeral Or Memorial Services.
  • 20. AIMS OF CARE OF TERMINALLY ILL PATIENTS  To Improve The Patients & Family Quality Of Life.  To Provide Prioritized Care & Symptoms Management .  To Provide Care Of Multiple Dimension Of The Illness Experience For Both Patients & Families. Promoting Self Care & Self Esteem.
  • 21. AIMS OF CARE OF TERMINALLY ILL PATIENTS  meeting clients need.  prepare for and mange life closure & the dying process. Coping with loss & grief during the illness & bereavement.
  • 23. DEFINITION ♠The fact or process of losing something or someone. ♠Loss is an inevitable (which can not be avoid) part of life, loss is an actual and symbolic (sure to happen) situation in which something that is valued is changed or no longer available or gone.
  • 24. TYPES ♠Maturational Loss ♠Actual Loss ♠Perceived Loss ♠Sudden Loss ♠Predictable Loss ♠Physical Loss ♠Physiological Loss ♠Anticipatory Loss
  • 25. ♠ MATURATIONAL LOSS – A maturational loss is a form of necessary loss which is normally expected occur during the life cycle. Ex. Death of spouse due to old age. ♠ACTUAL LOSS – Actual loss is when something valuable is lost or damaged unexpectedly. .Ex. – If you buy a toy and it breaks. ♠PERCEIVED LOSS – A perceived loss is a loss that is not necessarily seen or felt by others. loss occurs when a Divorce, property, Job termination .
  • 26. ♠SUDDEN LOSS - sudden loss or shocking losses due to event like crime, accident, suicide . ♠PREDICTABLE LOSS / ANTICIPATORY LOSS - Predictable loss occurs due to terminal illness sometime allow more time to prepare for loss. ♠PHYSICAL LOSS – Loss of part or aspect of the body, such as loss of an extremely in an accident, burn. ♠PHYSIOLOGICAL LOSS - Emotional loss such as women feeling inadequately after menopause.
  • 27. GRIEF ,TYPES & STAGES
  • 28. ♠Grief is a subjective state of emotional, physical & social response to the loss. ♠Grief is a series of intense physical, psychological response that occurs following loss. ♠Grief is the subjective feeling participated by the death of loved one. DEFINITION
  • 29. TYPES 1. Normal / Common Grief 2. Anticipatory Grief 3. Complicated Grief 4. Absent Grief 5. Delayed Grief 6. Exaggerated grief
  • 30. TYPES 1. NORMAL / COMMON GRIEF - • Normal or common grief begins soon after a loss and symptoms go away over the time. • Normal grief usually includes some common emotional reaction shock, denial occurring immediately after death if death is unexpected. • Normal or common grief occur in 50 Percentage – 80 Percentage of person begin soon after a loss.
  • 31. TYPES 2. ANTICIPATORY GRIEF - • Anticipatory grief has been defined as feeling of grief or loss that are felt before the loss actually happens. • Individuals are able to complete unfinished work with the dying patient or person. (express feeling ,spend quality time ,practice forgiveness ask them about funeral wishes)
  • 32. TYPES 3. COMPLICATED GRIEF - It is defined as lack of adapting to the loss of loved one that persistent for more than one year in adult & more than 6 month in child. • Minimal grief – a grief pattern in which the person has no, or only a few signs of distress or problems that occur. • Chronic grief – a grief pattern in which symptoms of common grief last for a much longer time than usual , these symptoms are a lot like ones occurs with major depression or PTSD.
  • 33. TYPES 4. ABSENT GRIEF - The kind of grief in which the person affected blocks their feelings they try to act as nothing happening. 5. DELAYED GRIEF – Delayed grief is a reaction to loss which occurs at present, but emotional responses are not felt or expressed at same time. Some time its associated to PTSD . ( Disaster , Accident)
  • 34. TYPES 6. EXAGGREATED GRIEF - • A person with exaggerated grief response self destructive or maladaptive behaviors. • Person may experience nightmares, suicidal thought or cope up with loss through Substance abuse or using drugs.
  • 36. introduction • The five stages of grief model was developed by Elisabeth Kübler-Ross, and became famous after she published her book On Death and Dying in 1969. • Elisabeth Kübler-Ross (July 8, 1926 – August 24, 2004) was a Swiss-American psychiatrist, a pioneer in near-death studies, and author of the internationally best-selling book, On Death and Dying (1969), where she first discussed her theory of the five stages of grief, also known as Kübler-Ross the " model".
  • 37. 1. DENIAL – Refusal to believe the loss has occurred. Acts as a defense mechanism to give you a chance to understand the news. EX. – THIS CANT’T BE HAPPENING TO ME, IT IS TRUE? HE/SHE REALLY GONE ?
  • 38. 2. ANGER – Experiencing anger after the loss, may blame themselves or others. EX. WHY ME ? IT IS NOT FAIR…..
  • 39. 3. BARGAINING – Making promises to change if the loss is returned to them , Often accompanied by guilt. EX. IF ONLY I WOULD HAVE OR MAKR THIS GO AWAY I WILL…….. OR TAKE ME INSTEAD……….
  • 40. 4. DEPPRESION – Feeling od sadness, regret, fear, loneliness, loss of interest. EX. THERE IS NO HOPE OR I JUST WANT TO BE ALONE .
  • 41. 5. ACCEPTANCE – Accepting the reality that the loved one is physically gone and that this new reality is permanent . EX. MY LIFE WILL NEVER BE THE SAME BUT I AM AT PEACE WITH WHAT HAS HAPPENED.