GUARANTEED PASS
What influences someone's grief experience? Life experiences, quality of life
Available coping mechanisms/support
How the person died (expected/ unexpected)
What they are leaving behind
Religion, culture, faith, personal beliefs (how someone sees the afterlife)
Coping and grief People might have more maladaptive coping mechanism or they might find
hope and persevere
Be aware that people might challenge their faith (blame God, why did God do this?)
Nursing process and grief Grief is very individualized - meet the patient where they are with
whatever they are expressing to you
Type/stage of grief
Grief reactions (box 25-4 - symptoms of normal grief)
Factors that affect grief
End-of-life decisions:
- Are those in place, has the patient or family talked about what the end of life looks like?
Nurses' experiences with grief
Patient's expectations:
- What are their cultural, religious, etc views?
,Caregiver role strain: family members are often the main caregivers for their loved ones. It is
important to check in with the caregivers since they might also be struggling and need support
too
Nursing diagnosis for grief Anticipatory grieving
Caregiver role strain:
Social isolation
Ineffective coping
Powerlessness: feeling overwhelmed
Hopelessness
Planning Goals and outcomes
Setting priorities
Continuity of care
Implementation Therapeutic communication
Prompting hope
Facilitating mourning
plans and implementations are often: communication based and then pain-symptom
management
Palliative care Philosophy and an approach to providing care
- misconception that when someone is palliative, they stop receiving care (very false, just that
the approach changes from curing disease to being supportive and comforting)
- Palliative care can start months to years before someone dies, not just a couple days before
death
,- Palliative care provides a very holistic approach
Palliative care aims Aims - relieve suffering & improve quality of living & dying
Strives to help patients/families:
Address physical, psychological, social, spiritual, practical issues, associated expectations,
needs, hopes, fears
Prepare & manage self-determined life closure & dying process
Cope with loss/grief during illness, bereavement
Where people prefer to die Canada wide, most people prefer to die at home, but 61% die in
hospital
People prefer to die at home, yet many will die in hospital because there's not enough
community support
Practice recommendations - care and management Knowledgeable about pain & symptom
management
Advocate for pharmacologic & non-pharmacologic care
Educate/share information with families
Use effective communication to facilitate end-of-life discussions
Become familiar with symptoms patients who are dying experience (like dyspnea, nausea,
urinary incompetence, fatigue) and able to respond appropriately
When it comes to death, what do patients worry about the most? They fear that death is
painful
, The nurses role in palliative care The nurse in palliative care will spend time focusing on a
holistic approach to care delivery, attending to the physical, spiritual, psycho-social and
practical issues that may arise during the illness period
Looking at all aspects of the individual, not just their physical health
What a good death is: - One of the most important things was pain management
- Having everything taken care of in life so they can pass with peace
- They wanted to have preferences (some control) in the dying process
- Emotional wellbeing for themselves and their family (family can also be friends, pets, etc, not
just by blood)
- Patients and family members also wanted a good relationship with healthcare providers
When it is appropriate to say nothing: When it is too difficult for you
When you would appear false
When you don't know the answer
It is better to say nothing than to make the situation worse...
Silence is helpful, try to become comfortable with it
Medical assistance in dying (MAID) Bill C-7 Historically a crime to assist another person in
ending their own life - Now has been legal as of 2015
Carter v Canada (2015) - case where a daughter helped her mom travel to Switzerland to seek
MAID which led to the legalization of it in Canada
What is MAID? Medical Assistance In Dying
When a MD or NP (in Ontario, different in other provinces) causes death at a individual's
request via: