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, Idealization: Idealization is the exaggeration of the good qualities the person or object had, followed by
acceptance of the loss.
Outcome: Outcome involves dealing with the loss as a common life occurrence.
Definition of Death
-Uniform Definition of Death Act: An individual who has sustained either (1) irreversible cessation of
circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain,
including the brainstem, is dead.
-Medical criteria used to certify a death: cessation of breathing, no response to deep painful stimuli, and
lack of reflexes (such as the gag or corneal reflex) and spontaneous movement, flat encephalogram.
Clinical Signs of Impending Death
Difficulty talking or swallowing
Nausea, flatus, abdominal distention.
Urinary and/or bowel incontinence or constipation.
Loss of movement, sensation, and reflexes.
Decreasing body temperature, with cold or clammy skin.
Weak, slow, or irregular pulse.
Decreasing blood pressure
Noisy, irregular, or Cheyne-Stokes respirations.
Restlessness and/or agitation.
Cooling, mottling, and cyanosis of the extremities and dependent areas.
Providing Care to Facilitate a Good Death
- guided by the values and preferences of the individual patient.
- independence and dignity are central issues.
- providing control
- palliative care