End-of-Life, Grief, and Bereavement: Strategies to Provide Comfort?

Author(s):  
Sonia Malhotra
2021 ◽  
pp. 409-415
Author(s):  
Richard Ackermann

Most dying patients take a peaceful road to death, progressing from sleepiness to lethargy to coma to death, without substantial agitation. Although many dying patients experience fever, hypotension, and tachycardia, no combination of physical signs accurately predicts death. Noisy respiratory secretions should be prevented and treated by discontinuing artificial hydration and nutrition and by prescribing anticholinergic drugs such as glycopyrrolate or a scopolamine patch. Delirium at the end of life is not generally evaluated with blood tests or imaging but is treated with nonpharmacological measures or with haloperidol. Teach the family what to expect as death approaches. Be prepared with a systematic approach to declaring death and comforting families in the early stages of grief and bereavement.


Author(s):  
Maria Flynn ◽  
Dave Mercer

An important aspect of nursing practice is caring for people in the last days and hours of their life, whether in a hospice, a clinical environment, or their own homes. Whilst death may be sudden and unexpected, or the anticipated result of an intractable health condition, the effective support of dying people and their families is an important aspect of nursing and care. The UK Leadership Alliance for the Care of Dying People describes key principles to guide nurses who are working with people and families at the end of life. This chapter discusses these principles and considers how they may be translated into general nursing practices. It also discusses the features of loss, grief, and bereavement, and how nurses may continue to support the bereaved after a person has died.


Author(s):  
Rony Dev

One of the frequent psychosocial issues that arises at the end of life for patients and their family caregivers is grief and bereavement. In patients facing death, anticipatory grief is part of a normal dying process. However, some patients may have difficulty coping with their immortality and have complications of clinical depression. Healthcare providers must be able to distinguish anticipatory grief from clinical depression in patients facing a life limiting illness. After a patient dies, the majority of family caregivers will experience a normal grieving process; however, some family members may experience prolonged complicated grief and other depressive disorders which must be treated. This chapter reviews this important topic as well as the burial customs of various religious groups.


2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.


2005 ◽  
Vol 14 (3) ◽  
pp. 15-19 ◽  
Author(s):  
Melanie Fried-Oken ◽  
Lisa Bardach

2014 ◽  
Vol 23 (4) ◽  
pp. 173-186 ◽  
Author(s):  
Deborah Hinson ◽  
Aaron J. Goldsmith ◽  
Joseph Murray

This article addresses the unique roles of social work and speech-language pathologists (SLPs) in end-of-life and hospice care settings. The four levels of hospice care are explained. Suggested social work and SLP interventions for end-of-life nutrition and approaches to patient communication are offered. Case studies are used to illustrate the specialized roles that social work and SLP have in end-of-life care settings.


Pflege ◽  
2011 ◽  
Vol 24 (3) ◽  
pp. 171-182
Author(s):  
Mandy Lohe ◽  
Manja Zimmermann ◽  
Christiane Luderer ◽  
Katharina Sadowski

Als Einrichtungen des Gesundheitswesens sind stationäre Hospize in Deutschland zur Qualitätssicherung und internen Qualitätsentwicklung verpflichtet. Die Bedeutung der Patientenzufriedenheit als einer der indirekten Indikatoren zur Beurteilung der Pflege- und Betreuungsqualität ist mittlerweile unumstritten. Eine subjektive Bewertung des Hospizes durch den Gast selbst birgt sowohl praktische als auch ethische Probleme. Eine Befragung der Angehörigen empfiehlt sich. Der vorliegende Artikel beschreibt die Entwicklung eines Instruments zur Evaluation stationärer Hospize aus der Sicht hinterbliebener Angehöriger. Mit dessen Hilfe soll die Frage, wie Angehörige die Begleitung und Pflege beurteilen, die ihnen sowie ihrem verstorbenen Familienmitglied durch das Hospiz zuteil wurde, beantwortet werden. Die Konstruktion der Fragen erfolgte auf Basis bestehender Konzepte zum Assessment der end-of-life care und einer Analyse aller identifizierten Instrumente zur Evaluation stationärer Hospize aus der Perspektive hinterbliebener Angehöriger. Die Fragebogenentwicklung umfasste neben der umfassenden Literaturrecherche die Bildung eines Itempools, die Itemauswahl, die kritische Diskussion der Fragen im Expertenkreis sowie einen standardisierten und kognitiven Pretest. Entstanden ist ein fünfdimensionaler Fragebogen, der physische, psychologische, soziale, spirituelle und versorgungsorganisatorische Aspekte der end-of-life care integriert. Das Instrument umfasst 53 Items in Form überwiegend geschlossener Fragen.


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