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End of Life Care (Types of Loss (Perceived Loss Any loss that is defined…
End of Life Care
Types of Loss
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Maturational Loss Any change in the developmental process that is normally expected during a lifetime
Actual Loss Any loss of a person/object that can no longer be felt, heard, known, or experienced
Situational Loss Any sudden, unpredictable external event
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Types of Grief
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Complicated Grief
1. Chronic
Acute mourning characterized by normal grief reactions that do not subside & continue for very long periods of time
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3. Delayed
Normal grief reactions that are suppressed/postponed & by the survivor’s conscious/unconscious avoidance of the pain of the loss
4. Masked
Lack of awareness by the survivors that behaviours that interfere w/ normal functioning are a result of their loss
Normal Grief
Normal/uncomplicated feelings, behaviours & reactions to a loss (Ex. Resentment, sorrow, crying, temporary withdrawal, etc.)
Disenfranchised Grief
When a person has difficulty progressing normally through the stages of grieving/bereaving
Frameworks for Grieving
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Kubler-Ross
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Denial
An individual acts as though nothing has happened & may refuse to believe/understand that a loss has occurred
Bargaining
The individual postpones awareness of the reality of the loss & may try to deal in a subtle/overt way as though the loss can be prevented
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Engel
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Developing Awareness
The person experiences loss of energy and becomes increasingly affected by the loss
Restitution
The person works to adapt to a new life w/o the deceased; a resurgence of hope & renewed energy is felt when successful grieving occurs
Manifestations of Grief
Cognitive
- Disbelief
- Confusion
- Perceptual disturbances
- Hopelessness
Physical
- Tightness in chest
- Tightness in throat
- Shortness of breath
- Muscle weakness
- Lack of energy
- Abdominal pain
Emotional
- Sadness
- Anger
- Guilt
- Anxiety
- Loneliness
- Shock/numbness
- Yearning
Behavioural
- Sleep pattern changes
- Appetite disturbances
- Absent-minded behaviour
- Dreams about the deceased
- Sighing
- Emotional lability
- Carrying objects that belonged to the deceased