N109: Foundations in Nursing Practice

N109: Foundations in Nursing Practice Study Guide

Chapter Four: End of Life Care Learning Objectives 1. Discuss the process of death and dying. 2. Discuss legal issues and documents surrounding the dying process. 3. Describe the steps of the grieving process according to various theorists. 4. Describe factors that influence end of life care. 5. Using the nursing process, develop a plan of care related to end of life care. 4.1 Types of Loss Loss occurs when someone or something that has value and meaning in life is permanently gone, taken from someone, or changed. When any loss occurs, an individual may experience different types of loss. These may include: • Anticipatory loss: Anticipatory loss includes feelings of loss, concern for the dying person, balancing conflicting demands, and preparing for death. Anticipatory mourning is a natural process that enables the family more time to prepare for the reality of the loss. • Actual loss: The actual loss of an individual, object, or skill. • Perceived loss: A perceived loss is one that is felt by the individual but may not be obvious to another person. • Developmental loss: A developmental loss is one that occurs naturally as a result of the maturation process. For example, menopause is a developmental milestone that results in the loss of child-bearing ability. • Situational loss: Situational loss refers to the loss of a person, thing, or quality, resulting from an alteration of a life situation, including changes related to illness, body image, environment, and death. An individual can experience loss of some aspect of himself, loss of an object, loss of some aspect of an environment, or loss of a loved one. A loss can, in turn, result in a grief response. is the period of grief and mourning after having suffered a loss. This is an individualized overall reaction. Mourning is the expression of deep sadness for someone who has died. Mourning is influenced by cultural and spiritual beliefs, as well as customs and rituals. Typically, this involves following certain traditions, such as wearing black clothing. Grief is a bereaved person’s internal emotional response to a loss. It has physical, behavioral, emotional, mental, social, and spiritual components. Grief can sometimes be so pronounced that it affects a person’s physical self and can mimic illnesses. While grief is an expected and normal response to loss, severe or prolonged grief can cause problems. Signs and symptoms of normal grieving include crying, verbalization of the loss, sleep disturbance, loss of appetite, and difficulty 4.2 Types of Grief Responses Bereavement

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