4 awareness contexts of dying
- Closed awareness
- Suspected awareness
- Mutual pretense
- Open awareness
Define closed awareness
Dying person is unaware of death
Define suspected awareness
Dying person suspects prognosis involves death
Define mutual pretense
Recognize death is outcome but act as if patient will recover
Define open awareness
Dying person and outsiders openly discuss that death is expected
What is palliative care
- Lesson pain without hope for cure
- “Care that aims to relieve suffering and improve the quality of living and dying”
What comprises assumptive world
How we expect the world to work; how others should be, and our view of ourselves in relation to the world and others
Define nonfinite loss
Ongoing and no forseeable end
Define ambiguous loss
Physically present but psychologically absent and vice versa
Define chronic sorrow
Response to nonfinite loss
Tangible loss
Apparent or readily visible or identified
Intangible loss
Invisible or symbolic in nature
Current thinking about grief
- Normal and healthy response
- Normal to have ongoing sense of connection
- Need and ability to make meaning after a loss is a significant aspect of the function of grief
Instrumental grief
Focus on activity and not talking openly about loss
Intuitive grief
Talk about deceased and openly express feelings
Disenfranchised grief
A loss that cannot be openly acknowledged, publicly mourned, or socially supported (Kenneth Doka)
How to be most helpful…
- Aware of own loss
- Be comfortable saying “I don’t know”
- Nonverbal communication
- Empathy is safe (put yourself in their shoes)
- Don’t try and “fix” it
When is professional help needed
- Talks of suicide
- Spiral thinking
- Unable to complete normal activities
- Physical symptoms (sleep and eating)
- Complicating factors to loss - trauma or abuse
5 purposes a funeral serves
- Sanitary disposal
- Celebration of life
- Beginning of mourning process
- Reintegration of the community without the deceased
- Reaffirmation of one’s belief system
4 illness trajectories
- Hospital
- Nursing home or long-term care home
- Home
- Hospice
5 ways people experience the dying process
- Physical
- Emotional
- Psychological
- Social
- Spiritual
6 ways grief can manifest
- Physically - lump in throat
- Emotionally - feelings
- Cognitively - thoughts
- Behaviourally - sleep or appetite disturbances
- Socially - relationship difficulty
- Spiritually - searching for meaning
Alzheimer’s
- Brain disorder that destroys memory and thinking
- Unable to perform simple tasks
Disposition
- Cremation
- Burial
- Visitation
- Remains and ashes (urn)
