Lecture 10 Boxes

Question 1

Box 34.3; patterns of adjustment to widowhood

Answer 1

• Stage 1: Reactionary (1st few weeks)
• Stage 2: Withdrawal (1st few months)
• Stage 3: Recuperation (2nd 6 months)
• Stage 4: Exploration (2nd year)
• Stage 5: Integration (5th year)
• Interventions: assist individual to recognize and share own pattern of growth through the
  trauma of loss

Question 2

Box 35.2; factors influencing the grieving process

Answer 2

Physical:
* Number of concurrent medical conditions
* Use of sedatives (delays but does not lessen grief)
* Nutritional status
* Exercise

Emotional:
* Unique nature and meaning of loss
* Individual coping behavior, personality, and mental health
* Individual level of maturity and intelligence
* Previous experience with loss and death
* Social, cultural, ethnic, religious, or philosophic background
* Sex role conditioning
* Immediate circumstances surrounding loss
* Timeliness of loss
* Perception of preventability (sudden vs. expected)
* Perceived importance of the loss or relation to that which it lost
* Number, type, and quality of secondary issues
* Presence of concurrent stresses or crises

Social:
* Individual support system and the acceptance of assistance of its members
* Individual sociocultural, ethnic, religious, or philosophic background
* Educational, economic, and occupational status
* Rituals

Question 3

Box 35.3; identifying those with better coping skills

Answer 3

• Avoid Avoidance
• Confront realities and take appropriate action
• Focus on solution
• Redefine problems
• Consider alternatives
• Have good communication with others
• Seek and use constructive help
• Accept support when offered
• Can keep up their morale

Question 4

Box 35.6; helping grievers move through the impact of loss to the reestablishment of new memories

Answer 4

• Functional Disruption: provide functional assistance
• Searching for Meaning: provide reliable sources of info, inform appropriate providers of the
  person’s needs for info and make sure they receive it, and active listening.
• Engaging Emotions: “give permission” to express emotions, offer physical presence, offer to locate usual sources of support during times of crisis (ex. Minister), and active listening.
• Inform Others: offer physical presence and active listening.
• Adaptation: identify meaningful events influenced by the loss, help find new ways of
  replacing that which has been lost, offer discussions to how the loss has affected life, and
  active listening.
• Reframing Memories: offer to discuss mechanisms to develop new memories without
  denying connection with that or with whom has been lost, encourage reminiscence, facilitate opportunities for culturally based and desired bereavement rituals, assure grievers that stability will return, and active listening.

Question 5

Box 36.2; traits of self-actualized people

Answer 5

• Time competent
• Inner directed
• Flexible
• Sensitive to self
• Spontaneous
• Values self
• Accepts self
• Positively views others
• Positively views life
• Acceptance of aggressiveness
• Capable of intimate contract

Question 6

Box 36.10; brief assessment of spiritual resources and concerns

Answer 6

• Does your religion/spirituality provide comfort or serve as a cause of stress?
• Do you have any religious or spiritual beliefs that might conflict with health care or affect of
  health care decisions?
• Do you belong to a supportive church, congregation, or faith community?
• Do you have any practices or rituals that help you express your spiritual or religious beliefs?
• Do you have any spiritual needs you would like someone to address?
• How can we help you with your spiritual needs or concerns?

Question 7

Box 36.12; personal spirituality questions for reflection for nurses

Answer 7

• What do I believe in?
• How do I find purpose and meaning in my life?
• How do I take care of my physical, emotional, and spiritual needs?
• What are my hopes and dreams?
• Whom do I love, and who loves me?
• How am I with others?
• What would I change about my relations?
• Am I willing to heal relations that trouble me?

Question 8

Box 36.13; characteristics of individuals with a high degree of gerotranscendence

Answer 8

• Have high degrees of life satisfaction
• Engage in self-controlled social activity
• Experience satisfaction with self-selected social activities
• Social activities not essential to their well being
• Midlife patterns and ideals no longer prose motivators
• Demonstrate complex and active coping patterns
• Have greater need for solitary philosophizing
• May appear withdrawn when engaged in inner development
• Have accelerated development of gerotranscendence fomented by life crises
• Feel shifts in perception of reality