1
Q
What is living-dying interval?
A
time between awareness of death and actual death
2
Q
Key ideas of Loss Response Model
A
Loss is universal and ongoing. Grief response is individual, dynamic and non-linear
3
Q
Types of loss
A
normative (expected), non-normative (unexpected).
4
Q
Cyclical loss process of Loss Response Model
A
- Shock / loss feels unreal
- Searching for meaning (“Why?”)
- Informing others → loss becomes real
- Expressing emotions → releases energy
- Reorganizing roles (someone replaces lost role)
- Reframing memories → new normal
- Goal: Restore balance and adapt
5
Q
What is loss, grief, mourning
A
loss: remove of valued
grief: emotional response to loss
mourning: express and adapt to loss
6
Q
What is bereavement overload
A
multiple loss in short time, overwhelm coping ability
7
Q
3 Grieving process
A
- Acute grief (intense reactions, comes in waves, no time frame, distracted)
- Middle phase (daily functioning affected)
- Adjustment phase (new normal)
*non-linear process
8
Q
4 Worden’s Tasks of Bereavement/Grief
A
- Accept the loss
- Work through pain
- Adjust to life without the loss
- Maintain connection while moving forward
9
Q
Types of grief
A
anticipatory grief (emotional up/down, early detachment)
acute grief (intense distress, confusion, affect function, hospitality due to self-blame)
persistent/complicated grief (prolonged, intense, professional help, shadow grief)
disenfranchised grief (not socially supported, e.g. hidden relationship, loss of roles, stigmatized deaths).
10
Q
Kübler-Ross 5 stages of grief
A
- Shock
- Denial
- Anger
- Bargaining (What if, try to live normally)
- Depression
- Testing (investigating solutions)
- Acceptance (loss processed)
*Not everyone experiences all stages or in order
11
Q
Special loss of child/grandchild
A
highly emotional & nonnormative, hide grief, feel isolated, stay strong for others.
*Grandparents are often neglected mourners
12
Q
Nursing role in grief
A
Assessment (understand meaning, culture, coping ability), intervention (build rapport, help with immediate needs, encourage storytelling, support meaning-making)
13
Q
N.U.R.S.E. technique
A
Name, Understand, Respect, Support, Explore
14
Q
What does livig-dying interval starts with?
A
Crisis knowledge of death (realize life is shorted than expected, anxiety, crisis)
15
Q
Phases of living-dying interval
A
acute (shock, anxiety, anticipatory grief), chronic (return to normal life, living while dying), terminal (rapid decline, withdrawal, prepare for death)
16
Q
2 trajectories of living-dying interval
A
integrated: good adaptation
disintegrated: unresolved crises, poor quality of life
17
Q
Needs of the Dying (6 Cs Model)
A
- Care → comfort, symptom control
- Control → autonomy, decision-making
- Composure → emotional balance on cultural norms
- Communication → open or culturally appropriate dialogue (mutual pretense, let’s pretend)
- Continuity → maintain normal life/roles (legacy)
- Closure → resolve, say goodbye, meaning (reminiscing, self-reflection)
18
Q
Nursing Role in End-of-Life Care
A
Manage symptoms
Coordinate care
Advocate for dignity
Support family
Provide emotional presence
19
Q
Advance Care Planning (ACP)
A
choosing substitute decision-maker, communicating care wishes
20
Q
3 death trajectories
A
- rapid decline (terminal illness, cancer)
- intermittent decline (organ failure)
- Gradual decline (frailty, dementia)
21
Q
meaning of “palliation” and “hospice”
A
palliation: improve quality of life and reduce suffering
hospice: hospitality, kindness (medieval travelers)
22
Q
medication for acte grief
A
Anxiolytics (benzodiazepine)
23
Q
Safeguards for MAID
A
communicate medications, waiting period, second opinion, written request for witness.
24
Q
What are the major features of living options available to older adults?
A
- Aging in place
- Senior retirement communities
- Shared housing
- Assisted-living settings
- Long-term care (LTC) or nursing homes
Each option has its own advantages and disadvantages, influencing the choice of residence for older adults.
25
What does **aging in place** mean?
Continuing to live in one’s home; not having to move to another location to receive services as care needs change.
## Footnote
This concept emphasizes the importance of support for changing care needs.
26
What are the **eight domains** of age-friendly communities?
* Outdoor spaces and buildings
* Transportation
* Housing
* Social participation
* Respect and social inclusion
* Civic participation and employment
* Communication and information
* Community support and health services
## Footnote
These domains are essential for enhancing the health and well-being of older adults.
27
True or false: Most older adults prefer to **move to nursing homes** rather than age in place.
FALSE
## Footnote
Most older adults prefer to remain in their own homes, aging in place, rather than relocating to nursing homes.
28
What is the **definition of social housing**?
Includes municipally owned and operated housing; nonprofit and for-profit properties; provincial cooperative housing; and privately owned housing with government rent supplements for low-income tenants.
## Footnote
Ensures tenants do not spend more than 30% of income on rent.
29
What is a **life lease**?
An arrangement where a resident has a lifelong lease for a home, requiring an upfront payment and monthly fees for management and upkeep.
## Footnote
Residents can occupy their units until they die or move, often with access to care services.
30
What are **adult lifestyle communities** also known as?
* Retirement communities
* Resort communities
* 55-plus communities
## Footnote
These communities are designed for newly retired persons and often include recreational facilities.
31
What are some **factors to consider** when planning to add an older adult to a household?
* Needs of the new member and family
* Space allocation
* Inclusion in family patterns
* Shared responsibilities
* Community resources for adjustment
## Footnote
These considerations help facilitate a smooth transition for the older adult.
32
What is the **impact of the culture change movement** on long-term care homes?
Focuses on creating environments that enhance care outcomes and promote dignity and respect for older adults.
## Footnote
This movement encourages a shift towards more person-centered care.
33
What is the **main theme** regarding older adults' housing needs from their perspective?
The social aspect of the meaning of home, including access to services and amenities.
## Footnote
Participants expressed a desire for neighborhoods with people of all ages and pedestrian safety.
34
What are some **areas of conflict** that may arise in multigenerational housing?
* Privacy issues
* Expenses
* Vacations
* Child rearing disagreements
* Child care concerns
## Footnote
These conflicts can affect the dynamics between older adults and younger family members.
35
How can you **decrease areas of conflict** in multigenerational housing?
* Respect privacy
* Discuss space allocations
* Discuss furnishings before moving
* Clarify social event inclusivity
* Clear household task responsibilities
* Have older adults pay a share of expenses
## Footnote
These strategies can help maintain harmony in shared living situations.
36
What is a **granny flat**?
An apartment added to existing homes or small housing units on family property
## Footnote
Provides privacy while allowing older adults to live close to family for assistance.
37
What is the **cohousing model**?
Older adults own or rent individual homes clustered around a common house
## Footnote
Residents share facilities like kitchens and dining rooms, promoting community.
38
What are the **three types of adult day centres**?
* Social
* Medical–health
* Specialized
## Footnote
Each type offers different levels of care and services for older adults.
39
What are the **goals of home care**?
* Maintain or improve health status
* Assist with independence
* Support families
* Help stay at home
* Provide caregiver support
## Footnote
These goals aim to enhance the quality of life for older adults.
40
What services are included in **home care**?
* Nursing
* Personal care
* Physiotherapy
* Occupational therapy
* Speech therapy
* Social work
* Dietitian services
* Homemaking
* Respite
* Meals on Wheels
* Friendly visiting
* Medical supplies and equipment
* Case management
## Footnote
Home care services can be tailored to individual needs.
41
True or false: **Home care** is an insured service under the Canada Health Act.
FALSE
## Footnote
Home care is considered an extended service, not covered by provincial health insurance.
42
What is **supportive housing**?
Apartment buildings for older adults with on-site personal support services
## Footnote
Often operated by charitable or nonprofit organizations, providing social and recreational programs.
43
What are **retirement homes**?
Nonmedical community-based settings providing housing and services for seniors
## Footnote
They offer meals, medication supervision, and assistance with daily living activities.
44
What are the **characteristics of long-term care homes (LTC)**?
* Provide around-the-clock care
* Operate on a for-profit or nonprofit basis
* Care for various health conditions
* Majority of residents are women
* High prevalence of cognitive impairment
## Footnote
LTC homes cater to individuals needing specialized care.
45
What are the **payment models** for facilities fees in LTC homes?
* Per diem based on public pension incomes
* Subsidized per diem based on income
* Subsidized per diem based on assets and income
## Footnote
These models help determine the cost of care for residents.
46
What are the **rights of residents** in long-term care homes in Ontario?
* Treated with courtesy and respect
* Protected from abuse
* Not neglected
* Properly sheltered, fed, and cared for
* Live in a safe and clean environment
* Exercise rights as citizens
## Footnote
These rights are designed to ensure dignity and safety for residents.
47
Every resident has the right to be protected from _______.
abuse
## Footnote
This right emphasizes the importance of safety and dignity for residents in long-term care homes.
48
What are the rights of residents regarding their **personal needs**?
* Proper shelter
* Food
* Clothing
* Grooming
* Care consistent with needs
## Footnote
Residents should receive care that respects their individual needs.
49
Every resident has the right to live in a _______ and _______ environment.
safe and clean
## Footnote
A safe and clean environment is essential for the well-being of residents.
50
True or false: Every resident has the right to exercise the rights of a citizen.
TRUE
## Footnote
This right ensures that residents can participate in civic activities.
51
Every resident has the right to be told who is responsible for and who is providing the resident’s _______.
direct care
## Footnote
Transparency in care provision is crucial for trust and safety.
52
Every resident has the right to have his or her participation in _______ respected.
decision making
## Footnote
Involvement in decision-making enhances the dignity of residents.
53
Every resident has the right to keep and display _______ in his or her room.
personal possessions, pictures, and furnishings
## Footnote
This right supports the individuality and personal identity of residents.
54
Every resident has the right to participate fully in the development, implementation, review, and _______ of his or her plan of care.
revision
## Footnote
Active participation in care planning is essential for personalized care.
55
Every resident has the right to give or refuse _______ to any treatment, care, or services.
consent
## Footnote
Informed consent is a fundamental aspect of patient autonomy.
56
Every resident has the right to have personal health information kept _______.
confidential
## Footnote
Confidentiality is vital for trust in the care relationship.
57
Every resident has the right to receive care and assistance toward _______ based on a restorative care philosophy.
independence
## Footnote
This approach aims to maximize residents' independence.
58
Every resident has the right not to be _______ except in limited circumstances.
restrained
## Footnote
Restraints should only be used under specific legal and ethical guidelines.
59
Every resident has the right to communicate in _______ and receive visitors of his or her choice.
confidence
## Footnote
Privacy in communication is essential for emotional well-being.
60
Every resident who is dying or very ill has the right to have family and friends present _______ hours per day.
24
## Footnote
This right supports emotional support during critical times.
61
Every resident has the right to raise concerns or recommend changes in _______ and services.
policies
## Footnote
Residents should feel empowered to voice their opinions without fear.
62
The **culture change movement** in long-term care homes aims to transform homes from a typical medical model into homes that nurture _______.
quality of life
## Footnote
This movement focuses on person-centered values and practices.
63
What are the core **person-directed values** in the culture change movement?
* Relationship
* Choice
* Dignity
* Respect
* Self-determination
* Purposeful living
## Footnote
These values guide the transformation of care practices.
64
The **Eden Alternative** is known for adding _______ to long-term care homes.
* Animals
* Plants
* Children
## Footnote
This approach aims to create a more homelike environment.
65
The **PC P.E.A.R.L.S.** guideline developed by the Alzheimer Society of Canada focuses on sustaining culture change through several principles. Name one of these principles.
Person and family engagement
## Footnote
This principle emphasizes the involvement of families in care.
66
What is the most appropriate method of choosing an **LTC home**?
* Personally visit the home
* Meet with the director of nursing or resident care
* Observe care practices
* Discuss the potential resident’s needs
## Footnote
Personal visits provide insight into the quality of care.
67
True or false: Integrated care was developed as an alternative to LTC homes for frail older adults who want to live in their communities independently.
TRUE
## Footnote
Integrated care aims to enhance the quality of life for older adults.
68
What are some common outcomes for seniors receiving **alternate level of care (ALC)** in hospitals?
* Unnecessary functional decline
* Increased risk of transitional care problems
## Footnote
ALC days can lead to complications for older adults.
69
Relocation is often a stressor for older adults and their families. What is one way to mitigate negative reactions to relocation?
Advance notice
## Footnote
Preparation can help ease the transition for older adults.
70
The **Self-Efficacy Relocation Scale** is used to assess the self-efficacy of individuals who are relocating. What does self-efficacy refer to?
Beliefs in one’s capability to organize and execute required actions
## Footnote
Self-efficacy can influence adjustment to relocation.
71
What should nurses tailor interventions to for the **older adult** during relocation?
* Values and preferences
* Sense of control
* Autonomy
* Mastery
* Social support
* Coping with relocation
* Orientation to new surroundings
* Continuity of care
* Meeting physical and psychosocial needs
## Footnote
Family members or care partners often need support when an older adult moves into an LTC home.
72
True or false: Family members often feel they have failed the older adult when they move into a long-term care home.
TRUE
## Footnote
This feeling can arise regardless of the circumstances surrounding the move.
73
What are the **eight elements** of age-friendly communities that enhance older adults' ability to remain in their homes?
1. Outdoor spaces and buildings
2. Transportation
3. Housing
4. Social participation
5. Respect and social inclusion
6. Civic participation and employment
7. Communication and information
8. Community support and health services
## Footnote
These elements help older adults maintain their independence and quality of life.
74
What role do **nurses** play in the care of older adults?
* Leadership in improving care
* Promoting healthy aging
* Advocacy
* Ensuring optimal outcomes during transitions of care
## Footnote
Gerontological nurses are in great demand as the population ages.
75
Fill in the blank: A familiar and comfortable environment allows an older adult to function at their _______.
highest capacity
## Footnote
This emphasizes the importance of familiarity in the care of older adults.
76
What are the **integral parts** of the health care system for older adults?
* Long-term care homes
* Home care
## Footnote
These services provide subacute, chronic, long-term, and palliative care.
77
What is the **culture change** movement in long-term care homes aimed at?
Integrating models of person-centred care
## Footnote
This movement seeks to improve care outcomes and quality of life for residents.
78
What factors can affect the **relocation** of an older adult?
* Personality
* Health
* Cognitive capacities
* Sense of control
* Opportunities for choice
* Self-esteem
* Preferred lifestyle
## Footnote
These factors can lead to variable effects on the individual during relocation.
NURS 1002
flashcards
Decks in class (6)
# Cards
