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Stages of dying

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Stages of grief
Stages of grief
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Stages of dying

  1. 1. Presnted By Rajnee Shresthta Lecturer of Bheri Nursing College Nepalgunj; Nepal
  2. 2. STAGES OF DYI NG  When someone is told they are going to die and have only a short time to live, there are five basic stages they go through.
  3. 3. ST AGES OF DYI NG  These stages were created by Elisabeth Kubler-Ross.  Elisabeth Kubler-Ross was a pioneer in the psychological field of death counseling.  While working with dying patients she analyzed what goes on in their minds.  From her experience-oriented research, she found five specific emotional and mental stages that are consistent with almost all patients.  These five stages don't usually follow any particular order, and each can be experienced more than one time.
  4. 4. STAGES OF DYING  State 1: Denial and Isolation  Stage 2: Anger  Stage 3: Bargaining  Stage 4: Depression  Stage 5: Acceptance
  5. 5. The fact or process of losing something or someone. -oxford dictionary Unrecoverable and usually unanticipated and non- recurring removal of, or decrease in, an asset or resource.
  6. 6. Grief is an emotional response to a loss. Grief is a deep emotional and mental anguish that is a response to the subjective experience of loss of something significant.
  7. 7. Mourning is the psychological process through which individual passes on to successful adaptation to the loss of a valued object. • Bereavement includes grief and mourning-the inner feeling and outward reactions of survivor MOURNING
  8. 8.  Healing the self  Recovering from the loss GOAL OF GRIFING PROCESS
  9. 9. The sadness of losing someone you love never goes away completely, but it shouldn’t remain center stage. If the pain of the loss is so constant and severe thatit keeps you from resuming your life, you may be suffering from a condition known as complicated grief. COMPLICATED GRIEF
  10. 10.  Chronic grief: Prolonged grief disorder refers to a syndrome consisting of a distinct set of symptoms following the death of a loved one  Delayed grief: Hose who feel a delayed grief reaction often describe it as a devastating sadness that hits them out of the blue. It might arrive a few weeks or months
  11. 11.  Exaggerated grief Exaggerated grief may include major psychiatric disorders that develop following a loss such a phobias as a result of hyper- grieving thoughts, actions, words  Masked grief  Masked grief is grief that the person experiencing the grief does not say they have or that they mask.  This can be common among men or in society and cultures. Cont..
  12. 12.  Disenfranchised grief Also known as hidden grief or sorrow refers to any grief that goes unacknowledged or invalidated by social norms e.g. death of a friend, the loss of a pet, the loss of a home or place in the case of children, who generally have little or no control in such situations
  13. 13. Intrusive thoughts or images of your loved one Denial of the death or sense of disbelief Imagining that your loved one is alive Searching for the person in familiar places Avoiding things that remind you of your loved one Extreme anger or bitterness over the loss Feeling that life is empty or meaningless SYMPTOMS OF COMPLICATED GRIEF
  14. 14. 1. Denial and Isolation The first reaction to learning of terminal illness or death of a cherished loved one is to deny the reality of the situation. It is a normal reaction to rationalize overwhelming emotions. It is a defense mechanism that buffers (guard) the immediate shock. We block out the words and hide from the facts. This is a temporary response that carries us through the first wave of pain.
  15. 15. 2. Anger As the masking effects of denial and isolation begin to wear, reality and its pain re-emerge; We are not ready. The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family. Anger may be directed at our dying or deceased loved one..
  16. 16. 3. Bargaining The normal reaction to feelings of helplessness and vulnerability is often a need to regain control. If only we had sought medical attention sooner If only we got a second opinion from another doctor. If only we had triedto be a better person toward them. Secretly we may make a deal with God or our higher power in an attempt to postpone the inevitable. • This is a weaker line of defense to lprotect us from the painful reality.
  17. 17. 4. Depression • Two types of depression are associated with mourning. • The first one is a reaction to practical implications relating to the loss. • Sadness and regret predominate this type of depression. • This phase may be eased by simple clarification and reassurance. •We may need a bit of helpful cooperation and few kind words. • The second type of depression is more subtle and, in a sense, perhaps more private. • It is our quiet preparation to separate and to bid our loved one farewell.
  18. 18. 5. Acceptance • Reaching this stage of mourning is a gift not afforded to everyone. • Death may be sudden and unexpected. • Acceptance is often confused with the notion of being “all right” or “OK” with what has happened. • Most people don’t ever feel OK or all right about the loss of a loved one. • This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality.
  19. 19. •We will never like this reality or make it OK, but eventually we accept it. • We learn to live with it; it is the new norm with which we must learn to live. •We must try to live now in a world where our loved one is missing. •In resisting this new norm, at first many people want to maintain life as it was before a loved one died.
  20. 20.  Nursing care involves providing comfort, maintaining safety, addressing physical and emotional needs ,and teaching coping strategies to terminally ill patients and their families . More than ever ,the nurse must explain what is happening to the patient and the family and be a confident who listens to them talk about dying. Hospice care , attention to family and individual psychosocial issues ,and symptom and pain management are all part of the nurse's responsibilities.
  21. 21. • The nurse must also be concerned with ethical considerations and quality-of-life issues that affect dying people. • Of utmost importance to the patient is assistance with the transition from living to dying, maintaining and sustaining relationships, finishing well with the family, and accomplishing what needs to be said and done. • In the hospital, in long-term care facilities, and in home settings, the nurse explores choices and end-of-life decisions with the patient and family.
  22. 22. Referrals to home care and hospice services, as well as specific referrals appropriate for the management of the situation, are initiated. The nurse is also an advocate for the dying person and works to uphold that person's rights. • The use of living wills and advance directives allows the patient to exercise the right to have a "good death or to die with dignity.

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