DEATH AND DYING

By: Nelson Munthali Dip/RN

16th March, 2013

Objectives

1. Define common terms used in death and dying.

2. Describe the stages of dying/ grieving.

3. Describe factors that influence loss and grief.

4. Explain the nursing process and the nurses role in death and greiving.

Loss

This is when the other person, possession, body part, familiar environment or sense of self is no longer present

Grief

It is when emotional response to a loss manifest in ways unique to an individual, based on personal experiences, cultural expectation and spiritual beliefs.

Mourning

It is the social expression of grief and the behaviors associate with loss.

Bereavement

It captures both grief and mourning and includes the emotional response and outward behavior of a person experiencing loss.

Death is loss of life.

Stages of dying or grieving

There are five stages that are in an orderly manner but some people do not experience them in that order or length of time. They sometimes move back and forth between the stages.

1. Denial and isolation Recognition and acceptance of facing

death is shortly difficult. A person acts as if nothing has happened

and refuses to accept the reality, shows no understanding of what is happening

Denial permits hope to exist and its short lived.

2. Anger The person asks the “Why me” question,

expresses resistance and sometimes feels intense anger at God, other people or the situation.

The person is hostile to people assisting him and anything done does not please him.

3. Bargaining The dying person attempts to negotiate not to die at

that time This cushions and postpones awareness of the loss

by trying to prevent it from happening. It involves a deal with God, doctors, nurses. The dying or grieving person make promises to self,

god or loved ones that they will live or believe differently if they are spared.

4. Depression This happen when the person realises the full

impact of the loss The defensive mechanism are no longer effective The person expresses sadness and anguish and some

individuals are overwhelmingly sad, hopeless and lonely.

Crying elicit support of the loved ones and the nurse so they should be available for the patient.

They sometimes withdraw from relationships and life and may have suicide attempts.

Resolution leads to acceptance.

5. Acceptance The person incorporates the loss into life and finds

ways to move forward This time the person finds peace and contentment. The patient may desire time alone with his

thoughts

Some patients may ask to get out side the room This time the patient reviews his past and

thinks of the unknown future. Patient need quietness with minimal

verbalization. The patient may now talk about his funeral

plans. Writing of the will.