Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

HOSPICE 101HOSPICE 101

Midwest Palliative & Hospice CareCenterMidwest Palliative & Hospice CareCenter2050 Claire Ct., Glenview, IL 600252050 Claire Ct., Glenview, IL 60025

847-467-7423847-467-7423

PresentersPresenters

Midwest Palliative & Hospice CareCenterMidwest Palliative & Hospice CareCenter

Families with Children CounselorsFamilies with Children Counselors

What is Hospice?What is Hospice?

A special way of caring for A special way of caring for people with life limiting people with life limiting

illness.illness.

GOALS OF HOSPICEGOALS OF HOSPICE

Comfort and quality of life Comfort and quality of life as as defined by the patient.defined by the patient.

Support for the family as the primary Support for the family as the primary unit of care.unit of care.

WHERE ARE PATIENTS WHERE ARE PATIENTS CAREDCARED FORFOR??

At home At home Independent or Assisted Living Independent or Assisted Living

facilityfacility Long Term Care or Skilled Care Long Term Care or Skilled Care

FacilityFacility HospitalHospital Hospice Inpatient UnitHospice Inpatient Unit

ELIGIBILITYELIGIBILITY Patients who desire to end curative phase of Patients who desire to end curative phase of

treatmenttreatment Patients who want to be kept as physically, Patients who want to be kept as physically,

emotionally and spiritually comfortable as emotionally and spiritually comfortable as possible.possible.

Patients whose doctors certify that they have a Patients whose doctors certify that they have a prognosis of 6 months or lessprognosis of 6 months or less

THE HOSPICE THE HOSPICE TEAMTEAM

PatientPatient Patient’s familyPatient’s family Primary physicianPrimary physician Hospice physicianHospice physician NursesNurses

ChaplainsChaplains Social workersSocial workers Nursing AssistantsNursing Assistants VolunteerVolunteer Others as needed by Others as needed by

plan of careplan of care

COMMON COMMON QUESTIONSQUESTIONS

Can I change my mind?Can I change my mind? Nutrition, hydration, CPRNutrition, hydration, CPR

““Giving Up”Giving Up” For cancer patients onlyFor cancer patients only

HOW DO I TALK HOW DO I TALK ABOUT THIS?ABOUT THIS?

ASK YOUR LOVED ONE ASK YOUR LOVED ONE WHAT S/HE THINKS IS WHAT S/HE THINKS IS

HAPPENING.HAPPENING.

WHAT ARE YOUR LOVED WHAT ARE YOUR LOVED ONE’S GOALS?ONE’S GOALS?

WHAT IT IS S/HE REALLY WHAT IT IS S/HE REALLY WANTS?WANTS?

HELP THE PERSON HELP THE PERSON IDENTIFY AND ASSESS IDENTIFY AND ASSESS

THE BENEFITS AND THE BENEFITS AND BURDENS OF VARIOUS BURDENS OF VARIOUS

TREATMENTS.TREATMENTS.

BEREAVEMENTBEREAVEMENT

Telephone ContactTelephone Contact

Memorial ServicesMemorial Services

Support GroupsSupport Groups

Individual CounselingIndividual Counseling

ReferralReferral

RESOURCESRESOURCES

National Palliative Care & National Palliative Care & Hospice OrganizationHospice Organization

800.658.8898800.658.8898 www.nhpco.orgwww.nhpco.org

www.Medicare.comwww.Medicare.com

Personal Loss ActivityPersonal Loss Activity

Phases of Phases of GriefGrief

Helping Children Cope Helping Children Cope with Griefwith Grief

Author: Author: Alan Wolfelt, Ph.DAlan Wolfelt, Ph.D 13 Dimensions13 Dimensions

Shock/Denial/Disbelief/Shock/Denial/Disbelief/NumbnessNumbness

Most intense 6-8 weeks after deathMost intense 6-8 weeks after death Can resurface over timeCan resurface over time

Lack of FeelingsLack of Feelings

Appear unaffected by deathAppear unaffected by death

Continue with age appropriate activities to Continue with age appropriate activities to avoid intense emotionsavoid intense emotions

Physiological ChangesPhysiological Changes

Grief may be expressed through physical Grief may be expressed through physical symptomssymptoms

Symptoms are usually temporary and normalSymptoms are usually temporary and normal

RegressionRegression

Occurs when previously mastered tasks are no Occurs when previously mastered tasks are no longer completedlonger completed

Can represent need for protection and securityCan represent need for protection and security

If ongoing, may need therapeutic interventionIf ongoing, may need therapeutic intervention

““Big Man”/”Big Woman” SyndromeBig Man”/”Big Woman” Syndrome

Opposite of regressionOpposite of regression

Take on adult rolesTake on adult roles

Can be an attempt to replace the deceasedCan be an attempt to replace the deceased

Disorganization and PanicDisorganization and Panic

Feeling of being overwhelmed and anxiousFeeling of being overwhelmed and anxious ManifestationsManifestations

RestlessnessRestlessness IrritabilityIrritability Inability to concentrateInability to concentrate

Routines are important Routines are important

Explosive EmotionsExplosive Emotions

FeelingsFeelings AngerAnger HatredHatred TerrorTerror

Directed at anyone or Directed at anyone or anythinganything

Enjoyable events lose their Enjoyable events lose their appealappeal

Important to validate Important to validate feelings of pain, frustration feelings of pain, frustration

and hurtand hurt

Acting-Out BehaviorActing-Out Behavior

Result of Explosive EmotionsResult of Explosive Emotions

May be associated with feelings of May be associated with feelings of abandonmentabandonment

FearFear

““Who will take care of Who will take care of me?”me?”

Fear of own deathFear of own death

Fatalistic ViewFatalistic View

Consistency is Consistency is importantimportant

ReliefRelief

Natural expression after witnessing prolonged Natural expression after witnessing prolonged illnessillness

Difficult to admitDifficult to admit Associated with guiltAssociated with guilt

Loss/Emptiness/SadnessLoss/Emptiness/Sadness

Most difficult emotionsMost difficult emotions

May demonstrate physiological changesMay demonstrate physiological changes

Guilt and Self-BlameGuilt and Self-Blame

May assume responsibility of deathMay assume responsibility of death

““If only I had done something differently”If only I had done something differently”

ReconciliationReconciliation

Grief no longer Grief no longer overwhelms daily overwhelms daily functioningfunctioning

Begin to feel hope and Begin to feel hope and anticipation for the anticipation for the futurefuture

QuestionsQuestions

Hospice 101 Phases Of Grief Nov 3 2006

Health & Medicine

Transcript of Hospice 101 Phases Of Grief Nov 3 2006

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