equivalent to cardiopulmonary death (by law). all electrical activity has ceased. if higher brain centers are deprived of O2 for more than 5-10 minutes, patient will never recover mental/motor abilities, or will recover with severe impairment.
persistent vegetative state (PVS)
severe brain damage and coma, but show signs of sleep-wake cycles, no detectable evidence of awareness. Terry Schiavo.
ensures right of individual to choose whether to sustain his/her life. chooses how and when life-sustaining treatments will be provided or withheld. makes treatment a less complex decision for physicians and family.
do not resuscitate (DNR) orders
specifically direct doctors and staff not to use resuscitation measures (CPR, electric shock, medication injections into heart, open chest massage, tracheotomy).
active euthanasia vs. passive euthanasia
deliberate, intentional action to kill a suffering patient vs. failure to act or withdrawal of life-sustaining medication or machine.
complete loss of existence - self and body
cumulative effects of dealing with deaths of friend, neighbors and relatives in a short time span.
near-death experiences (NDE)
report tranquility, noise, dark tunnel, out-of-body experience, seeing others who are dead, intense white light, reviewing life, return across a border.
coping with death, five stages, can also be applied to loss of a job or miscarriage
1. denial (diagnosis must be wrong) 2. anger (why me?) 3. bargaining (trying to buy more time) 4. depression (attempts to cheer up at this stage should be avoided) 5. acceptance
occurs prior to someone's physical death, isolation, distancing
imagining the disease is not terminal and recovery is possible
free from avoidable distress, matches patient's and family's wishes, meets clinical, cultural, ethical standards.
3 requirements for open communication
listen nonjudgmentally, respect wishes of dying person above all else, be calm and supportive.
4 domains of coping
physical - minimizing pain and discomfort psychological - independence, security, quality of life social - ties with significant others spiritual - meaning, hope, transcendence
occurs in last hours of life; rapid breathing patterned with periods of no respiration
describes hospice care; designed to control pain and physical symptoms, offers no treatment to cure the terminal illness.
bereavement counseling offered by the hospice to a family for up to a year after death of relative
circle of care
hospice treats everyone in the circle of care, including family and dying patient.
describes someone who has just lost a loved one to death
human reaction to loved one's death
overt behavioral expression of grief by the bereaved
delayed grief reaction vs. anticipatory grief
when grief work is delayed or arrested by an individual who denies their feelings about it vs. grieving long before a loved one dies
uncomplicated vs. complicated grief disorder
80-90% of individuals experience predictable grief and resume life vs. those who don't recover in first 6 months (depression, suicidal thoughts, PTSD)
somatic stress in waves, last 20-60 minutes, tight feeling in throat, shortness of breath, need to sigh, empty stomach, sobbing, crying.
may occur each year on the day of the dead loved one's birthday or death day.
instrumental vs. intuitive grieving
men are more instrumental, and may practice hobbies in grieving vs. women who are intuitive grievers and share emotions
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