Summary
Summary NSG 221 Grief and Death Review
- Course
- NSG 221
- Institution
- Herzing University
This is a comprehensive and detailed review on grief and death for NSG 221. An Essential Study Resource just for YOU!!
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30: Dying, Death, and GrievingDeath and Dying
the primary cause of death in the United States was infectious diseases
chronic health problems such as heart disease, cancer, stroke, Alzheimer’s disease, and kidney disease
are the primary causes of death
dying has become more complex precisely because there is so much we can do to sustain and prolong
life.
the medical model is based on the prolongation of life. When does one more surgery, one more round of
chemotherapy
An Aging Population
The United States experienced an unprecedented birth rate in the 18 years after the end of World War II
(1946–64). This generation became known as the baby boomers
staggering 26% of the total US population
People age 65 and over are expected to number 77 million
Medicare is the federal government’s national program that provides health insurance for older adults.
Medicare is a fee-for-service system
more medical services result in more reimbursement for healthcare providers.
Healthcare expenditures in the last 3 years of life were attributable to the cost of chronic conditions and
functional limitations rather than to the cost of aggressive end- of-life medical car
Models for End-of-Life Care
Hospice
In 1967, Cicely Saunders established St. Christopher’s Hospice in London to address this state of neglect
physical comfort was aggressively pursued with around-the-clock pain medication that allowed these
patients to experience a higher quality of life
Hospice is now a standard model of care that supports and cares for patients who are facing death
To qualify, a physician or advanced practice nurse certifies that life expectancy is 6 months or less
Hospice care begins after treatment of the disease or condition is stopped
In addition, the patient must choose hospice care rather than curative treatments
Routine hospice care- the most common level of care
, Continuous home care- between 8 and 24 hours a day to manage pain and other acute medical
symptoms in terminally ill patients
Inpatient respite care - provides temporary relief to the patient’s primary caregiver. provided in
hospitals, hospice facilities, or long-term care facilities that have 24-hour nursing presence
General inpatient care - provides pain control or other acute symptom management that cannot easily
be provided in other settings
Medicare covers almost all aspects of hospice care with little expense to patients or families, as long as a
Medicare-approved hospice program is used
Many people cite the 6-month rule to determine eligibility for hospice care
Six months or less is thought to be the amount of time that physicians, nurse practitioners, or physician
assistants must certify that a person has to live.
The goal is quality of life
Palliative Care
Palliative medications related to a patient’s terminal illness are covered by Medicare’s hospice benefit
palliative care promotes comfort
palliative care can begin at the time of diagnosis and continue throughout the treatment of the illness
terminally ill to benefit from this type
Palliative care is patient- and family-centered care that optimizes quality of life anticipating, preventing,
and treating suffering
Palliative care addresses physical, intellectual, emotional, social, and spiritual needs. Palliative
caregivers promote patient autonomy, access to information, and choice
Key components of both hospice and palliative care philosophy include:
• Honoring the experiences of the patient and family
• Respecting autonomy and informed choice
• Allowing care to be directed by the patient (and family)
• Honoring the dignity of the patient and family
Death and Dying Theory
Kübler-Ross (1973) identified distinctive phases, or cycles, in people’s responses to terminal illness:
Denial and Isolation: Denial is typically a brief reaction, in which the patient is in disbelief or shock about the
situation
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