In fact, the sooner you refer your patients to Chaplaincy Hospice or Palliative Care the more physical, emotional and spiritual support we can provide.
Figure Health care professionals have an obligation to family members of terminally ill or recently deceased patients. To carry out this role responsibly, they should be able to communicate about sensitive issues, to understand the nature of normal and abnormal more Although grief is not an illness, health professionals and health care institutions have important roles to play in caring for the bereaved, both before and after the death of a patient.
One hundred years ago, most people were Grief patient and health care providers and died at home; now most are born and die in a hospital. The widespread perception of hospitals as bureaucratic, impersonal institutions gives people the impression that the psychosocial needs of dying people in hospitals are often underserved, that families are provided no regular help in understanding and coping with death, and that the capacity for compassion has been lost in a technologically oriented, strange world.
However, several concrete, helpful suggestions were made: Secondly, consultants and general practitioners should recognize and accept an obligation to talk to the relatives whenever there is an unexpected death An interview should be offered-not every relative has the courage or the social skills required to ask for one—and its prime purpose should be to give comfort and answer questions.
Finally, [we] must not let lawyers set our priorities. Most relatives simply want to know what happened. That Americans want such issues to receive more attention is evidenced by the grass-roots development of the primary care and hospice movements and by the establishment of numerous support groups to assist the bereaved discussed further in Chapter In no small part, these have come about because of the shortcomings of traditional medical settings in meeting emotional needs.
With the increased emphasis on patients' perceptions of illness and death, quality of life, and medical ethics, more hospitals are beginning to acknowledge a responsibility for providing emotional support that traditionally rested with families and chaplains.
However, the nature of an institution's responsibility to survivors, once the immediate concerns surrounding a death have been dealt with, is unclear. In recent years there have been striking improvements in the care of dying people and their families.
Yet family care following bereavement is still generally meager. Limitations in the attention paid to the bereaved by health care professionals appear to derive from three factors: Despite currently inadequate therapeutic guidelines, however, it is necessary for health professionals to formulate some approach to the bereaved because, whether they are trained or untrained, those who interact with a bereaved person will have an impact—negative or positive—on that individual.
This chapter offers practical guidance on professional and organizational practices based on humane considerations, professional norms, and the experiences and informed judgment of the committee. The contributions of individual health professionals to the bereaved depend on the organizational setting in which they work; the religious, psychosocial, and cultural characteristics of the bereaved; the individual characteristics, interest, competence, accessibility, and availability of the professional; and the nature of his or her relationship with the bereaved.
Although the exact nature of the assistance given following death varies, several professional tasks following bereavement can be identified: Families usually turn to both physicians and nurses for information about the illness and its management and for assurances that "everything has been done.
In the committee's view, it is important that there be one identifiable health professional who the family knows is responsible for overseeing care and to whom they can turn for support and information. Even in the complex teams of health professionals that care for patients in some institutions, that person most often is a physician.
The family should know that person's name, and the rest of the team should be aware of who has that central role.
In addition, the primary care physician who cared for the patient prior to admission to the hospital should remain informed about the patient's status and responsive to the family's need for reassurance and information.
Although physicians usually direct patient care activities, in some settings especially at home and in nursing homes families may relate most closely and comfortably to a nurse. For this reason the primary nurse should be present when relatives are told that an illness seems to be in its final stage or when the nature of a medical or surgical problem is discussed.
The nurse is then fully knowledgeable when the family later asks questions or if it becomes evident that they did not hear or understand the implications of what a physician said.
Clear explanations of the cause of the death may prevent misconceptions and self-blame by the bereaved. Although an institution's responsibility to provide the family with information on the patient's condition is clear, doing so has often proved difficult because the general public is so unfamiliar—and health professionals are so very familiar—with hospital routines and the intricacies of medicine.
People are often afraid to question a physician, fearing their confusion or uncertainty will be interpreted as lack of trust. Often, too, they may need help in identifying and formulating their questions.
Although these problems are frequently cited in the literature, few detailed solutions have been proposed, suggesting that this is an area in need of much attention. Nurse-counselors visit patients the afternoon before surgery to find out what information each patient wants transmitted to relatives during the surgery.
Providing a direct link to the operating room and the surgeons through their rounds of the operating rooms, the nurses carry progress reports to those in the waiting room. Since they are seen as sympathetic and supportive, the nurses also often become aware of misconceptions and fears that may distort a family's understanding of the illness and the surgery.
By clarifying the situation and answering questions as they arise, they can help relatives understand what the physician has already told them. It is increasingly accepted that the care received by a dying patient should facilitate the resolution of relations between patients and those close to them.
For this to occur, several goals must be pursued.
The first is to allow a smooth and emotionally complete separation at the time of death. Communications between patients and those close to them should be facilitated so that both patient and family know, as much as possible and desirable, the diagnosis and when death is to be anticipated.QUALITY Ideal Home Health Care is consistently ranked 4-stars across the board with regard to all aspects of our service, and all of our referrals come from doctors, which speaks volumes.
Death, Dying, Grief and Self-Care Training for Healthcare Providers. Learn More Yes, Sign Me Up. Alive in Death was created and developed by Death Coach and Death Educator Stephen Garrett, Connie Jorsvik, Olga Nikolajev, Meina Duetz, and Yvonne Heath to help you, as a nurse, be ready to handle the deaths we all know you will see throughout.
Grief may be experienced in response to physical losses, such as death, or in response to symbolic or social losses such as divorce or loss of a job. A resource for healthcare providers 2 Dementia and staff grief Grief and loss support for staff in dementia care: A resource for health and social care providers.
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Kathy Quan, RN, BSN, PHN, has over 30 years of experience in home health and hospice srmvision.comng patients, caregivers, and other nurses has always been a passion of hers.
She also loves to write and has several websites and blogs for nurses, caregivers, and patients.