Nursing-CarePlan.com,Nursing Care Plan Grieving Definition; A normal complex process that includes emotional, physical, spiri tual, social, and intellectual responses and behaviors by which indi-viduals, families, and communities incorporate an actual,anticipated, or perceived loss into their daily lives Encourage patient to write or tape-record his or her life history as a lasting gift to family members Life review allows patient to survey events from his or her past and give them meaningful interpretation.Inform: Inform patient about hospice services that emphasize symp-tomatic relief and caring, with the aim of improving patient and family comfort until death occurs, instead of prolonging life for its own sake. Hospice care is an appropriate alternative for a patient with an incurable illness ,Nursing Care Plan.
- Altered communication patterns
- Change in eating, sleep and dream patterns, activity level, or libido
- Denial of potential loss of life
- Difﬁculty taking on different roles
- Expressed guilt, anger, sorrow, and bargaining
- Expressions of distress over potential loss of life
- Anticipatory loss of signiﬁcant object or other
- Death of a signiﬁcant other
- Loss of signiﬁcant object (e.g., possession, job, status)
- Growth and Development
- Risk management
The Patient Will
- Express and accept feelings about anticipated death.
- Progress through stages of grieving process in his or her own way.
- Practice religious rituals and use other coping mechanisms appro-priate to end of life.
- Have participation of family members or signiﬁcant other in pro-viding supportive care and comfort to patient.
Suggested Noc Outcomes
Coping; Family Coping; Grief Resolution; Psychosocial Adjustment:Life Change
Interventions And Rationales
Determine: Assess stage of grieving to establish a baseline.Perform: Demonstrate acceptance of patient’s response to his or her anticipated death, whatever that response may be: crying, sadness anger, fear, or denial. Each patient responds to dying in his or her own way. Helping patient express feelings freely will enhance ability to cope.Help patient progress through psychological stages associated with anticipated death, including shock and denial, anger, bargaining,depression, and acceptance, to help you anticipate the dying 157 patient’s psychological needs. Keep in mind, however, that not all dying patients go through each stage.Provide time for patient to express his or her feelings about death or terminal illness. Active listening helps the patient lessen feelings of loneliness and isolation. Refrain from approaching patient with a busy, hurried attitude, which can block communication.Establish a relationship that encourages patient to express concerns about death. Basic nursing care combined with genuine interest in the patient fosters trust and understanding Guide patient in life review. Encourage patient to write or tape-record his or her life history as a lasting gift to family members Life review allows patient to survey events from his or her past and give them meaningful interpretation.Inform: Inform patient about hospice services that emphasize symp-tomatic relief and caring, with the aim of improving patient and family comfort until death occurs, instead of prolonging life for its own sake. Hospice care is an appropriate alternative for a patient with an incurable illness.Attend: Encourage family members to become involved in the care of the dying patient. Communicate with patient and family members honestly and compassionately. Giving family members a role in patient care helps relieve anxiety and lessen feelings of regret and guilt. Honest communication is important because family members need an opportunity to acknowledge their loss and say farewell.Support patient’s spiritual coping behaviors. For example, arrange for patient to have objects that provide spiritual comfort (such as a copy of Bible, prayer shawl, pictures, statues, or rosary beads) at the bedside. Even patients for whom religious practice hasn’t been a dominant part of life may turn to religion when confronted by death or serious illness.Manage: Involve an interdisciplinary team (including a psychologist,nurse, the patient, a nutritionist, physician, physical therapist, and chaplain) in providing care for a dying patient. Each team member offers unique expertise for meeting the dying patient’s needs.Provide referrals for home healthcare assistance if the patient will be cared for at home to support the patient’s decision to remain at home.
Suggested Nic Interventions
Anticipatory Guidance; Coping Enhancement; Family Support; Grief Work Facilitation
Zimmerman, C., & Wennberg, R. (2006, August–September). Integrating pal-liative care: A postmodern perspective. The American Journal of Hospice and Palliative Care, 23(4), 255–258.