Loss Death and

Palliative Care
 Life Transition
• 1. retirement
• 2. death of spouse

• Feelings of not orderly in

progress, conflicted, suicidal, or
suspicious
Stages of widowhood

St 1. reactionary ( first few wks)

St 2. withdrawal ( few mos)
St 3. recuperation (second 6
mos)
St 4. Exploration ( 2nd year)
St 5 Integration ( 5th yr)
 Caregiving
• Impact
• “ give back”
• Stressful
• Increasec level of
depression
• Spousal caregving
• Aging parents caring for dev
disabled children
• Grandparents raising grandchildren
• Long distance caregiving
LOSS RESPONSE
MODEL
Grieving Process
 Types of
grief
• 1. anticipatory
• 2. acute
• 3. Chronic and complicated
• 4. Disenfranchised
 Interventions
• 1. countercoping
• 2.Clarification and control
• 3. collaboration
• 4. directed relief
• 5. cooling off
 Dying
6 C’s Approach
1. Care
2. Control
3. Composure
4. Communication
5. Continuity
6. Closure
 Role in EOLC
- Direct care
- Coordinator
- Advocate for
humane care
for dying
 Decisions
• 1. Advance
directives
• 2. Euthanasia