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- To orient the nurse/health care professional to approaches and strategies in working with patient and families in the dying and bereavement experience.
If we live, we die; it is that simple and that complex. Every death is different and often speaks to the life that preceded it. If we are connected to others in our life, the impact of the dying may be far-reaching and may affect many lives. Those with whom we are close and closely bonded may suffer a complex and protracted period of grief. While in the grips of the drama of dying and for the period of bereavement/mourning after the loss, many people will turn to health care professionals - e,g., nurses, social workers, counselors, psychologists - to help them through this difficult period. An understanding of the phases of dying and the period of bereavement following a death have been discussed extensively in the literature; armed with this understanding and orientation, we can be helpful to those experiencing this difficult transition.
Throughout this course, the terms nurse and health care professional are used interchangeably.
*Caregivers and family are used interchangeably throughout the text, denoting those immediately involved with the dying person.
What is Dying?
While the answer to this question seems obvious - when we stop breathing - it begs further discussion. Dying can be seen within a psychosocial context as it is within the realm of the personal and social life that dying occurs. As such, there is a process to dying that affects both the patient and caregiver(s).* Viewed through this lens, it is more than the moment of death that has to be considered. Kastenbaum (1998) suggests several contexts in which the onset of dying begins:
The preparation for dying for both the patient and family may begin at any of these junctures. The pioneering work of psychiatrist Elisabeth Kubler-Ross (1969) identified stages that both the patient and family members go through when receiving information of a terminal situation:
- Dying begins when the patient/caregiver(s) has been informed of their terminal condition.
- Dying begins when the patient/caregiver(s) begins to realize/internalize the reality of the dying.
- Dying begins when there is nothing more that can be done to preserve life.