Grief, Loss, End-of-Life Care, and Sensory Alterations in Older Adults

Vocabulary flashcards reviewing concepts of grief, bereavement models, palliative care, and sensory alterations in hearing and vision among older adults.

Loss Response Model

A framework viewing grievers as part of a system striving to maintain equilibrium or stability following a loss, moving from disequilibrium and functional or emotional disruption through searching for meaning, adaptation, and reframing memories.

Anticipatory Grief

A grief response experienced in reaction to a real or perceived loss before the loss actually occurs.

Acute Grief

A normal initial crisis response to loss marked by somatic, functional, and emotional symptoms of distress that are most intense during the first months and lessen over time.

Shadow Grief

Healthy, normal, and restorative moments of intermittent sadness that may be accompanied by a temporary disruption of normal day-to-day function.

Complicated Grief

A prolonged, maladaptive grief response characterized by increased yearning and longing, decreased interest in day-to-day activities, and insomnia; it can present as chronic, exaggerated, or delayed grief and may transition to major depression.

Disenfranchised Grief

Grief experienced following a loss that is not openly acknowledged, socially accepted, or understood by others.

Good Copers

Individuals who adapt effectively to loss by acknowledging it, trying to make sense of it, focusing on solutions, using good communication skills, seeking constructive help, and keeping up morale.

Spiritual Dimension in Dying

The facet of dying that addresses the relationship between the dying individual and another, specifically between the person and their god or significant others.

Hospice

A holistic, interdisciplinary model of end-of-life care focusing on quality of life rather than quantity of life; requires a physician referral and a certified life expectancy of $6\text{ months}$ or less.

Palliative Care

A holistic care approach focusing on symptom management and quality of life that can be delivered simultaneously with life-prolonging or stabilizing treatment for chronic illness, without the strict life expectancy criteria of hospice.

1990 Patient Self-Determination Act

Federal legislation supporting patient autonomy and end-of-life decision-making, reinforcing legal protections for individuals refusing unwanted treatment.

Palliative Sedation

Terminal or palliative administration of sedatives intended solely to relieve intractable distress and provide comfort without hastening death.

Pinna

The outer ear structure where sound collection begins, directing sound waves into the external auditory canal.

External Auditory Canal

The ear canal containing hair follicles and cerumen-producing glands through which sound vibrations pass to strike the tympanic membrane.

Tympanic Membrane

The eardrum; a membrane that vibrates in response to sound waves striking it and transmits those vibrations to the ossicles.

Ossicles

A chain of $3$ tiny bones located in the middle ear that receive and transmit vibrations from the tympanic membrane to the inner ear.

Impacted Cerumen

An accumulation of earwax that clogs the auditory canal, exacerbated in older adults by increased ear canal hair and decreased sweat gland activity.

Presbycusis

Age-related sensorineural hearing loss caused by inner ear degenerative changes and loss of hair cells and neurons, characterized by a reduced ability to hear higher-pitched tones.

Tinnitus

The perception of noise or ringing in the ears in the absence of an external acoustic source.

Macula

A small, highly sensitive specialized region of the retina responsible for providing central vision.

Cataract

An opacity or clouding of the crystalline lens caused by age-related protein degeneration, resulting in diminished visual acuity and impaired color discrimination.

Corneal Arcus (Arcus Senilis)

An age-related visual change characterized by an opaque, greyish-white ring or band around the periphery of the cornea.

Critical Flicker Fusion

The visual ability to perceive rapidly flashing or pulsing lights as distinct separate stimuli, which diminishes with normal aging.

Presbyopia

The age-related loss of lens accommodation power, resulting in a diminished ability to focus clearly on near objects.