PUBH 4327 - Death and Dying Midterm Baylor - Klempnauer

Who makes up IDT (interdisciplinary team)?

• Medical director (Physician)

• nurses RN

• Social workers

• Chaplains

• Volunteer coordinator

• Bereavement coordinator

What are some things we just cannot know

• How quickly or slowly death happens

• where will death happen (in hospital, nursing home?)

• being alone or not being alone

• knowing what is comfortable

• talking or not talking about it

• whether celebration/intolerable or both

• whether taxing/deliberating

• whether accepted/denied

What are the three acts of listening?

1. Compassion

2. Empathy

3. Sympathy

Six steps in order of listening continuum

1. Reflection of feelings

2. content

3. questions

4. reassurance

5. diagnose and analyze

6. advice

4 levels of treatment for hospice

1. routine

2. respite

3. inpatient

4. continuous care

any order (doesn’t matter)

“BE” manners (know any 5 of 10)

• be there

• be a giver

• be supportive

• be helpful

• be a writer

• be at ease

• be a listener

• be honest

• be calm

• be normal

• be with the person

4 examples of euphemisms

• pushing up daisies

• kicking the bucket

• left this world

• checked out

• singing to the choir

• gone to meet their maker

• singing to the choir

values of studying death/dying (list 4)

• better understand the grieving process

• deal with death in a more compassionate way

• better cope with our reactions to death

• do better resolve guilt feelings, focus our attention on relationships and their importance

• say the things that need to be said

• put a better perspective on emotionally disturbing experiences

• make satisfying final decisions

List 4 of the 5 tips on what you can do while visiting a dying person

1. sit by the person

2. take the dying person’s hand

3. be alert to breathing

4. be calm

5. talk slowly and quietly

Death rattle

• a gurgling sound

  • sometimes made in throat of dying person when mucus and fluid builds up

Dame cicely saunders

founder of modern hospice movement

Robert D. Myrick

made list of continuum

Thanatology

study of death

IDT

interdisciplinary team

St. christopher's house

located in london, england

• started by dame cicely saunders

The art of living

ars vivendi

The art of dying

ars moriendi

Two greatest fears

1. being alone

2. being in pain

Two essential elements

1. being a good listener

2. expressing good manners

Year saunders visited US

1963

Last sense to go

hearing

Who wrote the book, “Talking About Death Won't Kill You”?

Virginia Morris

Where can a hospice patient receive care

• wherever the patient resides

  • nursing home, assisted living, residential home

T/F: morbidity is defined as illness

True

Who said, "You can be a king or a street sweeper, but everyone dances with the grim reaper?"

Robert Allton Harris

US University Saunders visited

Yale

A person has been on hospice for 6 months and the disease is progressing. What happens next?

1. With document from IDT, shows the patient is in a state of decline

2. Dr. (Medical director) will refer the patient for additional time frame

Bereavement program is how long

13 months

T/F: Quality of life can be defined as a balance of life and quality together, a yardstick that measures either the continued day to day living or the outcome of the end of life of how someone has lived his/her life

True

Mortality is defined as….

Death

T/F: "Listening Continuum" is attributed to Robert D. Myrick

True

T/F: Being a good listener and expressing good manners are essential elements in an end of life experience

True

Goal of a hospice team…..

is to provide comfort for the patient and family

T/F: Life is defined as the time someone lived

True

Founder of hospice is…

Dame Cicely Saunders

“Principles of a Good Death” include….

• realize death is coming

• dignity & privacy

• choice where death occurs 

• access to information in expertise

• adequate control over physical pain relief in symptoms management

• emotional & spiritual pain

• access to hospice…care

• who is present and who shares the moment of death

• issue advanced directives

• time to say goodbye

• to let go

Main health components of a good death…

physical, emotional, social and spiritual

In listening with sympathy, the appropriate response would begin

“I feel ...”

T/F: Virginia Morris said, "A good death is for the dying and for the people who love them."

True

Gurgling sound is called

Death rattle

First modern hospice was located where?

London

How do we become aware of death

• Losing a pet, hearing a siren, at holidays, motorcade, funeral procession

T/F: Awareness is having the knowledge of something from observing it or realigning it is happening

True

Average # of years between life and death is

Longevity

T/F: Genealogy is the study of history of families and the line of descent from their ancestors

True

T/F: Illness and chronic pain = depression and anxiety = health

False

• all… = disease

T/F Thanatology is the study of death

True

What are the 4 aspects of a “Diamond concept”?

Physical, emotional, social, spiritual

Who can enter the hospice program?

Anyone from birth to 100+ years of age

Our attitudes toward living and dying are developed through who and what?

Family is primary influence, traditions, religion, culture, socioeconomic status

T/F Hospice is a holistic program of care and comfort for the patient

False

Key word for the semester is….

communication

When does dying well begin?

• Long before death happens

• prior to brain damage or coma sets in

• prior to medical treatment decisions being made

• prior to administering treatment

T/F: Examples of what hospice may do during the bereavement period includes phone calls, visits, memorial services, and letters

True

Statements that reflect good manners of a funeral

• Dress respectively

• Enter quiet and reverently

• Don't interrupt the service

• Pay respect to the family afterwards

T/F: Funding for hospice comes from medicare, medicaid, and private insurances include medical equipment, services of the team but does not include any medication

False

• do provide medication

T/F: One way to face our fears about death is to have simple conversations

True

T/F: Goal of hospice is not to fight death, but to make the most of life, however much or little that is

True

Listening is defined as…

• Giving ear

• hearing with thoughtful attention

• paying attention to

• giving ear to conversation or music

T/F: Manners is a social conduct or rules of conduct

True

Person enters hospice program by…

A physician must refer patient to hospice with a prognosis of 6 months or less to live

In listening with empathy, appropriate response would begin with

“You feel ...”

T/F: Fear is accompanied by a desire to flee or flight

True

Term hospice comes from the same linguistic root as…

Hospitality

At time of death, the hospice nurse will want to know what?

• What is the name of the funeral home you're using

• will the body be embalmed or cremated

• can i help you out by making phone calls to family or friends

T/F: Continuum is defined as uninterrupted ordered sequence

True

Interment is defined as…

Burial

T/F: Empathy is the capacity for participation in another's feelings

True

Who made up the audience Saunders spoke to while in the US

• Medical students

• social workers

• nurses

• chaplains