hospice 101 phases of grief nov 3 2006

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Midwest Palliative & Hosp Midwest Palliative & Hosp ice CareCenter ice CareCenter HOSPICE 101 HOSPICE 101 Midwest Palliative & Hospice Midwest Palliative & Hospice CareCenter CareCenter 2050 Claire Ct., Glenview, IL 60025 2050 Claire Ct., Glenview, IL 60025 847-467-7423 847-467-7423

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Page 1: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

HOSPICE 101HOSPICE 101

Midwest Palliative & Hospice CareCenterMidwest Palliative & Hospice CareCenter2050 Claire Ct., Glenview, IL 600252050 Claire Ct., Glenview, IL 60025

847-467-7423847-467-7423

Page 2: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

PresentersPresenters

Midwest Palliative & Hospice CareCenterMidwest Palliative & Hospice CareCenter

Families with Children CounselorsFamilies with Children Counselors

Page 3: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

What is Hospice?What is Hospice?

A special way of caring for A special way of caring for people with life limiting people with life limiting

illness.illness.

Page 4: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

GOALS OF HOSPICEGOALS OF HOSPICE

Comfort and quality of life Comfort and quality of life as as defined by the patient.defined by the patient.

Support for the family as the primary Support for the family as the primary unit of care.unit of care.

Page 5: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

WHERE ARE PATIENTS WHERE ARE PATIENTS CAREDCARED FORFOR??

At home At home Independent or Assisted Living Independent or Assisted Living

facilityfacility Long Term Care or Skilled Care Long Term Care or Skilled Care

FacilityFacility HospitalHospital Hospice Inpatient UnitHospice Inpatient Unit

Page 6: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

ELIGIBILITYELIGIBILITY Patients who desire to end curative phase of Patients who desire to end curative phase of

treatmenttreatment Patients who want to be kept as physically, Patients who want to be kept as physically,

emotionally and spiritually comfortable as emotionally and spiritually comfortable as possible.possible.

Patients whose doctors certify that they have a Patients whose doctors certify that they have a prognosis of 6 months or lessprognosis of 6 months or less

Page 7: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

THE HOSPICE THE HOSPICE TEAMTEAM

PatientPatient Patient’s familyPatient’s family Primary physicianPrimary physician Hospice physicianHospice physician NursesNurses

ChaplainsChaplains Social workersSocial workers Nursing AssistantsNursing Assistants VolunteerVolunteer Others as needed by Others as needed by

plan of careplan of care

Page 8: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

COMMON COMMON QUESTIONSQUESTIONS

Can I change my mind?Can I change my mind? Nutrition, hydration, CPRNutrition, hydration, CPR

““Giving Up”Giving Up” For cancer patients onlyFor cancer patients only

Page 9: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

HOW DO I TALK HOW DO I TALK ABOUT THIS?ABOUT THIS?

Page 10: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

ASK YOUR LOVED ONE ASK YOUR LOVED ONE WHAT S/HE THINKS IS WHAT S/HE THINKS IS

HAPPENING.HAPPENING.

Page 11: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

WHAT ARE YOUR LOVED WHAT ARE YOUR LOVED ONE’S GOALS?ONE’S GOALS?

WHAT IT IS S/HE REALLY WHAT IT IS S/HE REALLY WANTS?WANTS?

Page 12: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

HELP THE PERSON HELP THE PERSON IDENTIFY AND ASSESS IDENTIFY AND ASSESS

THE BENEFITS AND THE BENEFITS AND BURDENS OF VARIOUS BURDENS OF VARIOUS

TREATMENTS.TREATMENTS.

sbeggs
Page 13: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

BEREAVEMENTBEREAVEMENT

Telephone ContactTelephone Contact

Memorial ServicesMemorial Services

Support GroupsSupport Groups

Individual CounselingIndividual Counseling

ReferralReferral

Page 14: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

RESOURCESRESOURCES

National Palliative Care & National Palliative Care & Hospice OrganizationHospice Organization

800.658.8898800.658.8898 www.nhpco.orgwww.nhpco.org

www.Medicare.comwww.Medicare.com

Page 15: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Personal Loss ActivityPersonal Loss Activity

Page 16: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Phases of Phases of GriefGrief

Page 17: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Helping Children Cope Helping Children Cope with Griefwith Grief

Author: Author: Alan Wolfelt, Ph.DAlan Wolfelt, Ph.D 13 Dimensions13 Dimensions

Page 18: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Shock/Denial/Disbelief/Shock/Denial/Disbelief/NumbnessNumbness

Most intense 6-8 weeks after deathMost intense 6-8 weeks after death Can resurface over timeCan resurface over time

Page 19: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Lack of FeelingsLack of Feelings

Appear unaffected by deathAppear unaffected by death

Continue with age appropriate activities to Continue with age appropriate activities to avoid intense emotionsavoid intense emotions

Page 20: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Physiological ChangesPhysiological Changes

Grief may be expressed through physical Grief may be expressed through physical symptomssymptoms

Symptoms are usually temporary and normalSymptoms are usually temporary and normal

Page 21: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

RegressionRegression

Occurs when previously mastered tasks are no Occurs when previously mastered tasks are no longer completedlonger completed

Can represent need for protection and securityCan represent need for protection and security

If ongoing, may need therapeutic interventionIf ongoing, may need therapeutic intervention

Page 22: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

““Big Man”/”Big Woman” SyndromeBig Man”/”Big Woman” Syndrome

Opposite of regressionOpposite of regression

Take on adult rolesTake on adult roles

Can be an attempt to replace the deceasedCan be an attempt to replace the deceased

Page 23: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Disorganization and PanicDisorganization and Panic

Feeling of being overwhelmed and anxiousFeeling of being overwhelmed and anxious ManifestationsManifestations

RestlessnessRestlessness IrritabilityIrritability Inability to concentrateInability to concentrate

Routines are important Routines are important

Page 24: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Explosive EmotionsExplosive Emotions

FeelingsFeelings AngerAnger HatredHatred TerrorTerror

Directed at anyone or Directed at anyone or anythinganything

Enjoyable events lose their Enjoyable events lose their appealappeal

Important to validate Important to validate feelings of pain, frustration feelings of pain, frustration

and hurtand hurt

Page 25: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Acting-Out BehaviorActing-Out Behavior

Result of Explosive EmotionsResult of Explosive Emotions

May be associated with feelings of May be associated with feelings of abandonmentabandonment

Page 26: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

FearFear

““Who will take care of Who will take care of me?”me?”

Fear of own deathFear of own death

Fatalistic ViewFatalistic View

Consistency is Consistency is importantimportant

Page 27: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

ReliefRelief

Natural expression after witnessing prolonged Natural expression after witnessing prolonged illnessillness

Difficult to admitDifficult to admit Associated with guiltAssociated with guilt

Page 28: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Loss/Emptiness/SadnessLoss/Emptiness/Sadness

Most difficult emotionsMost difficult emotions

May demonstrate physiological changesMay demonstrate physiological changes

Page 29: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

Guilt and Self-BlameGuilt and Self-Blame

May assume responsibility of deathMay assume responsibility of death

““If only I had done something differently”If only I had done something differently”

Page 30: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

ReconciliationReconciliation

Grief no longer Grief no longer overwhelms daily overwhelms daily functioningfunctioning

Begin to feel hope and Begin to feel hope and anticipation for the anticipation for the futurefuture

Page 31: Hospice 101 Phases Of Grief Nov 3 2006

Midwest Palliative & Hospice CareCMidwest Palliative & Hospice CareCenterenter

QuestionsQuestions