Death and Dying_13.pptxGGGUJJUJNGBGRFRERE
- 1. Death and Dying Emotional and Physiologic Elements of Death and Dying
- 2. Copyright 息 Texas Education Agency, 2017. All rights reserved. 2 These Materials are copyrighted 息 and trademarked as the property of the Texas Education Agency (TEA) and may not be reproduced without the express written permission of TEA, except under the following conditions: 1) Texas public school districts, charter schools, and Education Service Centers may reproduce and use copies of the Materials and Related Materials for the districts and schools educational use without obtaining permission from TEA. 2) Residents of the state of Texas may reproduce and use copies of the Materials and Related Materials for individual personal use only, without obtaining written permission of TEA. 3) Any portion reproduced must be reproduced in its entirety and remain unedited, unaltered and unchanged in any way. 4) No monetary charge can be made for the reproduced materials or any document containing them; however, a reasonable charge to cover only the cost of reproduction and distribution may be charged. Private entities or persons located in Texas that are not Texas public school districts, Texas Education Service Centers, or Texas charter schools or any entity, whether public or private, educational or non- educational, located outside the state of Texas MUST obtain written approval from TEA and will be required to enter into a license agreement that may involve the payment of a licensing fee or a royalty. For information contact: Office of Copyrights, Trademarks, License Agreements, and Royalties, Texas Education Agency, 1701 N. Congress Ave., Austin, TX 78701-1494; phone 512-463-7004; email: copyrights@tea.state.tx.us. Copyright 息 Texas Education Agency, 2017.
- 3. Copyright 息 Texas Education Agency, 2017. All rights reserved. 3 Emotional Transitions at Lifes End > Although there are many theories about the emotional transitions encountered by dying people, the best known is. . . . . ELISABETH KUBLER-ROSS > Landmark work entitled On Death and Dying > Identified five emotional stages experienced by dying individuals
- 4. Copyright 息 Texas Education Agency, 2017. All rights reserved. 4 Five Emotional Stages > Denial - or no not me > Anger - or why me? > Bargaining - or Yes, but. . . > Depression - or Its me! > Acceptance - or Its part of life. I have to get my life in order.
- 5. Copyright 息 Texas Education Agency, 2017. All rights reserved. 5 Fears That are Physical, Social, and Emotional > Physical - Helplessness, dependence, loss of physical faculties, mutilation, pain > Social - Separation from family, leaving behind unfinished business > Emotional - Being unprepared for death and what happens after death
- 6. Copyright 息 Texas Education Agency, 2017. All rights reserved. 6 Interventions for Fears > Talk as needed > Avoid superficial answers, i.e. Its Gods will > Provide religious support as appropriate > Stay with the patient as needed > Work with families to strengthen and support
- 7. Copyright 息 Texas Education Agency, 2017. All rights reserved. 7 Physiology of Dying > Somatic death or death of the body > Series of irreversible events leading to cell death > Causes of death varies > However, there are basic body changes leading to all deaths
- 8. Copyright 息 Texas Education Agency, 2017. All rights reserved. 8 Changes That Lead to Deaths > Pulmonary Unable to oxygenate the body Assess for poor oxygenation-skin pale, cyanotic, mottled, cool If dark skinned - assess mucous membranes, palms of hands, soles of feet > Cardiovascular Large load on heart when lungs fail Heart not getting needed oxygen Pumping heart not strong enough to circulate blood Blood backs up causing failure Leads to pulmonary and liver congestion
- 9. Copyright 息 Texas Education Agency, 2017. All rights reserved. 9 Changes That Lead to Deaths > Blood circulation Decreased, as heart less able to pump May have a drenching sweat as death approaches Pulse becomes weak and irregular If pulse relatively strong, death is hours away If pulse is weak and irregular, death is imminent
- 10. Copyright 息 Texas Education Agency, 2017. All rights reserved. 10 Changes That Lead to Deaths > Failing Urinary System Urinary output decreases Blood pressure too low for kidney filtration Further load on cardiovascular system due to increase circulating volume > Failing Nervous System Decrease oxygen to the brain, means decreasing brain function Sensation and power lost in legs, first, then arms May remain conscious, semi-conscious, or comatose
- 11. Copyright 息 Texas Education Agency, 2017. All rights reserved. 11 Changes That Lead to Deaths > Specific Sensory Decline Dying person turns toward light - sees only what is near Can only hear what is distinctly spoken Touch is diminished - response to pressure last to leave Dying person might turn toward or speak to someone not visible to anyone else Eyes may remain open even if unconscious Person might rally just before dying
- 12. Copyright 息 Texas Education Agency, 2017. All rights reserved. 12 Changes That Lead to Deaths > Further Neurologic Decline at Death Pupils might react sluggishly or not at all to light Pain might be significant Assess for pain if person unable to talk: restlessness, tight muscles, facial expressions, frowns Provide pain medication as needed
- 13. Copyright 息 Texas Education Agency, 2017. All rights reserved. 13 In Summary > Death is the end, as we know it, for that person > We can only support, listen therapeutically, and > Make the person as physically comfortable as possible > We can also use our knowledge and expertise to strengthen, support, and prepare the family