Psychology
Dr. Maha Younis
Lecture 23 Death and DyingDoctors: save life, maintain the hope and help the family through the grief process in anticipation of death.
Task of the clinician:
Achieve an empathetic relationship with the dying patient
To help the key family members and friends work through their own reactions
To provide a forum for the associated medical staff to express their feeling
Kubler -Ross Model for grief stages:
common themes rather than typical responsedepends on intrapsychic and social milieu
the 5 stages of grief :
Denial : - “error”
Anger: - “Why me?”
Bargaining : -“time”
Depression : - “Fully recognize “
Acceptance : - “goodbye”
The stage of awareness: always a new(insight), fragmentation reaction; by anxiety or panic, anger, regression, failure of judgement.
Normal response to an overwhelming stress.
The stage of equilibrium: resolution of stress. Should be no new symptoms or complications like pain, chemotherapy.
Sometimes it takes 2 years to resolve grief and bereavement.
Stages of the grief process:
Acute disbelief :
Days
The person isn’t fully aware that death is real
Anger doctor self
Dis-organization:
Emotional sense of loss (feeling the presence).
Resolution (reorganization)
Loss is real
By the end of this phase the grieving person is ready to return to the world.
Reaction afterwards may take many forms:
Withdrawn : small children, elderly.
Psychosomatic : illnesses
Children may show hyperactivity and behavioural disorders.
Delayed grief: maintain the stage of shock
Personality trait: closeness of the lost person (key figure)
Cultural models : in expressing grief
Even with terminal patient may continue with treatment
Although these stages are discrete, they are fluid in reality
Usually predominance of one stage to other
Management: reality, don’t distort facts
Grief Reaction:
Normal
Abnormal (pathological, delayed)
Normal grief : stage 1 stage 2 resolution
Abnormal : fixation, not proceeding to resolution
Prolonged > 6 month > 1 year
Persistence of the same symptoms that suddenly follow the death
Not dealing with the death consequences (reality problem).
Pathological coping mechanism, drug, alcohol, isolation, sucide.
This is the last lecture of Psychology for the year, I hope you had fun and that there are no complaints about the lecture’s (as in typing and releasing). Enjoy your time and good luck with the finals, - Ibo