Death and Dying Exam 3

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Nursing 464—Exam 3
Death in the Lives of Adults (Class 11)
* I. Parental Bereavement
* Introduction
* Erickson, adulthood- Generativity vs. Stagnation: A child’s death is opposed to the nurturing psychosocial task of adulthood * Death of a child represents the untimely loss of a potential future * In earlier times and less developed countries, child is not viewed as a “person” until he/she has lived long enough to be viable * In modern societies, death of a child is considered the least natural death * The ultimate lack of protection and nurture, the ultimate breakdown of being a “good parent” * Many issues of bereavement over the adult life cycle * “He was going to take care of me when I got older”- 65 year old mother, losing 35 year old son * Coping as a Couple

* 1. Parents expected to support each other
* 2. Energy expended for own grief can deplete energy needed for mutual support * 3. Child’s death can improve or worsen relationship * 4. Can create an estrangement and strong bond at the same time * 5. Grieving “out of synch” with each other

* 6. Differences on grieving styles
* 7. Importance in open and honest communication
* 8. Couples who have a positive view of each other and their relationship report little conflict * Childbearing Losses
* 1. Miscarriages also called spontaneous abortion, is the death of a fetus prior to 20th week of pregnancy * Remark that it was “nature’s way” to weed out genetic abnormalities is no consolation to grieving parents; it was “their baby” * Series of miscarriages is loss on top of loss

* Grief can occur at significant events such as the birth of another child or menopause * 2. Induced Abortion: Intentionally ending a pregnancy by mechanical means or drugs; sometimes medically necessary * Grief reaction to elective abortion may be similar to other fetal loss * If woman is later unable to have child, she may have tremendous remorse * 3. Stillbirth: Fetal death occurring between the 20th week of pregnancy and birth resulting in the delivery of a dead child * a. “Instead of giving birth, I gave death” * b. “Instead of a cradle, a grave”

* c. “Instead of a blanket, burial clothes” * d. “Instead of a birth certificate, a death certificate” * e. Helping parents
* 1. Encourage parents to see and hold their baby * 2. Photograph of the baby
* 3. Lock of hair
* 4. Name the baby
* 5. Some hospital issue a certificate of stillbirth * 4. Neonatal Death: Death in the first weeks following birth * a. Baby born alive with life-threatening disabilities; overwhelming frustrations as medical interventions are attempted and fail * b. When baby dies, parents may resent medical personnel- Painful ordeal with a hospital bill * c. One neonatologist remarked, “One of the most difficult and important things for me to learn was to hand over the baby to the parents so it could die in their arms.” * 5. Post neonatal Deaths: Occur between 4 and 11 weeks following birth * 6. Infertility: Diminished capacity to produce offspring * a. Grieving

* 7. Sterility: complete inability to produce offspring * 8. Giving a child up for adoption
* a. In our society that defines women as mothers, mothers-to-be, or childless; the most unnatural of women * b. Deep emotional response for birth parents
* 9. Children born with severe disabilities or mental retardation * a. Grieve the loss of a “perfect child” or child wished for * 10. Grieving a childbearing loss
* a. Grieve...
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