THEORETICAL FRAMEWORKS:

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THEORETICAL FRAMEWORKS Understanding the
Process of Death, Grief Loss
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Love your work
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STAGE THEORY (Kubler-Ross)

• Shock
• Initial Response
• Denial Isolation
• Way of dealing with painful situation
• Buffer or defense allowing time to collect
  self
• Anger
• Often displaced
• May provide energy to cope
• Bargaining
• Relatively short/Trading for postponement
• Compromise when realize impending death cant be
  denied
• Depression
• Profound sense of loss
• May be-reactive or preperatory
• Acceptance
• Contemplation of coming end
• Quiet readiness

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• Rate of decline in functioning
• Used to estimate time frame of dying
• Perceived course of dying

DYING TRAJECTORY
PHASE 1 CRISIS OF KNOWLEDGE Acute
Crisis PHASE 2 CHRONIC LIVING-DYING
Longest in Duration Periods of Remission
Exacerbation Hope and Despair
Intermingled PHASE 3 Terminal Withdrawal
Response to Body Signals
TRAJECTORY PHASES
Fear Anxiety
Terminal Phase
Crisis of knowledge of death

• Death

Acute Phase
Chronic living dying Phase
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Death The Career Perspective

• CAREER A series of related stages of a given
  sphere of activity that a group goes through
  step-wise toward a goal
• REGRESSIVE STAGES TOWARD DEATH
• Social Stage- Bargaining against premature
  SOCIAL DEATH
• Terminal Stage- Letting go, end of bargaining,
  resignation to death
• SOCIAL DEATH-Viewed as non-person, without
  value, by others and, tragically, in eyes of
  terminally ill individual him/herself

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SANDERs PHASE MODEL of GRIEF
Phases ltltltltlt SHOCK gtgtgtgtgt AWARENESS OF
LOSS CONSERVATION-WITHDRAWAL
HEALING RENEWAL Moderating Variables
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CUMULATIVE LOSS Life growth are composed of a
series of losses. Terminally ill persons are also
facing loss of their own future persons in the
present future who are or could be important to
them.
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TASK BASED APPROACH

• No single right way to cope with dying
• Approaches people from their perspectives and
  their coping tasks
• Coping is a complex business
• Situational tasks, such as coping with dying, are
  undertaken with in the larger context of lifespan
  developmental tasks

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Coping with Life-Threatening Illness
Physical Dimension Possible Challenges Fundamental
bodily needs shelter, nutrition, hydration,
elimination, pain other sources of physical
distress Tasks of Coping To satisfy bodily needs
minimize physical distress in ways that are
consistent with the clients values
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Coping with Life-Threatening Illness
Continued PSYCHOLOGICAL DIMENSIONS Possible
Challenges Anxiety, fear, apprehension,
powerlessness, uncertainty, confusion guilt,
sorrow, anger, depression, hostility, etc. Tasks
of Coping To maximize psychological security,
autonomy, empowerment, and richness of living
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Coping with Life-Threatening Illness
Continued Social Dimension Possible
Challenges Disruption of relationships with
family and other social networks, social
isolation, loss of employment, financial issues,
etc. Tasks of Coping To sustain and enhance those
interpersonal attachments significant to the
person concerned and to address the social
implications of illness and dying
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Coping with Life-Threatening Illness
Continued Spiritual Dimensions Possible
Challenges Challenges to maintaining hope,
self-worth, a sense of wholeness, acceptance,
reconciliation, meaning and purpose of living,
etc. Tasks of Coping To identify, develop, or
reaffirm sources of spiritual energy and in so
doing, foster hope
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MANIFESTATIONS of NORMAL GRIEF
FEELINGS
Sadness Anger Guilt/Self-reproach Anxiety Loneline
ss Fatigue
Helplessness Shock Yearning Emancipation Relief Nu
mbness
PHYSICAL SENSATIONS
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MANIFESTATIONS of NORMAL GRIEF
cOGNITIONS
BEHAVIORS
Disbelief Confusion Preoccupation Sense of
Presence Hallucinations
Sleep Disturbances Appetite Disturbances Absentmin
ded Social Withdrawal Dreams of Deceased Reminder
Avoidance Searching/Calling Out Sighing,
Crying Restless Overactivity Visiting/Caring
Reminders Treasuring Objects