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Loved Ones (loved + ones)
Selected AbstractsCare for the Adult Family Members of Victims of Unexpected Cardiac DeathACADEMIC EMERGENCY MEDICINE, Issue 12 2006Robert Zalenski MD Abstract More than 300,000 sudden coronary deaths occur annually in the United States, despite declining cardiovascular death rates. In 2000, deaths from heart disease left an estimated 190,156 new widows and 68,493 new widowers. A major unanswered question for emergency providers is whether the immediate care of the loved ones left behind by the deceased should be a therapeutic task for the staff of the emergency department in the aftermath of a fatal cardiac arrest. Based on a review of the literature, the authors suggest that more research is needed to answer this question, to assess the current immediate needs and care of survivors, and to find ways to improve care of the surviving family of unexpected cardiac death victims. This would include improving quality of death disclosure, improving care for relatives during cardiopulmonary resuscitation of their family member, and improved methods of referral for services for prevention of psychological and cardiovascular morbidity during bereavement. [source] Promoting peaceful death in the intensive care unit in ThailandINTERNATIONAL NURSING REVIEW, Issue 1 2009W. Kongsuwan rn Background:, Having a peaceful death is a common wish among Thai people. Thai culture and religious beliefs offer practical ways to enhance having a peaceful death. Dying in an intensive care unit (ICU) is unnatural and oftentimes painful for the patient and their loved ones. Promoting a peaceful death is one of the least understood yet critical roles of nurses who practise in ICUs. Purpose:, To explore the ways that ICU nurses in Thailand could promote peaceful death and to attempt a definition of the concept of ,peaceful death'. Method:, Data were generated from ICU nurses' descriptions of peaceful death. These were given during in-depth telephone interviews, tape-recorded and analysed using the grounded theory method of analysis. Findings:, ICU nurses promote peaceful death through a three-dimensional process: awareness of dying; creating a caring environment; and promoting end-of-life care. Conclusions:, The study provided opportunities for nurses to understand and influence the practice of promoting peaceful death in ICUs in Thailand. Further research is needed to enhance the practices and processes necessary for promoting peaceful death among ICU patients. It is anticipated that this will advance policy changes in nursing care processes in Thailand. [source] How Would Terminally Ill Patients Have Others Make Decisions for Them in the Event of Decisional Incapacity?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2007A Longitudinal Study OBJECTIVES: To determine the role terminally ill patients would opt to have their loved ones and physicians play in healthcare decisions should they lose decision-making capacity and how this changes over time. DESIGN: Serial interviews. SETTING: The study institutions were The Johns Hopkins Medical Institutions in Baltimore, Maryland, and St. Vincent's Hospital, in New York. PARTICIPANTS: One hundred forty-seven patients with cancer, amyotrophic lateral sclerosis, or heart failure, at baseline and 3 and 6 months. RESULTS: Patients' baseline decision control preferences varied widely, but most opted for shared decision-making, leaning slightly toward independence from their loved ones. This did not change significantly at 3 or 6 months. Fifty-seven percent opted for the same degree of decision control at 3 months as at baseline. In a generalized estimating equation model adjusted for time, more-independent decision-making was associated with college education (P=.046) and being female (P=.01), whereas more-reliant decision-making was associated with age (P<.001). Patients leaned toward more reliance upon physicians to make best-interest determinations at diagnosis but opted for physicians to decide based upon their own independent wishes (substituted judgment) over time, especially if college educated. CONCLUSION: Terminally ill patients vary in how much they wish their own preferences to control decisions made on their behalf, but most would opt for shared decision-making with loved ones and physicians. Control preferences are stable over time with respect to loved ones, but as they live longer with their illnesses, patients prefer somewhat less reliance upon physicians. [source] Quality of Life While Dying: A Qualitative Study of Terminally Ill Older MenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2003Elizabeth K. Vig MD Objectives: To characterize the experience of quality of life while dying from the perspective of terminally ill men. Design: Descriptive study involving semistructured interviews. Setting: Patients attending clinics at two university-affiliated medical centers were interviewed in a private conference room or in their homes. Participants: Twenty-six men identified by their physicians as having terminal heart disease or cancer. Eligible participants acknowledged that they had serious illness. Measurements: The interview contained open-ended questions such as: "What are the most important things in your life right now?" The interview also contained closed-ended questions about symptom intensity, presence of depressed mood, and other items related to overall quality of life. The open-ended questions were tape-recorded, transcribed, and analyzed using grounded theory methods. The closed-ended questions were analyzed using descriptive statistics. Results: Participants believed that death was near. Participants saw engaging in hobbies and other enjoyable activities as an alternative to moving into the final stage of illness, in which they saw themselves as actively dying. They admitted to occasionally ignoring prescribed diets; these actions improved their overall quality of life but worsened symptoms. New symptoms brought concerns about progression to active dying. They anticipated what their dying would be like and how it would affect others. Participants believed that their actions in the present could improve the quality of their dying and lessen the burden of their deaths on others. Many participants therefore were preparing for death by engaging in such tasks as putting their finances in order and planning their funerals, to relieve anticipated burden on loved ones. Conclusion: To help terminally ill patients plan for the end of life, clinicians are encouraged to become familiar with their patients' experiences of living with terminal illness, to identify each patient's unique priorities, and to incorporate that information into care plans aimed at maximizing quality of life at the end of life. [source] Good grief and not-so-good grief: Countertransference in bereavement therapyJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2007Jeffrey A. Hayes This study examined the relationship between therapists' grief related to the death of a loved one and clients' perceptions of the process of bereavement therapy. Mail survey data were obtained from 69 client,therapist dyads. Results indicated that the extent to which therapists missed deceased loved ones was inversely related to client perceptions of therapist empathy, but not to client ratings of the alliance, session depth, or therapist credibility. Therapist acceptance of the death of a loved one was unrelated to any of the dependent measures. Results are discussed in terms of countertransference and its management. © 2007 Wiley Periodicals, Inc. J Clin Psychol 63: 345,355, 2007. [source] Health care professionals' grief: a model based on occupational style and copingPSYCHO-ONCOLOGY, Issue 3 2001Ellen M. Redinbaugh Many publications address grief in terminally ill patients and their loved ones. In contrast, this paper proposes a hypothetical model for grief reactions in health care professionals (HCPs) working with terminally ill patients. The model integrates three literatures: burnout, coping and personality/occupational interests. Grief-related job stress can culminate in burnout that affects over 50% of physicians treating the terminally and critically ill. Coping behaviors that attenuate burnout differ among HCPs, suggesting that nurses prefer different coping strategies when compared with physicians. The personality and occupational interests literatures provide a rationale for coping differences in HCPs. Personality characteristics associated with occupational preferences provide insight into HCPs' natural propensities for coping with stress. The model addresses personality/occupational differences among health care disciplines, thus providing a plausible explanation for coping differences among HCPs, as well as potential interventions that facilitate HCPs' adjustment to the deaths of their patients. Copyright © 2001 John Wiley & Sons, Ltd. [source] Suicide-related behavior after psychiatric hospital discharge: implications for risk assessment and management,BEHAVIORAL SCIENCES & THE LAW, Issue 6 2006Jennifer L. Skeem Ph.D. Suicide-related behavior (SRB), including suicide attempts and instrumental SRB, occurs far more often than completed suicide and exacts a toll on patients, their loved ones, and society. Nevertheless, few prospective studies of SRB have been conducted. In this study, 954 patients were interviewed in a psychiatric hospital and then followed for one year after discharge. During this one-year period, nearly one-quarter of patients (23%) engaged in SRB, with the rate of suicide attempts (18%) three times greater than the rate of instrumental SRB (5%). Risk factors for SRB were demographic (White ethnicity, female gender), clinical (past SRB, depression, impaired functioning), and contextual (unemployment, large social networks). In contrast with other studies, there was no "peak" in the risk of SRB shortly after hospital discharge. Instead, patients' rate of SRB was relatively constant over the one-year follow-up. Implications for risk assessment and management in acute inpatient settings are discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source] THE DUTY TO DIE AND THE BURDENSOMENESS OF LIVINGBIOETHICS, Issue 8 2010MICHAEL CHOLBI ABSTRACT This article addresses the question of whether the arguments for a duty to die given by John Hardwig, the most prominent philosophical advocate of such a duty, are sound. Hardwig believes that the duty to die is relatively widespread among those with burdensome illnesses, dependencies, or medical conditions. I argue that although there are rare circumstances in which individuals have a duty to die, the situations Hardwig describes are not among these. After reconstructing Hardwig's argument for such a duty, highlighting his central premise that ill, dependent, or aged individuals can impose unfair burdens upon others by continuing to live, I clarify precisely what Hardwig intends by his thesis that many of us have a duty to die. I then show that an important disanalogy exists between an uncontroversial example in which an individual has a duty to die and the situations in which Hardwig proposes individuals have a duty to die. More specifically, in situations where a duty to die exists, an individual's having a duty to die logically implies that those she burdens have a right to kill that individual in self-defense. I then suggest that the burdens that ill, dependent, or aged individuals impose on their families, loved ones, or caregivers do not constitute the kind of threat that warrants the latter killing the former in self-defense. Hence, the duty to die is much rarer than Hardwig supposes. [source] Die Chemie des Katers: Alkohol und seine FolgenCHEMIE IN UNSERER ZEIT (CHIUZ), Issue 1 2007Klaus Roth Prof. Das Überfluten jeder einzelnen Zelle unseres Körpers mit einer großen Menge Ethanol führt zu Störungen im Stoffwechsel aller Organe. Dies erklärt die große Variationsbreite der Symptome nach zu großer Ethanolaufnahme. Gegen den Kater gibt es keine echte Heilung. "Chemie in unserer Zeit" empfiehlt: Viel reines Wasser gegen den Wasserverlust, eine Aspirin oder Ibuprofen gegen die pochenden Kopfschmerzen, Fruchtsaft gegen den Glucosemangel, Muttis kräftige Hühnerbrühe gegen den Elektrolytverlust, eine Vitamintablette wegen ihres sehr wirksamen Placebo-Effekts, Zuspruch und Mitleidsbekundungen der Lieben und dann , wenn der Kreislauf und die Kontrolle der unteren Extremitäten den aufrechten Gang es zulassen, einen Spaziergang an der frischen Luft. Dabei sollte man intensiv über die Sinnlosigkeit übermäßigen Trinkens nachdenken. Das hilft, und am nächsten Tag ist alles vorbei , zumindest bis zum nächsten Mal. Na dann: Helau und Alaaf! Flooding of every cell in our body with a huge amount of ethanol affects the entire metabolism of all organs. This explains the broad variation of symptoms after drinking to much. There is no real cure für hangover. "Chemie in unserer Zeit" recommends much pure water against the dehydration, aspirin or ibuprofen against the throbbing headaches, fruit juice against hypoglycemia, Mom's powerful chicken soup to compensate for electrolyte losses, a vitamine pill because of its powerful placebo-effect, compassion and words of comfort of the loved ones and finally , if blood circulation and control of the lower extremities admit an upright walk , a long stroll in fresh air. Meanwhile one should think deeply about the pointlessness of excessive drinking. This all helps and on the next day it will all be over , at least until next time. Well then: Cheers and Bottoms up! 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