On this page, you will learn about anticipatory grief. Read the articles and watch the videos to gain an understanding of your role as the nurse providing care to the patient and family with anticipatory grief. You will then take the concepts from this lesson and apply them to a collaborative learning activity. The instructions for the activity will follow the concept discussed below.
Anticipatory Grief When a patient is faced with a terminal diagnosis and the anticipated loss, nurses are expected to be knowledgeable in meeting the needs of those affected. This includes the patient, as they prepare to lose their life and family, and the family as they plan to accept life without their loved one (Lindauer & Harvath, 2014). The nurse strategically plans care; assessing the needs and determining how to best meet them. One of the most immediate ways that we meet the needs of patients and families is by communicating. Read A Proposed Model of Person-, Family-, and Culture-Centered Nursing Care. Each interaction with patients and families starts with communication; introducing yourself, letting them know that you are their nurse, what they can expect from you, and how to contact you when they have a need. The way that you communicate with your patient will set the tone for the relationship that you develop with them. Effective communication consists of both verbal and nonverbal actions and active listening (Lor, Crooks, & Tluczek, 2016). The goal of communication is to obtain information that is necessary to provide care and convey a sense of trust. As the nurse, you will communicate through listening, talking, touching, and your body language. Communicating is a developed skill that requires an understanding of communication and the ability to use appropriate tactics (Marcus & Mott, 2014). Watch theTherapeutic Communication-Role Play video and read Difficult Conversations: From Diagnosis to Death. Anticipatory grief is one of many types of grief. It is a perceived loss; occurring before an actual loss and is experienced differently by everyone (Overton & Cottone, 2016). Your responsibility as the nurse is to identify the signs and symptoms of anticipatory grief, and be aware of its impact on providing care. People that are distracted or overcome with grief (Burke, et al., 2015) can neglect areas of health and miss out on the opportunity to have a meaningful life during end-of-life. When you have identified a person or family that is at risk for anticipatory grief, your assessment will direct you in determining the kind of care and resources they will need to cope. WatchSigns of Anticipatory Grief and readRisk Factors for Anticipatory Grief and Anticipatory Grief: A Family Systems Approach. Patients and families that experience anticipatory grief, demonstrate behaviors and emotions that vary with what stage of grief they are in and their personality. For example, a patient that is in the early stages of anticipatory grief may be withdrawn and uninvolved in care where as a different person in the early stages may be very exuberant, always keeping busy, and involved in their own care. Should we allow the behavior of the patient lead us to determine how they are coping with the diagnosis? While their behavior is worth noting; it will give you the opportunity to identify their mechanisms for coping with the diagnosis, but could impede the caring process if effective communication does not accompany the interaction. Initiating conversations after a terminal diagnosis can be uncomfortable. Because everyone experiences this emotional experience differently, communication can be met with uncertainty both in the nurse and the patient and family. As you gain an understanding of anticipatory grief, consider how communication can impact your ability to identify and engage with those experiencing this type of grief.
Collaborative Activity
After viewing the cases, you will work collaboratively to develop a plan of care for a patient diagnosed with a terminal illness. How did the participants' behavior or statements demonstrate anticipatory grief? Describe the communication you observed? What value does communication bring to the nurse's role in providing care to patients and families with anticipatory grief? Use these interactions to support the concepts in your groups presentation.
The group members are required to meet in a live environment at least two times while the presentation is being developed. Continue to use this environment as you work together. In these interactions you will identify four goals and the applicable nursing diagnosis for each. One of your diagnoses must be anticipatory grief. Include five nursing interventions for each diagnosis, relating to direct care, therapeutic communication, and patient- and family-centered care. Include the rational for each intervention and explain why it would be successful in meeting the identified goal. Your presentation will address the following :
What are your assessment findings; subjective and objective?
What are the goals for this patient?
What are your nursing diagnoses?
Is the anticipatory grief actual or risk for?
What interventions will you use to meet the identified goals?
State your rationale for the interventions that your chose.
References
Burke, L., Clark, K., Ali, K., Gibson, B., Smigelsky, M., & Neimeyer, R. (2015). Risk Factors for Anticipatory Grief in Family
Members of Terminally Ill Veterans Receiving Palliative Care Services. Journal of Social Work in End-of-Life and Palliative Care,
244-266.
Lindauer, A., & Harvath, T. (2014). Pre-death grief in the context of dementia caregiving: A concept analysis. Journal of Advanced
Nursing, 2196-2207.
Lor, M., Crooks, N., & Tluczek, A. (2016). A proposed model of person-, family-, and culture-centered nursing care. Nursing Outlook,
352-366.
Marcus, J., & Mott, F. (2014). Difficult conversations: From diagnosis to death. The Ochsner Journal, 712-717.
Overton, B., & Cottone, R. (2016). Anticipatory grief: A family systems approach. The Family Journal: Counseling and Therapy for
Couples and Families, 430-432.
Anticipatory Grief
When a patient is faced with a terminal diagnosis and the anticipated loss, nurses are expected to be knowledgeable in meeting the needs of those affected. This includes the patient, as they prepare to lose their life and family, and the family as they plan to accept life without their loved one (Lindauer & Harvath, 2014). The nurse strategically plans care; assessing the needs and determining how to best meet them. One of the most immediate ways that we meet the needs of patients and families is by communicating. Read A Proposed Model of Person-, Family-, and Culture-Centered Nursing Care.
Each interaction with patients and families starts with communication; introducing yourself, letting them know that you are their nurse, what they can expect from you, and how to contact you when they have a need. The way that you communicate with your patient will set the tone for the relationship that you develop with them. Effective communication consists of both verbal and nonverbal actions and active listening (Lor, Crooks, & Tluczek, 2016). The goal of communication is to obtain information that is necessary to provide care and convey a sense of trust. As the nurse, you will communicate through listening, talking, touching, and your body language. Communicating is a developed skill that requires an understanding of communication and the ability to use appropriate tactics (Marcus & Mott, 2014). Watch the Therapeutic Communication-Role Play video and read Difficult Conversations: From Diagnosis to Death.
Anticipatory grief is one of many types of grief. It is a perceived loss; occurring before an actual loss and is experienced differently by everyone (Overton & Cottone, 2016). Your responsibility as the nurse is to identify the signs and symptoms of anticipatory grief, and be aware of its impact on providing care. People that are distracted or overcome with grief (Burke, et al., 2015) can neglect areas of health and miss out on the opportunity to have a meaningful life during end-of-life. When you have identified a person or family that is at risk for anticipatory grief, your assessment will direct you in determining the kind of care and resources they will need to cope. Watch Signs of Anticipatory Grief and read Risk Factors for Anticipatory Grief and Anticipatory Grief: A Family Systems Approach.
Patients and families that experience anticipatory grief, demonstrate behaviors and emotions that vary with what stage of grief they are in and their personality. For example, a patient that is in the early stages of anticipatory grief may be withdrawn and uninvolved in care where as a different person in the early stages may be very exuberant, always keeping busy, and involved in their own care. Should we allow the behavior of the patient lead us to determine how they are coping with the diagnosis? While their behavior is worth noting; it will give you the opportunity to identify their mechanisms for coping with the diagnosis, but could impede the caring process if effective communication does not accompany the interaction.
Initiating conversations after a terminal diagnosis can be uncomfortable. Because everyone experiences this emotional experience differently, communication can be met with uncertainty both in the nurse and the patient and family. As you gain an understanding of anticipatory grief, consider how communication can impact your ability to identify and engage with those experiencing this type of grief.
Collaborative Activity
After viewing the cases, you will work collaboratively to develop a plan of care for a patient diagnosed with a terminal illness. How did the participants' behavior or statements demonstrate anticipatory grief? Describe the communication you observed? What value does communication bring to the nurse's role in providing care to patients and families with anticipatory grief? Use these interactions to support the concepts in your groups presentation.
The group members are required to meet in a live environment at least two times while the presentation is being developed. Continue to use this environment as you work together. In these interactions you will identify four goals and the applicable nursing diagnosis for each. One of your diagnoses must be anticipatory grief. Include five nursing interventions for each diagnosis, relating to direct care, therapeutic communication, and patient- and family-centered care. Include the rational for each intervention and explain why it would be successful in meeting the identified goal. Your presentation will address the following :
References
Burke, L., Clark, K., Ali, K., Gibson, B., Smigelsky, M., & Neimeyer, R. (2015). Risk Factors for Anticipatory Grief in Family
Members of Terminally Ill Veterans Receiving Palliative Care Services. Journal of Social Work in End-of-Life and Palliative Care,
244-266.
Lindauer, A., & Harvath, T. (2014). Pre-death grief in the context of dementia caregiving: A concept analysis. Journal of Advanced
Nursing, 2196-2207.
Lor, M., Crooks, N., & Tluczek, A. (2016). A proposed model of person-, family-, and culture-centered nursing care. Nursing Outlook,
352-366.
Marcus, J., & Mott, F. (2014). Difficult conversations: From diagnosis to death. The Ochsner Journal, 712-717.
Overton, B., & Cottone, R. (2016). Anticipatory grief: A family systems approach. The Family Journal: Counseling and Therapy for
Couples and Families, 430-432.