| Active Listening | Grief and Bereavement | Pain Control and Comfort Measures | Emotiona and Social Care (Psychosocial) | Spiritual Care |
|---|---|---|---|---|
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That the people we are listening to are NOT US.
What assumption do we need to begin with if we wish to be active listeners?
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Lots of things including loss of income, loss of role, loss of emotional support; loss of companionship; loss of someone to do certain things with, etc.
Name some secondary losses that might occur along with the loss of a loved one.
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Chronic pain has been experienced for greater than six months, a patient is less likely to show outer indications of suffering, and it needs to be treated with round the clock medication.
What is the difference between chronic and acute pain and the treatment of each?
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The INABILITY to accept the reality of a situation
How would you define DENIAL?
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Religion is about doctorine and it unites the like-minded and excludes the "other-minded." Spirituality is about meaning and experience and tends to be more uniting than dividing.
How would you describe the differences between religion and spirituality?
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It means we set aside our personal concerns and needs for the time we are spending with the patient or family member.
What does it mean to "bracket" our own concerns in order that we may listen with our full attention?
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Lots of possibilities
Name some normal grief reactions in the follow areas: physical, emotional, mental/cognitive, behavioral, spiritual
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Involvement of nerves, metastasis to organs and interference with function, also incidental pain such as migraines or arthritis.
Name several causes of pain in cancer patients.
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1) fear of the process of dying; 2) fear of being a burden; 3) fear of being abandoned; 4) fear of the unknown; fear of a loss of dignity, etc.
What are three primary fears of a person facing a terminal illness?
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What comes after death? What has my life meant? How can I reconcile with an estranged family member? I feel guilt... I feel fear... etc.
What are examples of spiritual issues that a grieving or dying person might raise with a trusted companion?
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1) pay attention to body language, 2) pick up on feeling words, 3) check our understanding, 4) Talk about specific situations, 5) Allow people to express even "dark" feelings.
As active listeners, we strive to "listen to the feelings as well as the words." List five ways we "get to the feelings."
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It takes as long as it takes
What is an acceptable length of time for an individual to continue to grieve the death of a beloved family member?
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Constipation
What side effect of narcotics must we ALWAYS pay attention to?
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1) flexibility in roles; 2) ability to accept outside help; 3) Direct communication skills
What are some attributes that might enable a family to adjust well when confronted with great loss or great stress?
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It can allow an individual to see that they still have worth despite their loss of income, personal beauty and role in the family.
What role can honest affirmation play in the spiritual care of a dying person?
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It is essential to any significant sharing.
What role does confidentiality play in active listening?
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Difference in relationship, difference in griever's experience of grief, difference in nature of death, difference in patient's readiness for death, etc.
Why do different people grieve differently?
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Remind the pt that it's time to take medicine, help them sit up, carry pre-measured medications to the patient, get them a glass of water... but we can NEVER administer meds.
How may a volunteer help in getting a patient's medications to him or her? What can a volunteer NEVER do in regard to a patient's mediations?
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If one has been trained NOT to admit to pain or weakness it may be difficult for that individual to communicate clearly what is needed to caregivers.
How may the military cultural norm of STOICISM impact end of life care.
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It gives the message, "I accept you, I am here with you, you are not alone in this journey."
What role can appropriate touch play in the spiritual care of a dying person?
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1) recounting our own experience; 2) giving advice too freely; 3) Reassuring too soon.
List three roadblocks to good listening:
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A history of mental illness or substance abuse; the presence of children in the home; the support group of the one facing loss; physical illness; strong denial; emotional or financial dependency; multiple losses, strong denial prior to the death, etc.
What are some risk indicators to pay attention to when someone is facing an anticipated loss?
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Fanning the patient's face.
What simple measure can relieve the discomfort of someone who is short of breath?
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Triangulation is getting caught up in a conflict between two other people and it can be avoided by not taking sides and by directing the conflicted individuals back toward one another.
What is "triangulation" and how can a volunteer avoid it?
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Don't minimize; listen and accept. Offer a visit from a chaplain.
How should we respond to the guilt feelings that a dying person may describe to us?
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