Conceptual Frameworks Guiding Approaches to Death and Dying in Patient Care

QUESTION

Identify and explain the conceptual frameworks guiding our approach to caring for dying patients/clients.
How has Dr. Kubler-Ross changed our response in Death & Dying?
How has the impact of her conceptual framework changed the nursing role in response to death and dying and how do we approach those dealing with death and dying?  Discuss various ways that nurses and other healthcare workers can approach the care of those dealing with death and dying.
Is there another framework or theory that guides death and dying and how patients cope which may change your personal approach in providing patient care?
Compare and contrast the personal approaches to death and dying in patient care and explain the pros and cons of the various approaches.

ANSWER

Conceptual Frameworks Guiding Approaches to Death and Dying in Patient Care

Introduction

Caring for dying patients or clients requires a compassionate and holistic approach that addresses their physical, emotional, and spiritual needs. Over the years, several conceptual frameworks have guided healthcare professionals in understanding and responding to death and dying. One of the most influential figures in this field is Dr. Elisabeth Kübler-Ross, whose work has significantly impacted our understanding of death and transformed the nursing role in providing end-of-life care. This essay will discuss the conceptual frameworks guiding our approach to caring for dying patients, the impact of Dr. Kübler-Ross’s work, and various approaches to death and dying in patient care.

Conceptual Frameworks for Death and Dying

Kübler-Ross’s Five Stages of Grief: Dr. Elisabeth Kübler-Ross introduced the five stages of grief, which include denial, anger, bargaining, depression, and acceptance. This framework highlights the emotional process individuals may go through when facing death or dealing with the loss of a loved one. It provides healthcare professionals with a foundation for understanding and supporting patients’ emotional needs during end-of-life care.

Palliative Care and Hospice Approach: Palliative care focuses on improving the quality of life for patients with life-limiting illnesses, whereas hospice care is specifically provided to patients in the terminal phase of their illness. These frameworks emphasize comprehensive symptom management, psychosocial support, and spiritual care for patients and their families. The goal is to enhance comfort, dignity, and emotional well-being while respecting the patient’s autonomy and individual wishes.

Impact of Dr. Kübler-Ross’s Work

Dr. Kübler-Ross’s pioneering work significantly influenced our response to death and dying. Her conceptual framework provided a roadmap for understanding the emotional journey individuals may experience. It encouraged healthcare professionals to acknowledge and address the psychological and existential aspects of dying, leading to a more holistic approach to end-of-life care. The stages of grief model helped normalize the emotions patients and families may go through, facilitating open communication and emotional support during this challenging time.

Transformation of the Nursing Role

Dr. Kübler-Ross’s work had a profound impact on the nursing profession, changing the way nurses approach death and dying. Nurses are now recognized as integral members of the interdisciplinary team providing end-of-life care. They play a pivotal role in advocating for patients’ preferences, facilitating communication, providing emotional support, managing symptoms, and promoting comfort and dignity. Nurses also collaborate with other healthcare professionals to ensure a comprehensive care plan tailored to the patient’s needs and goals.

Approaches to Death and Dying in Patient Care

Person-Centered Care: This approach focuses on individualizing care based on the patient’s values, beliefs, and preferences. It emphasizes open communication, shared decision-making, and actively involving patients and their families in the care planning process. Person-centered care respects the patient’s autonomy and ensures their wishes are respected throughout the end-of-life journey.

Spiritual and Existential Care: Recognizing the significance of spirituality and existential concerns, healthcare professionals provide support that aligns with the patient’s belief system. This may involve offering opportunities for religious or spiritual practices, facilitating discussions about meaning and purpose, and addressing existential distress.

Bereavement Support: The care provided to families and loved ones after the patient’s death is crucial. Nurses and healthcare professionals offer bereavement support, connecting families with appropriate resources, counseling services, and support groups to help them cope with their grief.

Alternative Frameworks and Personal Approach

While Kübler-Ross’s framework is widely known and utilized, other theories and frameworks also guide the approach to death and dying. For example, the dual-process model of bereavement highlights the oscillation between loss-oriented and restoration-oriented coping strategies. This framework recognizes that individuals alternate between grieving their loss and engaging in activities that help them adapt to life without the deceased.

Pros and Cons of Various Approaches

Each approach to death and dying has its strengths and limitations. Person-centered care promotes individualized support but may require significant time and resources. Spiritual and existential care acknowledges the importance of meaning-making but may not resonate with patients who do not identify as spiritual. Bereavement support is crucial, yet it may be challenging to access comprehensive services in some healthcare settings.

Conclusion

The conceptual frameworks and theories surrounding death and dying have significantly influenced patient care, particularly in the nursing profession. Dr. Elisabeth Kübler-Ross’s work revolutionized our understanding of grief and provided a foundation for addressing emotional needs at the end of life. Nurses and other healthcare workers employ various approaches, such as person-centered care, spiritual support, and bereavement services, to ensure holistic and compassionate care for patients and their families. As healthcare professionals, it is essential to integrate multiple frameworks and tailor care to meet the unique needs of each individual and their loved ones during this challenging time.