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  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
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    Site Index
    Back to Module 16: Social and Psychological Considerations
    Why are Social and Psychological Considerations Important?

    Why are Social and Psychological Considerations Important?
    • Dying, death, and bereavement are among life’s most stressful and difficult events
      • Social and psychological pain and suffering during dying and bereavement are often of greater significance than, and may contribute to, physical pain

      • Social and psychological pain and suffering that is not addressed in family members and others who are bereaved may contribute to further pain and suffering when these individuals experience their own dying
    • Yet, dying and bereavement are among the most significant and meaningful experiences that we have in our lives; it can
      • Increase awareness of change and natural experience

      • Provide opportunities for resolution of conflicts in important relationships

      • Heighten awareness of spiritual feelings and experiences

      • Offer new perspectives on living

      • Allow for greater appreciation of oneself, others, and the world
    • Recognition and consideration of psychological and social needs and concerns of dying persons and their families may make a difference in:
      • Completion of important tasks before death

      • Resolution of conflicts

      • Grieve in a constructive way that allows all to move ahead with their tasks

        • For the dying person
          • Die as he or she might chose to die
          • Experience few significant conflicts during dying
          • Maintain an intact personal identity during dying
          • Reach a broad sense of closure in life
          • Accept and understand losses across all dimensions of living
          • Accomplish important tasks, realize critical wishes, and address significant concerns before death

        • For the survivors
          • Appreciate the significance of one’s relationship with another
          • Reach closure in an important relationship
          • Experience and accept losses
          • Go on with living without the deceased
          • Establish new life patterns and relationships without the deceased
    • Working with persons who are dying and with survivors is one of the most stressful and difficult responsibilities of health care professionals
      • Reasons for the stressfulness is that working with individuals who are dying involves…
        • Exposure to the expression of painful emotions
        • Interacting with persons and individuals under extreme stress
        • Dealing with conflicts in family relationships
        • Being the one who communicates bad news
        • Awareness of one’s own mortality
        • Recognition of the limitations of medicine as well as one’s own limitations

      • Lack of training and preparation in end of life care is one reason for the stressfulness of working with dying persons
        • Thus, seeking education in end of life care is one way a health care professional can reduce this stress

        • Education can provide resources that allows the health care professional to provide excellent end of life care while maintaining own health and well-being

      • It is also a privilege to share these experiences with dying persons and their families, and for many health care professionals, it is significantly rewarding experience

      • Health care professionals working in end of life care need to be…
        • Prepared to experience difficult psychological responses themselves
        • Able to recognize their own psychological and social responses to dying and bereavement

      • Care for one’s own self psychologically and socially in order to…
        • Avoid emotional exhaustion as a consequence of this work
        • Maintain psychological and physical resilience
        • Continue to give outstanding end of life care
        • Fully realize the rewards of participating in this most important work
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