d. Depression.
(1)
Patient reactions. The patient:
(a)
May be anxious to put affairs in order.
(b)
Sense a great loss--(income, business, hair, limb, function, life).
(c) Have feelings of sadness and guilt over not having provided for
family. He may make a will or update one.
Health care provided by the medical specialist.
(2)
(a)
Allow the patient to mourn, cry, and talk about losses.
(b)
If possible, help patient take care of putting affairs in order.
(c)
Provide emotional support.
e. Acceptance.
(1)
Patient reactions. The patient:
(a)
Is prepared to die.
(b)
Is at peace.
(c)
Is tired.
(d)
May withdraw from all except a special loved one.
NOTE:
The patient wants to be left alone or have someone sit near, but in silence.
Family often needs more support than the patient. This is the time when it is
too late for so many words, and yet the time when relatives cry the hardest for
help--with or without words.
(2)
Health care provided by the medical specialist.
(a) Respect the patient's need for quietness and offer reassurance by
being there as much as possible.
(b) If the patient is unresponsive, do not discuss the patient in his room--
hearing is the last sense to cease function.
MD0549
6-5