Sudden Death In Intensive Care An Examination On The Bereavement Process And Counselling In An Itu Environment

2759 words - 11 pages

The purpose of this assignment is to explore the sudden death of individuals admitted to an intensive care unit, and the impact this has on their families and friends. It is also the objective of this assignment to explore the counselling services available to the families of the bereaved at the time of death and immediately afterward, and how these may assist the grieving process. References made to the clinical area refer mainly to that with which the author has had experience.Intensive care units derived from the polio epidemic of the early 1950`s and have subsequently developed to incorporate cardiovascular, neurological and multi organ failure care for critically ill adults and children. They are very technical areas and contain equipment and drugs designed to augment or replace normal physiological functions, and the patients are cared for by highly skilled nurses and doctors trained in the administration of such care. By the very nature of the types of conditions commonplace in intensive care units, it is an accepted fact that a significant percentage of people admitted to such units will not survive. It is possible to prepare relatives of critically ill people for an imminent death if this is anticipated, but frequently the death can come very soon after admission, or result from an unforeseen complication, much as on any other ward.It is these sudden deaths, which can result in a protracted, and abnormal grief reaction, especially if the death was violent or traumatic. This view is supported by Gross (1992) who suggests that it is more likely to lead to pathological (abnormal) grieving, a view also endorsed by Wright (1991). Pathological or abnormal grief occurs when the grieving process takes much longer than normal, or when an individual gets "Trapped" in one part of the grieving process (Parkes & Weiss (1983) cited in Gross (1992)). Gross (1992) has suggested that this is frequently as a result of ambivalent feelings to the deceased or an extreme response in intensity and duration of grief as a result of the mode of death. Wright (1991) agrees with this principle in that sudden death can frequently result in more an intense grieving and yield more physiological symptoms.In order to discuss bereavement further, it is first necessary to briefly mention some of the models of grieving proposed. A great deal of work has been carried out in the field of loss and bereavement, and almost all have identified several common stages or tasks of grieving. The first model of grieving to briefly discuss it that of Freud (1917) (cited in Goodall et al. (2000). In his work Mourning & Melancholy he described how the bereaved must confront their loss and on an intellectual and emotional level through an adaptive mechanism, must accept the grief, and that eventually time will heal. Failure to complete the grief-work will result in prolonged suffering and abnormal grieving. Central to the Freudian theory is that the relationship with the deceased...

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