Bereavement and End of Life Issues
1)

For someone with a serious illness or declining health, all of the following suggest that a person might be nearing the end of life, except:
 
Dyspnea and/or depression Legerity and/or depression Refusal to eat or drink Tiredness and/or sleepiness
 
2)

Complicated grief is all of the following, except:
 
Specific term that is easily defined within the outlined standards Term for describing when people adjust poorly to a loss May be treated with psychological therapy May be treated with antidepressant medication to help alleviate depression
 
3)

Physical reactions to grief may include the following, except:
 
Trembling or shakiness Muscle weakness Avoidance of talking about or reminders of the person who has died Nausea and trouble eating
 
4)

Kubler-Ross’ stages of grief includes all of the following, except:
 
Denial Anger Acceptance Yearning
 
5)

All of the following are tasks in the bereavement process according to Psychologist J W Worden, except:
 
To accept the reality of the loss To work through the pain of grief To avoid restoration activities To maintain a connection to the deceased while moving on with life
 
6)

Complicated grief therapy (CGT) is all of the following, except:
 
A relatively new psychotherapy model designed to address symptoms of complicated grief. Draws from attachment theory with roots in both interpersonal therapy (IPT) and cognitive-behavioral therapy Focuses on personal goal and relationships Person-to-person exchange based on identification and reciprocity
 
7)

Attachment theory…
 
Holds that humans are biologically programmed to seek, form, and maintain close relationships Holds that behavioral change is determined by environment, personal and behavioral elements Assumes that individuals consider behavior consequences before performing a task to seek attachment Holds that an individual’s impression of their own ability to perform a demanding or challenging task with help them form attachments
 
8)

In Complicated Grief (CG), the mental representation of the attachment figure is disrupted…
 
Such that the exploratory system reengages so that the grieving individual can become closer to other people and the world in general Such that the loss is acknowledged in declarative memory but not in implicit memory Moving the individual from acute grief to integrated grief When the individual moves to another attachment figure
 
9)

CGT or Complicated Grief Treatment 
 
Takes an average of two years to complete Is done under general anesthesia, with small electric currents passing through the brain May be a challenging treatment, particularly for individuals who are not also taking medication Consists of 45 sessions, each approximately 60 minutes long
 
10)

 Imaginal revisiting is all of the following, except:
 
The core element of CGT In some ways resembles prolonged exposure Recommended to begin around session 15 The client briefly visualizing and telling the story of when they became aware of the loved one’s death
 
11)

Mutual support or self-help groups include the following, except:
 
Relies on complex technologies introduced by group therapists Associations of people who share the same problem, predicament, or life situation who unite for the purpose of mutual aid The element of commonality is solely what determines inclusion in the group All decisions about content, organization, and external relationships are made by the participants
 
12)

According to Parkes, the assumption that underlies mutual support bereavement groups is that…

 
 
“The person best qualified to understand and help with the problems of a bereaved person is another bereaved person.” “Therapeutic methods based on human behavior theory and professional skills introduced to the group are best practices.” “Making decisions as a group can, in ways, discourage creativity or individual responsibility” “Well-intentioned people make irrational or non-optimal decisions spurred by the urge to conform or uneasiness of dissent.”
 
13)

Interpersonal Therapy is designed to treat individual patients who have depression associated with abnormal grief reactions.  Treatment proceeds in three stages, that include the following, except:
 
the depression is explained to The patient and related to current and past interpersonal relationships, and major problem areas are identified Facilitation of the grieving process, assisting the patient in developing relationships to substitute for what has been lost, to make the necessary role transitions, and restore self-esteem Self-reflection is discussed with the patient which includes apperception and the use of a mirror for self recognition The end of therapy is discussed explicitly and the patient is helped to recognize his or her independent competence
 
14)

Medications used to assist the bereaved are almost always psychopharmacologic agents from three classes of drugs including the following, except:
 
Anti-anxiety drugs Hypnotics Antidepressants Stimulants
 
15)

Anticipatory grief includes the following, except:
 
Occurs when a death is expected, but before it happens Occurs when a death transpires after a natural disaster, like a hurricane, tornado or flood Helps family members get ready emotionally for the loss For the patient who is dying, may be too much to handle and may cause him or her to withdraw from others
 
16)

Normal or common grief
 
Occurs when a death his expected, but before it happens Begins soon after a loss and symptoms go away over time Begins soon after a loss, lingers and gets worse Occurs when a death in unexpected and often leads to suicidal ideation
 
17)

In general, _____ have more problems than _____ do after a spouse’s death.  _____ tend to have worse depression and more health problems than ______ do after the loss.
 
men, women, men, women women, men, women, men men, women, women, men women, men, men, women
 
18)

In general, _______ bereaved people have more problems after a loss than ______ bereaved people do.  ______ bereaved people may recover more quickly than ______ bereaved people do.
 
younger, older, younger, older older, younger, older, younger younger, older, older, younger older, younger, younger older
 
19)

Palliative care includes the following, except:
 
A resource for anyone living with a serious illness, such as heart failure, chronic obstructive pulmonary disease, cancer or dementia Helpful at any stage of illness and is best provided from the point of diagnosis A process that can help patients understand their choices for medical treatment Not provided along with curative treatment and depends on prognosis
 
20)

Hospice care includes the following, except:
 
Can be provided in any setting—home, nursing home, assisted living facility, or inpatient hospital Designed for a patient who chooses not to undergo certain treatments Attempts to cure the person’s illness are continued, clinical trials may start Provided for a person with a terminal illness whose doctor believes he or she has 6 months or less to live if the illness runs its natural course
 
21)

True or False?  Hospice care includes stopping all medical treatment.
 
True False
 
22)

 True or False?  The law considers an adult refusing medical treatment to be either suicide or euthanasia.
 
True False
 
23)

Caregivers for people with Alzheimer’s or other dementias at home may experience the following, except:
 
Loss of wages and/or loss of employment Abnormal relief when death happens, for themselves and for the person who died Fatigue Depression
 
24)

Advance care planning includes all of the following, except:
 
Involves learning about the types of medical decisions that might need to be made, considering those decisions ahead of time, and then letting others know your preferences Allows you to express your values and desires related to end-of-life care Can be adjusted and changed Is not required unless you reach old age
 
25)

There are two main elements in an advance directive ______ and _____.
 
DNR/organ tissue donation Living will/ POLST Organ tissue donation/MOLST A living will/durable power of attorney for health care