care plan

[monish_0210]

I'm having problem with this care plan. I have this diagnosis. Grieving. He loss his wife a year ago and has some type of depression about it his wife died of a brain tumor. He has cancer also in the lungs and bladder. I can find nursing interventionsn I have a headache just thinking and not finding anything. Please help!!!! Thanyou.

[Daytonite, BSN, RN]

this is complicated grieving. i would word the nursing diagnosis as complicated grieving r/t the death of his wife. an alternative diagnosis to consider might be chronic sorrow because it allows for loss of loved ones along with having ones own terrible things that are happening to them so they always feel anger, misunderstood, confused, depressed, disappointed, empty, fearful, guilty, helpless, hopeless, lonely, have low self-esteem, overwhelmed by life because recurring loss is a theme in their life.

you must first get your assessment data assembled since that is what defines the diagnosis and what gets treated. these are the defining characteristics (signs and symptoms) of complicated grieving [formerly called dysfunctional grieving], the nursing diagnosis, listed in the nanda taxonomy for this nursing diagnosis. see if you recognize any of them in this patient (page 265, nanda international nursing diagnoses: definitions and classifications 2009-2011):

• decreased functioning in life roles
  
• decreased sense of well-being
  
• depression
  
• experiencing somatic symptoms of the deceased
  
• fatigue
  
• grief avoidance
  
• longing for the deceased
  
• low levels of intimacy
  
• persistent emotional distress
  
• preoccupation with thoughts of the deceased
  
• rumination
  
• searching for the deceased
  
• self-blame
  
• separation distress
  
• traumatic distress
  
• verbalizes anxiety
  
• verbalizes distressful feelings about the deceased
  
• verbalizes feeling dazed
  
• verbalizes feeling empty
  
• verbalizes feeling in shock
  
• verbalizes feeling stunned
  
• verbalizes feelings of anger
  
• verbalizes feelings of detachment from others
  
• verbalizes feelings of disbelief
  
• verbalizes feelings of mistrust
  
• verbalizes lack of acceptance of death
  
• verbalizes persistent painful memories
  
• verbalizes self-blame
  
• yearning
  

this web site lists some nursing interventions: dysfunctional grieving

other websites with information and suggestions for treatment of grief:

• http://mayoclinic.com/health/complicated-grief/ds01023/dsection=coping-and-support - coping and support for people experiencing grief
  
• http://www.medicinenet.com/loss_grief_and_bereavement/article.htm - grief: loss of a loved one
  
• http://www.webmd.com/balance/tc/grief-and-grieving-topic-overview - grief and grieving
  
• http://www.webmd.com/depression/default.htm - depression center on webmd
  
• http://www.stvincent.org/ourservices/hospice/bereavsupport/grief.htm - understanding grief and mourning
  
• http://www.stvincent.org/ourservices/hospice/bereavsupport/manifestations.htm - manifestations of grief
  

this site has information for the caregivers of patients with cancer:

• http://www.mywhatever.com/cifwriter/library/eperc/fastfact/ff43.html - distinguishing between grief and depression as well as other types of feelings. this is from http://www.mywhatever.com/cifwriter/library/eperc/fastfact/ff_index.html
  

[dadfirst]

If a patient is verbalizing, how is that considered dysfunctional or complicated. I would think denying feelings would be dysfunctional.