University Nursing Report: Palliative Care and Grief Theory

This report analyzes the case of a 40-year-old woman, Maria, diagnosed with lung cancer, and her family's experiences with palliative care and grief. It explores the application of grief theories, particularly the Kubler-Ross model, to understand the emotional stages of patients and their families. The report examines denial, anger, bargaining, depression, and acceptance within the context of Maria's treatment. It also provides coping strategies for Maria's husband, John, including effective communication, sharing responsibilities, and engaging support teams like bereavement and hospice care. The report emphasizes the importance of holistic nursing approaches and the need for comprehensive support for both patients and their families during end-of-life care. References include relevant studies on grief models and coping mechanisms.

Running Head: Nursing
Palliative care and Grief theory
Name of the Student
Name of the University
Authors Note

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Response to the Question 1
The case study will analyse the condition of a patient suffering from lungs cancer and
her family. Maria, 40 year old person is diagnosed with lung cancer. Maria is married to John
for 10 years and has two sons. Maria and her family face tremendous grief and sorrow during
her treatment of palliative care as her health advisor has suggested that there is no chance of
recovery. To manage the grief and mental stress during palliative care, one can take help
from different theories and models. These models will understand the mental state and
patterns of grieving process. Different theories which are used to understand the grief of the
clients as basics of counselling. They use models for helping and supporting patients to
analyse their emotional experiences and mental distress. The examples of the grief model are
Kubler-Ross model, Tonkin’s model, Four tasks of grieving, Six Rs of Mourning, Dual
process model. The effect of Kubler-Ross model in managing grieves and distresses will be
analysed in the context of the given case study.
In very beginning of the palliative care, the patient cannot believe his or her poor
health condition could lead death. As a coping mechanism denial comes very naturally with
the shock. With the sense of denial the patient wants to find another alternative and
sometimes patient thinks that diagnosis might be incorrect. Patient might feel tremendous
anger against God as he or she cannot change the present and a feeling of resentment can be
supported by counsellor, psychologists and nurses. Afterwards, the patient and his/her family
might have developed a hope of recovery (Maniscalco et al., 2019). This state is called
“bargaining” state in 5 stages of grief. The person can suffer from depression which affects
both her physical and psychological wellbeing. As a result of depression the patient can
suffer from loss of appetite, energy, weight along with disturbed sleep and pains. The
patient remains in the state of sorrow and suffered from low motivation and lack of
happiness. The patient majorly chooses social isolation and withdrawal. The last step of this

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grief model is acceptance where the patient and her family members accept the fact of the
death and emphasise on the positivity of the being with that person than the fear of losing
loved ones (Gregory,2019). During the depression, the family of a terminally ill patient gets
equally depressed. Every member of family gets affected as they have to watch their love
ones in distressed. This regular struggle with sorrow and grief can make them demotivated
and depressed. In the anger stage, both the patient and their family feels that something
highly unjustified incidence has occurred and why they have to suffer only. The five stages of
grief is significant for treating and providing mental support to a patient of end of life care
and to the respective family.
Response to the Question 2
Three coping strategies for John to cope with the process of Maria’s diagnosis;
Effective communication and counselling: John should be engaged in interpersonal
effective communication with the mental health nurses and the health professional associated
with Maria’s treatment. He can take help of a psychologists or therapist to cope up with
stress. The nurses involved in the recovery procedure should treat John for fulfilling his
mental, spiritual and health related necessities (Betriana and Kongsuwan, 2019). He should
be treated with the holistic approach of nursing. The health professionals and social workers
of end of life care should give him proper information and knowledge about his spouse’s
health. Proper education will help him to cope with the situation and developing acceptance.
Sharing responsibility: John should share his responsibility with his close friends and
family members so that he can spend more time with his wife. If not possible he can hire
some professionals to manage his finance related to the medical expenses. There are social
workers who help the patient and family without any financial benefit in different sectors
such as assisting in psycho-social interventions and care coordination. Some of non-

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beneficial organisations helps the families with daily life assistance and sharing responsibility
can be helpful for John.
Engagement of support teams
The bereavement and hospice care teams help family members of an end of life care
patient (Newsom et al., 2017). They arranges social, psychological and physical health
assistances. These organisation not only help the spouse or the adults but also the children
of the patient .They organise bereavement counselling, phone counselling and encourage the
people to express their emotions rather suppress it. They re-evaluate the necessities of
patient’s family and establish by the strengthening the relationship among the family
members.

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References
Maniscalco, G.T., Ziello, A.R., Panetta, V., Guarcello, G. and Improta, G., 2019. The
application of Kubler-Ross model in Newly Diagnosed Patients with Relapsing-Remitting
Multiple Sclerosis. Arch Depress Anxiety, 5(2), pp.047-051.
Gregory, C., 2019. The five stages of grief: An examination of the Kubler-Ross model.
Betriana, F. and Kongsuwan, W., 2019. Grief reactions and coping strategies of Muslim
nurses dealing with death. Nursing in critical care.
Newsom, C., Schut, H., Stroebe, M.S., Wilson, S., Birrell, J., Moerbeek, M. and Eisma, M.C.,
2017. Effectiveness of bereavement counselling through a community‐based organization: A
naturalistic, controlled trial. Clinical psychology & psychotherapy, 24(6), pp.O1512-O1523.