XVII Glossary

Acute grief: Grief that begins immediately after the death of a loved one and includes the separation response and response to stress. (Chapter 17.2)

Advance directives: Legal documents that direct care when the patient can no longer speak for themselves, including the living will and the health care power of attorney. (Chapter 17.2)

Anorexia: Loss of appetite or loss of desire to eat. (Chapter 17.4)

Anticipatory grief: Grief before a loss, associated with diagnosis of an acute, chronic, and/or terminal illness experienced by the patient, family, and caregivers. Examples of anticipatory grief include actual or fear of potential loss or health, independence, body part, financial stability, choice, or mental function. (Chapter 17.2)

Bereavement period: The time it takes for the mourner to feel the pain of the loss, mourn, grieve, and adjust to the world without the presence of the deceased. (Chapter 17.2)

Burnout: A caregiver’s diminished caring and cynicism that can be triggered by workplace demands, lack of resources to do work professionally and safely, interpersonal relationship stressors, or work policies that can lead to diminished caring and cynicism. Burnout may be manifested physically and psychologically with a loss of motivation. (Chapter 17.2)

Cachexia: Wasting of muscle and adipose tissue due to lack of nutrition. (Chapter 17.4)

Cardiopulmonary resuscitation (CPR): Emergency treatment initiated when a patient’s breathing stops or their heart stops beating. It may involve chest compressions and mouth-to-mouth breathing, electric shocks to stop lethal cardiac rhythms, breathing tubes to open the airway, or cardiac medications. (Chapter 17.2)

Comfort care: Care that occurs when the patient’s and medical team’s goals shift from curative interventions to symptom control, pain relief, and quality of life. (Chapter 17.2)

Compassion fatigue: A state of chronic and continuous self-sacrifice and/or prolonged exposure to difficult situations that affect a health care professional’s physical, emotional, and spiritual well-being. (Chapter 17.2)

Complicated grief: Chronic grief, delayed grief, exaggerated grief, and masked grief are types of complicated grief. (Chapter 17.2)

Disenfranchised grief: Any loss that is not validated or recognized. (Chapter 17.2)

Do-not-resuscitate (DNR) order: A medical order that instructs health care professionals not to perform cardiopulmonary resuscitation (CPR) if a patient’s breathing stops or if the patient’s heart stops beating. (Chapter 17.2)

Fading away: A transition that families make when they realize their seriously ill family member is dying. (Chapter 17.2)

Grief: The emotional response to a loss, defined as the individualized and personalized feelings and responses that an individual makes to real, perceived, or anticipated loss. (Chapter 17.2)

Health care power of attorney: A legal document that identifies a trusted individual to serve as a decision maker for health issues when the patient is no longer able to speak for themselves. (Chapter 17.2)

Hospice care: A type of palliative care that addresses care for patients who are terminally ill when a health care provider has determined they are expected to live six months or less. (Chapter 17.2)

Living will: A legal document that describes the patient’s wishes if they are no longer able to speak for themselves due to injury, illness, or a persistent vegetative state. The living will addresses issues like ventilator support, feeding tube placement, cardiopulmonary resuscitation, and intubation. (Chapter 17.2)

Loss: The absence of a possession or future possession with the response of grief and the expression of mourning. (Chapter 17.2)

Mourning: The outward, social expression of loss. Individuals outwardly express loss based on their cultural norms, customs, and practices, including rituals and traditions. (Chapter 17.2)

Normal grief: The common feelings, behaviors, and reactions to loss. (Chapter 17.2)

Palliative care: A broad philosophy of care defined by the World Health Organization as improving the quality of life of patients, as well as their family members, who are facing problems associated with life-threatening illness. It prevents and relieves suffering through early identification, correct assessment, and treatment of pain and other problems, whether physical, psychosocial, or spiritual.^[1] (Chapter 17.2)

Rule of Double Effect: If the intent is good (i.e., relief of pain and suffering), then the act is morally justifiable even if it causes an unintended result of hastening death. (Chapter 17.5)