1. DEALING WITH DEATH AND BEREAVEMENTDR
NEVIN ZAKI
Assistant professor of Psychiatry
تحت اشراف أد/هاله البرعي

3. Reaction to death varies
Sudden death
Accidents
Peaceful death in elderly
Cause :natural or environmental
Extreme physical illness due to death
Process of death is frightening

4. Factors influencing reaction to death
Religious and spiritual beliefs
Sudden or due t chronic illness
Age (young will be more anxious
Older will worry about their dependents
Feeling of disengagement and depression
Anticipatory grief about losses
Dying person is withdrawing

5. We should encourage to support patient’s attempts to remain as independent as possible.
He can be involved in making decisions concerned with the family

6. In our culture there is a tendency to hide facts from the patient
In our culture there is a tendency to hide facts from the patient. When we do not talk about death with the patient, it does not mean that the patient is not aware of it.

7. Bereavement The effect of death on those who are still alive
Typical or uncomplicated grief is usually seen following the death of a parent, child, sibling or first-degree relative

8. stages Shock and denial Despair and distress Searching for the dead
Irritability and anger
Blame the doctor or oneself
Behaving as if he is still alve
Appearance of traits similar to the deceased
Acceptance
stages

9. Children develop the concept of death around seven years of age.
young children often cannot accept the absence
of the person due to death.
As children do not openly express their fears regarding death,
They often develop emotional problems, which are manifested in a sudden drop in their academic performance, sleep disturbances, development of fears, depression and insecurity.

10. Provide some information
Attitudes of doctors
Its not right to tell
Provide some information
Mum effect
Have to tell the truth

11. The bereaved person needs empathetic
understanding but not pity, and at this time,
social support system provided by relatives and
friends in our culture is very helpful in coping
with the loss

12. There is evidence for an increased incidence of both morbidity and mortality from organic
disease, following bereavement. Bereavement
may also result in a psychiatric illness such a
neurotic illness, depression, schizophrenia, or
mania

13. There are three types of abnormal grief.
Chronic grief represents an intensification and prolongation of the typical form, and is frequently associated with recurrent ideas of guilt and self-blame,
Inhibited grief tends to occur in the very young or the very old, and is characterised by the prolonged inhibition of a large part of the total picture of typical grief
Delayed grief is typical or chronic grief occurring after a delay of months or years.

14. Breaking bad news
The first position is that patients should always be given full information regardless of their individual perceptions or needs.
Second view states exactly the opposite; that under no circumstances should patients be informed that they have acquired a fatal disease, and that falsehood and deception should be used if necessary, on the basis that the patient needs protection from the terrible reality of terminal illness.
A third view suggests a more flexible approach, with a variety of psychological and sociological factors to be taken into consideration, but without guidelines as to how this might be done