Outcomes for End-of-Life Patients With Anticipatory Grieving

Abstract

Anticipatory grieving, grief associated with an impending loss, is common for patients facing end of life or for their families. There is little research on the outcomes of interventions for anticipatory grieving among hospitalized patients. A descriptive, comparative analysis of an existing valid and reliable data set that was obtained through routine nursing clinical practice using standardized nursing terminologies was completed. We applied data mining techniques on a targeted data set consisting of hospital episodes for end-of-life patients who were given a diagnosis of anticipatory grieving. Less than 50% of the patients given a diagnosis of anticipatory grieving met the expected ratings of monitored nursing outcomes at the time of death or discharge. Specifically, for the spiritual health outcome, only more than 50% of the patients met the expected outcome rating. For the comfortable death outcome, only 45.9% of the patients met the outcome rating. For the comfortable death outcome, patients were significantly more likely not to meet the expected outcome rating if they were also given a diagnosis belonging to the physical comfort class (χ2(1) = 8.99, P < .003). These results demonstrate that expected outcomes are not being met and suggest the need of better education for the clinicians about the diagnosis and treatment of anticipatory grieving.

Loss and bereavement: A focus on cancer and families, death of a parent, death of a young child, and sudden or violent death in families.

“…Anticipatory grief, which can be indicative of complicated grief, has been studied among both family caregivers and cancer patients. Approximately 25% of patients with incurable cancer experience anticipatory grief, which commonly mirrors the reactions and signs of distress associated with normal grief (Johnson et al, 2017). However, as many as 26% of family caregivers of cancer patients have been found to be at high risk of complicated, anticipatory grief (Areia et al, 2019).…”

The Role of Advance Care Planning in Cancer Patient and Caregiver Grief Resolution: Helpful or Harmful?

“…Grief in this context has been described as the anticipation of one’s own or a loved one’s future death, coupled with the navigation of prior and ongoing losses as a result of a terminal illness [ 1 , 2 , 3 ]. It is often unrecognized or mistaken for mental disorders such as anxiety, posttraumatic stress, or depression [ 1 , 2 , 4 , 5 , 6 ]. Evans [ 7 ] describes grief during caregiving as a “reaction to a multiple loss situation” rather than a reaction “to the loss incurred by the actual death” (p. 163), highlighting the multifaceted experience of grief that takes place in advance of a physical death.…”