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Anxiety, Depression, Caregiver Burnout, Grief, Anger, Frustration in End of Life Care

Anxiety

  • According to the DSM-5, anxiety disorders are those that share features of excessive anxiety and fear with related behavioral disturbances.
  • These disorders differ from normal fear and anxiety in their being excessive and persisting beyond developmentally appropriate periods, typically lasting 6 months or more
  • Types of anxiety:
    1. Separation anxiety – anxiety or fear about separation from an attachment figure
    2. Selective mutism- consistent failure to speak in social situations
    3. Social anxiety – fear or anxiety about social interactions or situations
    4. Panic disorder -recurrent panic attacks
    5. Phobias- fear of a specific object or situation
    6. Generalized anxiety disorder- persistent or excessive anxiety and worry about various domains.
  • Treatment:
    • Nonpharmacological interventions
      1. Establish a trusting relationship
      2. Be aware of any anxiety that you as a nurse may have that may be picked up on
      3. Do not leave a person experiencing an anxiety disorder exacerbation alone
      4. Maintain a calm, nonthreatening, manner-of-fact approach
      5. Keep stimuli minimized
      6. Use simple words and brief messages that are calmly and clearly explained
      7. Discuss the reality of the situation
      8. Include person on decision-making to feel more in control
      9. Encourage exploration of underlying feelings that contribute to irrational fears
      10. Teach and reinforce stress management /relaxation techniques
    • Pharmacological interventions
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