Answer to Question 1
Grief is an active process in which people must do several things. The first is to acknowledge the reality of the loss. One must overcome the temptation to deny the loss, and one must openly acknowledge it and accept that it affects every aspect of one's life. The second task is to work through the emotional turmoil. One must find positive ways to confront and express the range of emotions felt due to a loss.
Emotions are not to be avoided or repressed. The third task is to adjust to the environment in which the deceased is absent. One must define new patterns of living. Finally, one must loosen ties to the deceased. One must find an effective way to say goodbye in order to reengage with one's social network.
Answer to Question 2
Passed in 1990, the Patient Self-Determination Act requires most health care facilities to provide information to patients in writing that they have several rights. They have the right to make their own health care decisions, accept or refuse medical treatment, and make an advance health care directive. Patients must be asked if they have an advance directive, and if so, this must be included in the medical record. Staff at medical facilities must be trained regarding advance directives but cannot base admissions or treatment decisions based on whether such directives exist.
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