Grief and Loss

Chapter 22

Loss is part of human experience Grief and bereavement are normal responses to loss Grieve on reoccurring basis as we face commonplace

losses in our lives (loss of persons, relationships, body parts, etc)

Course of life depends on how we adapt to loss and how we change to grow

Loss through death is major life crisis Well known the sequelae of grief can lead to morbidity

and mortality

Grief and loss

Grief Reaction to loss Include depression, anxiety, loss of interest, sadness

Bereavement Social experience of dealing with death of loved one

Mourning Refers to culturally patterned expressions of bereavement and

grief Sensitivity to ethnic, cultural spiritual and religious beliefs of

diverse cultural population can help nurses identify needs Disenfranchised Grief Grief engendered by public tragedy

Grief and loss

Grieving is psychological process that involves disengaging strong emotional ties from significant relationship and reinvesting the energy once given to deceased in a new and productive direction over time

Studies of grief and loss by Kubler-Ross, Parkes, Caplan, and Engel and postulate various phases of bereavement in sequences and timeframes Shock and Disbelief: denial is 1st response Development of Awareness: anger, guilt & crying Restitution: formal ritualistic phase of mourning during

acute phase Loss oriented & restoration oriented

Theory

Assessment Most come to terms of loss with family/friends 30% require professional help Unresolved grief result in physical complaints Assessment guidelines review

Diagnosis Grieving; normal process Complicated grieving & risk for complicated grieving; Persons

that have difficulty coming to terms with the loss Outcomes Identification Planning

Application of nursing process

Implementation Nurses focus is helping the bereaved deal with

important issues emerging at that time Communication: active listening Psychotherapy

Short term therapies Educational Component Encouragement of expression emotions and affect Help bereaved come to peace

Evaluation: acceptance, work through pain of grief, adjust to environment, restructure family relationship

Application of nursing process