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Grief and Loss Nursing 202

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Page 1: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

Grief and Loss

Nursing 202

Page 2: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

• Loss is the experience of separation from something of personal importance.

• Loss is anything that is perceived as such by the individual.

• Examples of loss include:– A significant other (person or pet)– Illness or debilitating conditions– Developmental/maturational changes– Decrease in self-esteem– Personal possessions

Page 3: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

Theoretical Perspectives– Elisabeth Kübler-Ross

• Stage I: Denial• Stage II: Anger• Stage III: Bargaining• Stage IV: Depression• Stage V: Acceptance

– John Bowlby• Stage I: Numbness or protest• Stage II: Disequilibrium• Stage III: Disorganization and despair• Stage IV: Reorganization

Page 4: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

– J. William Worden• Task I. Accepting the reality of the loss• Task II. Working through the pain of grief• Task III. Adjusting to an environment that

has changed because of the loss• Task IV. Emotionally relocating what has

been lost and moving on with life

Page 5: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

• Acute grief– Usually lasts 6 to 8 weeks

• The grief process– Is very individual --May last for many years

• The grief response is more difficult if:– The bereaved person was strongly dependent– The relationship was an ambivalent one– The individual has experienced a number of recent losses– The loss is that of a young person– The bereaved person’s health is unstable– The bereaved person perceives some responsibility for the

loss

Page 6: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

• The grief response may be facilitated if:– The individual has the support of significant

others– The individual has the opportunity to

prepare for the loss

Page 7: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

• Delayed or inhibited grief– The absence of grief when it ordinarily would be expected– Potentially pathological because the person is not dealing

with the reality of the loss– Remains fixed in the denial stage of the grief process– Grief may be triggered much later in response to subsequent

loss– All the symptoms associated with normal grieving are

exaggerated.– The individual becomes incapable of managing activities of

daily living.– The individual remains fixed in the anger stage of the grief

process.– Depressed mood disorder is a type of distorted grief

response.

Page 8: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

• Chronic or prolonged grieving– A prolonged grief process may be considered

maladaptive when certain behaviors are exhibited• Behaviors aimed at keeping the lost loved

one alive• Behaviors that prevent the bereaved from

adaptively performing activities of daily living

Page 9: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

• One crucial difference between normal and maladaptive grieving– The loss of self-esteem does not occur in

uncomplicated bereavement– The loss of self- ultimately precipitates

depression

Page 10: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

Assessment

• Children• Adolescents• Elderly adults

Page 11: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

Nursing Diagnosis

Page 12: Grief and Loss Nursing 202. Loss is the experience of separation from something of personal importance. Loss is anything that is perceived as such by

HospicePalliative Care

• Palliative Care is management approach for end-of-life issues that prevents, relieves, reduces, and/or ease the symptoms of the disease without compromising medical interventions.

• Hospice Care is a comprehensive care delivery system for the terminally ill.


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