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GRIEF AND LOSS
Loss is a universal experience that occurs throughout life span
Grief is a form of sorrow involving feelings, thoughts, and behaviors caused by bereavement
GRIEF AND LOSS
Responses to loss are strongly influenced by one’s cultural background
The grief process involves a sequence of affective, cognitive, and psychological states as a person responds to, and finally accepts a loss.
Loss and grieving
LOSS= something valuable is goneGRIEF= total response to emotional
experience related to lossBEREAVEMENT= Subjective
response by loved-onesMOURNING= behavioral response
GRIEF AND LOSSGRIEF AND LOSSStages of Grieving (Kubbler-Ross)Stages of Grieving (Kubbler-Ross) Denial- refuses to believe that the loss Denial- refuses to believe that the loss
has occurredhas occurred Anger- the individual resists the loss Anger- the individual resists the loss
and may “act out” feelings.and may “act out” feelings. Bargaining- the individual attempts to Bargaining- the individual attempts to
make a deal in an attempt to postpone make a deal in an attempt to postpone the reality of loss.the reality of loss.
Depression- overwhelming feeling of Depression- overwhelming feeling of loneliness and withdrawal from othersloneliness and withdrawal from others
Acceptance- the individual comes to Acceptance- the individual comes to terms with loss, or impending loss, terms with loss, or impending loss, psychological reactions to loss to the psychological reactions to loss to the loss cease, and the interaction to other loss cease, and the interaction to other people resumedpeople resumed..
Loss and grieving
Stages of Grieving by Kubbler-RossDABDADENIAL= refusal to believeANGER= hostilityBARGAINING= feeling of guilt, fear of
punishmentDEPRESSION= withdrawn behaviorACCEPTANCE= comes to terms with loss
Loss and grievingStages Behaviors
D Refuses to believe that loss is happening
A Retaliation
B Feelings of guilt, punishment for sins
D Laments over what has happened
A Begins to plan like wills, prosthesis
Death and Dying (Kozier)AGE Beliefs
Infancy to 5 years old NO clear concept of Death
It is Reversible, temporary sleep
5 to 9 years Understands DEATH is FINAL but can be AVOIDED
9-12 years Death is INEVITABLE
Understands own mortality
12-18 years Fears a lingering Death
18-45 Attitude is influenced by religion
45-65 years Experiences peak of death anxiety
65 and above Death as multiple meanings
Nursing responsibilities In Death and dyingNurses need to take time to analyze
their own feelings about death before they can effectively help others with terminal illness
Nursing responsibilities In Death and dying
The major goals for the dying clients are:1. To maintain PHYSIOLOGIC and
PSYCHOLOGIC support2. To Achieve a dignified and peaceful death3. To maintain personal control
Loss and Death RESPONSIBILITIES
Provide Relief from loneliness, fear and depression
Help clients maintain sense of security Help clients accept losses Provide physical comfort
LOSS ,GRIEVING AND DEATH DEATH CONCEPTS
– 1-5 – IMMOBILITY AND INACTIVITY Wishes and unrelated action responsible for action
– 5-10 – final but can be avoided– 9-12 – understands own mortality and fears death– 12 – 18 – fears and fantasizes avoidance– 18-45 – increased attitude awareness– 45-65 – accepts mortality– Above 65 – multiple meanings, encounters and fears
Interventions
D – SUPPORTIVE
A- PROVIDE STRUCTURE AND CONTINUITY
B – LISTEN AND ENCOURAGE
D- ALLOW EXPRESSION AND PROVIDE FOR SAFETY
A- ENCOURAGE PARTICIPATION