Grief and Loss

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

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.

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 gone GRIEF= total response to emotional experience related to loss BEREAVEMENT= Subjective response by loved-ones MOURNING= behavioral response

LOSS= something valuable is gone

GRIEF= total response to emotional experience related to loss

BEREAVEMENT= Subjective response by loved-ones

MOURNING= behavioral response

GRIEF AND LOSS Stages of Grieving (Kubbler-Ross) Denial- refuses to believe that the loss has occurred Anger- the individual resists the loss and may “act out” feelings. Bargaining- the individual attempts to make a deal in an attempt to postpone the reality of loss. Depression- overwhelming feeling of loneliness and withdrawal from others Acceptance- the individual comes to terms with loss, or impending loss, psychological reactions to loss to the loss cease, and the interaction to other people resumed .

Stages of Grieving (Kubbler-Ross)

Denial- refuses to believe that the loss has occurred

Anger- the individual resists the loss and may “act out” feelings.

Bargaining- the individual attempts to make a deal in an attempt to postpone the reality of loss.

Depression- overwhelming feeling of loneliness and withdrawal from others

Acceptance- the individual comes to terms with loss, or impending loss, psychological reactions to loss to the loss cease, and the interaction to other people resumed .

Loss and grieving Stages of Grieving by Kubbler-Ross DABDA DENIAL= refusal to believe ANGER= hostility BARGAINING= feeling of guilt, fear of punishment DEPRESSION= withdrawn behavior ACCEPTANCE= comes to terms with loss

Stages of Grieving by Kubbler-Ross

DABDA

DENIAL= refusal to believe

ANGER= hostility

BARGAINING= feeling of guilt, fear of punishment

DEPRESSION= withdrawn behavior

ACCEPTANCE= comes to terms with loss

Loss and grieving Begins to plan like wills, prosthesis A Laments over what has happened D Feelings of guilt, punishment for sins B Retaliation A Refuses to believe that loss is happening D Behaviors Stages

Death and Dying (Kozier) Death as multiple meanings 65 and above Experiences peak of death anxiety 45-65 years Attitude is influenced by religion 18-45 Fears a lingering Death 12-18 years Death is INEVITABLE Understands own mortality 9-12 years Understands DEATH is FINAL but can be AVOIDED 5 to 9 years NO clear concept of Death It is Reversible , temporary sleep Infancy to 5 years old Beliefs AGE

Nursing responsibilities In Death and dying Nurses need to take time to analyze their own feelings about death before they can effectively help others with terminal illness

Nurses 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: To maintain PHYSIOLOGIC and PSYCHOLOGIC support To Achieve a dignified and peaceful death To maintain personal control

The major goals for the dying clients are:

To maintain PHYSIOLOGIC and PSYCHOLOGIC support

To Achieve a dignified and peaceful death

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

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

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

D – SUPPORTIVE

A- PROVIDE STRUCTURE AND CONTINUITY

B – LISTEN AND ENCOURAGE

D- ALLOW EXPRESSION AND PROVIDE FOR SAFETY

A- ENCOURAGE PARTICIPATION

End