Loss And Grief

Slide 2: 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

Slide 3: 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.

Slide 4: 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

Slide 5: 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.

Slide 6: 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DABDA DENIAL= refusal to believe ANGER= hostility BARGAINING= feeling of guilt, fear of punishment DEPRESSION= withdrawn behavior ACCEPTANCE= comes to terms with loss

Slide 7: Loss and grieving Stages 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

Slide 8: Death and Dying (Kozier) AGE Beliefs Infancy to 5 years old NO clear concept of Death It is Reversible, temporary sleep Understands DEATH is FINAL but can 5 to 9 years be AVOIDED Death is INEVITABLE 9-12 years 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

Slide 9: 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

Slide 10: Nursing responsibilities In Death and dying The major goals for the dying clients are:  2. To maintain PHYSIOLOGIC and PSYCHOLOGIC support 3. To Achieve a dignified and peaceful death 4. To maintain personal control

Slide 11: Loss and Death RESPONSIBILITIES  Provide Relief from loneliness, fear and depression  Help clients maintain sense of security  Help clients accept losses  Provide physical comfort

Slide 12: 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

Slide 13: Interventions D – SUPPORTIVE  A- PROVIDE STRUCTURE AND CONTINUITY  B – LISTEN AND ENCOURAGE  D- ALLOW EXPRESSION AND PROVIDE FOR SAFETY  A- ENCOURAGE PARTICIPATION 