NurseReview.Org - Loss and Grief

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GRIEF AND LOSS Loss

is a universal experience that occurs throughout life span is a form of sorrow involving feelings, thoughts, and behaviors caused by bereavement

Grief

GRIEF AND LOSS Responses

to loss are strongly influenced by ones 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

GRIEF AND LOSSStages 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

Loss and grievingStages of Grieving by KubblerRoss DABDA DENIAL= refusal to believe ANGER= hostility BARGAINING= feeling of guilt, fear of punishment DEPRESSION= withdrawn behavior ACCEPTANCE= comes to terms

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

AGE

Death and Dying (Kozier) BeliefsNO clear concept of Death It is Reversible, Understands DEATH is temporarycan be FINAL but sleep AVOIDEDINEVITABLE Death is Understands own mortality Fears a lingering Death Attitude is influenced by religion Experiences peak of death anxiety Death as multiple meanings

Infancy to 5 years old 5 to 9 years 9-12 years 12-18 years 18-45 45-65 years 65 and above

Nurses

Nursing responsibilities In Death and dying

need to take time to analyze their own feelings about death before they can effectively help others with terminal illness

clients are: 2. To maintain PHYSIOLOGIC and PSYCHOLOGIC support 3. To Achieve a dignified and peaceful death 4. To maintain personal control

Nursing responsibilities In Death and dying dying The major goals for the

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

Interventions

D SUPPORTIVE A- PROVIDE STRUCTURE AND CONTINUITY B LISTEN AND ENCOURAGE D- ALLOW EXPRESSION AND PROVIDE FOR SAFETY A- ENCOURAGE PARTICIPATION