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EXAM 2 MENTAL HEALTH
Grief & Loss
| Question | Answer |
|---|---|
| Mourning Rituals | Funerals, wakes, sitting (shiva-Jewish faith)m and all religious/cultural ceremonies |
| Grief | The subject symptoms and affects that are a normal response to the experience of a loss |
| Anticipatory Grieving | When people facing imminent loss begin to grapple with the possibility of the loss or death in the near future. They are already mourning, before the actual loss |
| Mourning | The outward expression of grief |
| Physiologic Loss | Examples include amputation of a limb, a mastectomy or hysterectomy, or loss of mobility |
| Grieving Tasks | Recognize, React, Recollect/Re-experience, Relinquish, Readjust, Reinvest |
| Recognize | Experiencing the loss. Understanding it is real, and it has happened |
| React | Emotional responses to the loss, feeling the feelings |
| Recollect/Re-Experience | Memories are reviewed and relived |
| Relinquish | Accepting that the world has changed (as a result of the loss), and that there is no turning back |
| Readjust | Beginning to return to daily life. Loss feels less acute and overwhelming |
| Reinvest | Accepting changes that have occurred, re-entering the world, forming new relationships and commitments |
| Loss of security & a sense of belonging | Changes in relationships (birth, marriage, divorce, illness, death). When a loved one dies it affects the need to love |
| Loss of self-esteem | Losing a job, retirement, broken relationship. |
| Loss of Self-Actualization | External or internal crisis that blocks or inhibits striving toward fulfillment that may threaten personal goals and individual potential such as failing a class, or failing NCLEX |
| Bereavement | The process by which a person experiences grief, often from the result of losing someone very close, such as a spouse |
| Denial | Shock or disbelief regarding the loss |
| Anger | Expressed towards God, relatives, friends, or health care providers |
| Bargaining | Occurs when the person asks God or fate for more time to delay the inevitable loss |
| Depression | Results when awareness of the loss becomes acute |
| Acceptance | Occurs when the person shows evidence of coming to terms with the death |
| Shock & Disbelief | Initial reaction, stunned, numb feelings accompanied by the refusal to acknowledge the reality of the loss in an attempt to protect the self against overwhelming stress |
| Developing Awareness | The individual begins to acknowledge the loss. There may be crying, feelings of helplessness, frustration, despair, and anger that can be directed at self or others, including God or the deceased |
| Restitution | Participation in the rituals associated with death, such as funerals, wake, family gathering, or religious ceremonies. They help the individual accept the reality of the loss and begin the recovery process |
| Resolution | Individual is preoccupied with the loss. The lost person or object is idealized, and the mourner may even imitate the lost person. Eventually the preoccupation decreases, usually in a year or more |
| Recovery | Previous preoccupation and obsession ends. The individual is able to go on with life in a way that encompasses the loss |
| Acculturation | Altering ones values or behaviors as a way to adapt to another culture |
| African Americans and Loss | Tied to religious traditions. Typically deceased are seen in a church before burial in a cemetery. Mourning may be expressed through public prayer, black clothing, and decreased social activities |
| Muslim Americans and Loss | Does not permit cremation. Crucial to follow the five steps of the burial procedure (Washing, dressing, and positioning). They must be washed by someone of the same culture and gender |
| Haitian Americans and Loss | Practice Vodun (Voodoo or root medicine). The practice of calling on a group of spirits with whom one periodically makes peace during specific events in life, such as the death of a loved one |
| Chinese Americans and Loss | Strict norms for announcing death, preparing the body, arranging the funeral and burial, and mourning after burial. Burn incense, and read scriptures, are used to assist the spirit of the deceased in the afterlife |
| Japanese Americans and Grief | View death as a life passage. Close family members may bathe the deceased with warm water and dress the body in a white kimono after purification rites. For 2 days, family and friends come bearing gifts, and may visit with money for the deceased while saying prayers and burning incense |
| Buddhists and Grief | Essential to meditate before a shrine in the room |
| Filipino Americans and Grief | Depending on how close they are to the deceased, they wear black clothing or armbands in customary during mourning. Family and friends place wreaths on the casket and drape a broad black cloth on the home of the deceased. Family member commonly place announcements in local newspapers asking for prayers and blessings on the soul of the deceased |
| Vietnamese Americans and Grief | Predominately Buddhists, who bathe the deceased and dress them in white clothes. They may place a few grains of rice in the mouth and place money with the deceased so they can buy a drink as they move to the afterlife. Body may be displayed for viewing before burial. When friends enter, music is played as a way to warn the deceased of their arrival |
| Hispanic Americans and Grief | They may pray for the soul of the deceased during novena (9-day devotion) and a rosary (devotional prayer). They manifest luto (mourning) wearing black or black and white while behaving in a subdued manner. Respect for the deceased may include not watching TV, or going to the movies, or listening to the radio, or attending dances and other social events for some time. Friends and relatives bring flowers and crosses to decorate the grave |
| Native Americans and Grief | Baptism. Death is viewed as a state of unconditional love in which the spirit of the deceased remains present, comforts the tribe, aProper mourning is essential for the soul of the deceased and for protection of the tribe. Burial designates the end of mourning and the grave is covered with a blanket or cloth for making clothes. Later the cloth is given to a tribe member, a dinner featuring singing, speeches, and contributing money completes the ceremony |
| Which culture has conflicting beliefs of death | Native Americans. Some views are that the belief in and fear of ghosts and believing in death signifies the end of all that is good. - While another belief is that belief in a happy afterlife called the "land of the spirits" |
| Guatemalan Americans and Grief | May include marimba band in the funeral procession and services. Lighting candles and blessing the deceased during a wake in the home are common |
| Orthodox Jews Americans and Grief | Custom is for a relative to stay with the dying person, so the person is not alone when the soul leaves the body. It is disrespectful to leave the body alone during death |
| Universal Responses to Grief | Initially shocked, disorientation, attempts to continue relationship with deceased. Anger with those perceived as responsible for the death, and a time for mourning. |
| Cognitive Responses to Grief | Questioning and trying to make sense of a loss. Attempting to keep the lost one present. May alter views, opinions, and may view the world more realistically while re-evaluating religious or spiritual beliefs. |
| Emotional Responses to Grief | May gull over things that were not done or not said in the relationship. Often express anger, sadness, and anxiety as a response to the loss. |
| Spiritual Responses to Grief | May find comfort, and be angry with. May develop a feeling of anguish and abandonment, loss of hope, or loss of meaning can lead to deeper spiritual suffering |
| Behavioral Responses to Grief | May be numb and function automatically. Others may be tearfully sobbing, crying uncontrollably, showing great restlessness, searching, and hoarding deceased belongings. Some also may abuse drugs and alcohol |
| Physiological Responses to Grief | Anxiety, insomnia, headaches, impaired appetite, weight loss, lack of energy, palpitations, indigestion, and changes in immune and endocrine systems |
| Disenfranchised Grief | Greif over a loss that is not or cannot be acknowledged openly, mourned publicly, or supported socially |
| Examples of Disenfranchised Grief | Relationships that have no legitimacy, loss itself is not recognized by others, griever is not recognized, or loss involves social stigma |
| Complicated Grieving | Person void of emotion, grieving is prolonged, expressions of grief seem disproportionate to event. Previously existing psychiatric orders may complicate process. Clients can experience grief when a change is encountered |
| Characteristics of Complicated Grieving | Low self-esteem, low trust in others, previous psychiatric disorders, previous suicide threats or attempts, absent or unhelpful family members, ambivalent, dependent, insecure attachment to deceased person |
| Risk Factors for Complicated Grieving, Leading to Invulnerability | Death of a spouse or child, death of a parent (especially in young children), sudden and unexpected deaths, untimely death, multiple deaths, death by suicide. Maladaptive thoughts, dysfunctional behaviors, and inadequate emotional regulation |
| What are the three critical components in assessment of the dimensions of grieving | Adequate perception of the loss, adequate support while grieving, and adequate coping behaviors during the process of grieving |
| Examples of the outcomes of a client in the grieving process | Identifying the effects and meaning of the loss. Seek adequate support while expressing grief. Develop a plan for coping with the loss. Apply effective coping strategies while expressing and assimilating all dimensions of the human response to a loss. Recognize the negative effects of the loss, and seek or accept progression assistance if needed to promote the grieving process |
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