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Grief, Loss, Spirituality

Bereavement The state of being without, absence of someone or something a person values or is attached to
Mourning the outward, social expression of loss (strongly influenced by culture)
Grief The response to loss
Normal Grief physical (loss of aptetite, weight gain/loss, headache, lack of energy, etc), Emotional ( shame, relief, sadness, anger), Congntive (confusion, disbelief, dreams, inability to concentrate) & Behavioral (seeking reminders,role changes) reactions to loss
Anticipatory Grief Grieving before a loss, fear of potential loss, provides time for preparataion
Disenfranchied Grief when a loss cannot be openly acknowledged, socially or publically shared. (miscarriage/War)
Complicated grief includes normal grief reactions but the reactions are intensified and prolonged. -Interferes with physical, social , psychological functioning
chronic grief grief reactions that do not subside over time. Continue for long periods of time
delayed grief Reactions are suppressed/postponed. THe survivor conciously or unconciously aovids the pain of the loss
exxagerated grief Survivor resorts to self destructive behaviors ; eg. suicide
masked grief survivor is unaware that behaviors which are interfering with normal functioning are a result of a loss
Signs of complicated grief severe social withdrawl, loss of interest in self care, severe depression, suicidal ideation
Risk Factors for Complicated grief concrrent stressors, hx of mental illness, hx of substance abuse, poor symptom managment. poor support systems, no faith, no cultural support
Types of Death associated with Complicated grief traumatic, sudden, unexpected, suicide, homicide, dependent relationships, chronically ill, children, multiple losses
Signs of Grief in Younger children nervousness, uncontrolled rages, antisocial behavior, nightmares, excessive dependency, frequent illnesses
Signs of Grief in Older children poor academic/social perforamce. Isolation, nutritional imbalances, sexual promiscuity, drugs/alcool, nightmares, talk/attempt suicide
Kubler-Ross Stages of Grief 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance
Tasks of Mourning 1. accepting reality of loss 2. working through pain/grief 3. adjusting to environment without deceased 4. emotionally relocates deceased, moves on.
Nursing Assessment of Grief Should Include 1. type of grief 2. grief reactions 3. influencing factors 4. general health
Nursing Interventions for survivors provide presence, listen, touch, silence, let them tell story;encourage reflections, identify feelings, normalize grief, identify support systems, facilitate living, provide spiritaul care, connect to resources
Spirituality unique to each person, religion/culture shade the experience
Nursing Interventions r/t spirituality listen more;talk less, be present, avoid judgement, withold one's own beliefs, avaoid discussion of doctrine, accept participation invidiations, support the patients own spirituality
Created by: MEPN 2013