Grief, Loss, Spirituality
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Bereavement | The state of being without, absence of someone or something a person values or is attached to
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Mourning | the outward, social expression of loss (strongly influenced by culture)
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Grief | The response to loss
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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
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Anticipatory Grief | Grieving before a loss, fear of potential loss, provides time for preparataion
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Disenfranchied Grief | when a loss cannot be openly acknowledged, socially or publically shared. (miscarriage/War)
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Complicated grief | includes normal grief reactions but the reactions are intensified and prolonged.
-Interferes with physical, social , psychological functioning
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chronic grief | grief reactions that do not subside over time. Continue for long periods of time
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delayed grief | Reactions are suppressed/postponed. THe survivor conciously or unconciously aovids the pain of the loss
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exxagerated grief | Survivor resorts to self destructive behaviors ; eg. suicide
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masked grief | survivor is unaware that behaviors which are interfering with normal functioning are a result of a loss
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Signs of complicated grief | severe social withdrawl, loss of interest in self care, severe depression, suicidal ideation
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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
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Types of Death associated with Complicated grief | traumatic, sudden, unexpected, suicide, homicide, dependent relationships, chronically ill, children, multiple losses
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Signs of Grief in Younger children | nervousness, uncontrolled rages, antisocial behavior, nightmares, excessive dependency, frequent illnesses
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Signs of Grief in Older children | poor academic/social perforamce. Isolation, nutritional imbalances, sexual promiscuity, drugs/alcool, nightmares, talk/attempt suicide
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Kubler-Ross Stages of Grief | 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance
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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.
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Nursing Assessment of Grief Should Include | 1. type of grief 2. grief reactions 3. influencing factors 4. general health
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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
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Spirituality | unique to each person, religion/culture shade the experience
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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
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Created by:
MEPN 2013
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