The Experience of Loss, Death, and Grief. 2 Loss Loss is any situation in which a valued object is...
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The Experience of Loss, Death, and Grief
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Transcript of The Experience of Loss, Death, and Grief. 2 Loss Loss is any situation in which a valued object is...
The Experience of Loss, Death, and Grief
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Loss Loss is any situation in which a valued
object is changed or is no longer accessible to the individual.
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LOSS
Actual
Perceived
External Objects
Known Environment
Significant Other
Aspect of Self
Life
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Loss occurs with the destruction of property. Think ofthe many losses that are experienced by the family whose home was destroyed in an earthquake
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Types of Loss
Maturational loss occurs as a result of moving from one developmental stage to another.
Situational loss occurs in response to external events.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Types of Loss
Actual loss Perceived loss Physical loss Psychological loss Categories of Loss
Loss of an external object Loss of familiar environment Loss of aspect of self Loss of significant other
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Types of Loss
Loss as CrisisLoss precipitates anxiety and a feeling of
vulnerability, which may lead to crisis.When an individual is overwhelmed and his or
her usual coping mechanisms are no longer effective, crisis occurs.
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Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Grief
Grief is a normal, natural, necessary, and adaptive response following a loss.Bereavement is the period of grief following a
significant loss, especially death of a person or pet.
Mourning is the period of time during which the grief is expressed.
Mourning is an adaptive response to loss.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Grief
Theories of the Grieving ProcessLindemann coined the phrase grief work.Engle described three stages of mourning.
Shock and Disbelief Developing Awareness Restitution and Resolution
Worden identified four tasks in dealing with a loss.
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Kubler-Ross Stages of Grief
Denial
Anger
Bargaining
Depression
Acceptance
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Stages of Grief
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Grief
Types of GriefUncomplicated griefDysfunctional griefAnticipatory grief
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Types of Grief
Persons experiencing dysfunctional grief do not progress through the stages of overwhelming emotions associated with grief, or they may fail to demonstrate any behaviors commonly associated with grief.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Types of Grief
Disenfranchised grief is grief experienced in situations where grief is discouraged and social supports are absent.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Types of Grief
Anticipatory grief is the occurrence of grief work before an expected loss.
Promotes adaptive grieving by freeing up the mourner’s emotional energy.
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Algorithm to help differentiate between preparatory grief and depression.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Factors Affecting Grief
Developmental ConsiderationsChildhoodAdolescenceEarly AdulthoodMiddle AdulthoodOlder Adulthood
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Children
Concept of death varies with the child’s developmental level.
Children need to be included in mourning rituals as appropriate to their developmental level.
Children need explanations about death that are honest and comprehensible.
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Adolescence
Adolescents perceive themselves as being invulnerable and death as something that will not happen to them.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Middle Adulthood
The death of peers forces acknowledgement of one’s own vulnerability to death.
Other losses during middle age are those associated with changes in employment and relationships.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Older Adulthood
Most older adults recognize the inevitability of death.
Older adults commonly experience the loss of loved ones and friends, occupational role, material possessions, dreams and hopes, and physical and cognitive function.
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Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Factors Affecting Grief
Religious and cultural beliefs Relationship with the lost entity Cause of Death
Anticipated deathUnexpected deathTraumatic deathSuicide
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Nursing Care of theGrieving Person Assessment
Determination of the personal meaning of the loss
Understanding that the stages of grief the client is experiencing are not necessarily sequential
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Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Nursing Care of theGrieving Person Nursing Diagnoses
Dysfunctional GrievingAnticipatory Grieving
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Outcome Identification and Planning Verbalization of feelings of grief Sharing grief with significant others Acceptance of the loss Renewal of activities and relationships
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
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Nursing Diagnoses
Powerlessness Helplessness High Risk for Spiritual Distress Altered Family Processes
