greif and loss

6 different types of experiencing loss
Necessary,perceived, situational, actual, maturational, ultimate
Go away to college, leave friends behind, death of a loved one
Less obvious but real to the person
Results in a sudden, unpredictable life event. ex. divorce.
Loss of a body part, pet, friend, life partner ,or if material items are worn out or lost in a natural disaster
they can no longer touch, feel, see or hear valued people or objects.
Due to developmental changes, such as growing up and growing older. ex. child going to school for the first time.
Death is the ultimate loss as relationships with family and friends are ended.
emotional response to a loss, manifested in ways unique to an individual , based on personal experiences, cultural expectations, and spiritual beliefs.
includes grief and mourning, inner feeling and outward behaviors of a survivor. close family member
conscious, and unconscious behavior associated with loss. saddness.
4 types of grief
normal (uncomplicated), complicated, anticipatory, disenfranchised.
normal (uncomplicated)
commonly expected emotions and behavior. ex. crying, loniless. sadness, anger.
includes chronic, delayed, exaggerated,and masked. person doesnt accept reality of death. "get past"
the process of letting go. occurs before actual loss or death. when a patient has a diagnosis of terminal ill family begins to say their good byes. in situation of long illness or Alzheimer's. person moving and leaving friends behind.
experience a loss, but will not publicly acknowledge. death of ex- spouse or early misscarriage. keeps the grief hidden, often lack of social support. Certain situations : abortion, suicide, giving up a child for adoption.
type of complicated. on going. greif doesnt decrease and continues over time cant "get past"
type of complicated grief. years later. avoids pain of loss doesnt have common reaction at time of death
type of complicated grief. unrecognized. express thru another behavior- parents yelling at each other after child death, behavior due to grief but don't recognize it
type of complicated greif. overehelmed by loss cant function deep depression. grief alcoholism, drugs. they dont have good ability to cope
factors influencing loss and grief
Human development- age and stage of development determine her ability to understand loss.
Socioeconomic status- influences a persons access to a persons resources and support.
Nature of personal relationships- knowing what relationship the person hadcan better help the person cope with loss.
Nature of loss- the bigger the loss the more support.
Culture and ethnicity- mexicans like the whole family there
Spiritual beliefs- tend to do better with losses
Hope- tend to do better with losses.
Nature of the loss
Significance of loss
Support system
Cause of death
Kübler-Ross Stages of grief
Denial- often people start in this stage. disbelief.

Anger- common. " Why did god do this to me!?"

Bargaining- "If i can live till june, I can go to my daughter's wedding"

Depression- sucidiual?

Acceptance- I know I only have 6 months to live, I need to take care of some things.

This theory was developed in 1969. This is a behavior oriented model that includes five stages. The theory can be applied to any person undergoing a significant loss.
(Bowlby's Phases of Mourning)
This theory was developed in 1980.
Numbing "I can't believe"- feeling stunned or unreal
Yearning and searching- Outbursts, tearful sobbing, acute distress
Disorganization and despair- Think about how and why the loss occurred sense-making"
Reorganization- Acceptance of unaccustomed role, acquire new skills, build new relationships
yearning and searching
evokes emotional outbursts, tearful sobbing, and acute distress. Theorists explain that in order to move forward, bereaved persons must experience this painful phase of grief. Common symptoms: tightness in the chest and throat, shortness of breath, a feeling of weakness and lethargy, insomnia, and loss of appetite. Lasts for months or, intermittently, for years
a person has periods of extremely intense emotion and reports feeling "stunned" or "unreal", can last for several hours to 1 week.
final phase, usually requires a year or more, the person begins to accept unaccustomed roles, acquire new skills, and build new relationships.
Palliative care
focuses on the prevention, reduction, or relief of physical, emotional, social, and spiritual symptoms of disease or treatment at the end of life when cure is no longer possible.managing symptoms of patients who diseases prcoess no longer respond to treatment. DOESNT HAVE TO BE IN AN ACTIVELY DRYING PHASE. care over a long period of time.
why is kubler ross stages of grief important
sets frame work for ID where people are at with the grief process. gives ability to acess and document where they are in grief use that info to set goals and development plan of care.
Advance directives
provide people with a means to communicate their health care wishes, including end-of-life care, when they can no longer participate in decision making.
Hospice care
provides services for patients who are at the end of life. less than 6 months certified by 2 MD's. 100% reimbursed Medicare. provides support to family for upto 1 yr after death.
Postmortem care
care of the body after death
the surgical dissection of a body after death to determine cause of death, how the person died, or to contribute to knowledge of the disease.
assess stage of grief
ask patient how are you feeling right now.
health care power of attorney
a legal document that allows another person to make health care decisions for the patient, including withdrawel or withholding of care, when a patient is incapacitated
living will
should i become ill where 2 doctors think my illness is terminal then... DNR etc....
symptoms of end-of-life
restlessness, oral intake decreasesm disorientatio, decreaed circulation (yellowish tinge to skin) coolness of extremities, loss of muscle tone, incontinence, sensory impairment- not verbal but can still hear. cheyne stokes- respiration or death rattle.
autotopsy prohibited by what culturals?
eastern orthodox, muslims, Jehovah's witness, and orthodox jews.
organ donations prohibited by what religions?
Jehovah's witness and muslims
organ donations encouraged by which religions?
Buddhists in America.
opposed by many religions.