- Absence of a possession or future possession - person, thing, relationship, job - real, perceived, anticipated
what is grief?
- The emotional response to the loss - Feeling felt by the individual = anger, depression, powerlessness, regret, guilt, loneliness
what is mourning? (2)
- Outward social expression of loss - Dictated by cultural norms, customs and practices
what is bereavement? (3)
- Includes grief and mourning - inner feelings & outer reactions - time to adjust to loss of person
what is the nurses role? (3)
1. Assess the grief = what type is being experienced? 2. Assist the patient with grief = loss of body part, control 3. Support survivors = let feel, express loss, complete task of grieving
What is the grief process? (5)
Begins before the death Not orderly or predictable Includes a series of stages or tasks No one "gets over it" Grief work leads to living with the loss
What is anticipatory grief? (4) ****
1. Grief before loss (**Ex. wife is crying) 2. Actual or fear of potential losses 3. Experienced by patient, family, professionals 4. Children have unique needs = fear of abandonment, contracting disease, they act out in school
What are the interventions of anticipatory grief? (6)
1. Education 2. Adaptive equipment 3. Reframing = minimize loss by finding gain 4. Life review = reminisce 5. Advanced directives = RN don't sign legal docs 6. Presence = active listening, touch & reassurance
What is normal grief (uncomplicated)? (3)
1. Normal feelings, behaviors and reactions to loss 2. Physical, emotional, cognitive and behavioral reactions 3. can take years to reconnect with the world
Complicated grief: chronic
Complicated grief: delayed
avoids pain of loss, avoids reminders
Complicated grief: exaggerated
intense reactions, nightmare, suicides, calling out for deceased
Complicated grief: masked
not aware of abnormal behaviors, imitate deceased, replace loss quickly
what are four complicated grief risk factors
Sudden or traumatic death Suicide, homicide Death of a child Multiple losses
what is disenfranchised grief & who is at risk?
When loss cannot be openly acknowledged or socially sanctioned At risk- AIDS partners, ex-spouse, step-parent/child, terminated pregnancy
what are the three stages & tasks of grief?
Stage 1 Notification and shock = No, not me Stage 2 Experience the loss =anger person who died or who cared for them. guilt, sadness Stage 3 Reintegration = reorganize & restructure family, ↑ energy, participate in life events
what are eight interventions for grief?
1. Presence = attitude, non-judgemental 2. Honor cultural norms 3. Encourage story telling 4. Listen 5. express feelings 6. active listening 7. silence 8. support systems
what is cumulative loss? (4)
1. succession of losses 2. dont' have time to process the loss 3. personal life changes 4. expected to be in control
What are seven frequent symptoms in the last 48 hours?