Loss, Grief, and Bereavement Chapter 16 Loss, Grief, and Bereavement Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Objectives List the normal losses that occur during the stages of the life cycle. State how the response to normal losses influences responses to loss of life. Explain the difference between grief, mourning, and bereavement. List the stages and tasks of the grieving process. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Objectives (cont.) Describe an emotional, cognitive, and behavioral response to grief. State two religious and two cultural practices related to death. List two components of an abnormal grief response. State the response to loss and grief at different development stages within the lifespan. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Objectives (cont.) Discuss the achievement of the letting go phase of the grief process. State four ways condolences can be expressed. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Key Terms anticipatory grief bereavement condolence culture eulogy funeral grief legacy mourning Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. The Concept Of Loss Loss is a natural part of life Often painful and requires difficult adjustments Loss occurs at almost every stage of life Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Normal Losses During The Life Cycle Newborn’s loss of security of the womb Toddler’s loss of being exclusive focus when a sibling arrives Puberty involves the loss of perceived body image of adulthood Teen’s loss of security when leaves for college Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Abnormal Or Atypical Losses Pearl Harbor bombed World Trade Center and Pentagon attack Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 1 Why does it frequently take years for surviving family members to recover from a community or national disaster? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Responses To Loss Must learn how to cope with disappointments Attitude toward loss often determines the quality of life that is maintained Response to normal losses determines how losses are perceived and managed in old age Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Tasks Associated With Death Hospice movement has enabled the terminally ill to experience the task of dying with dignity Legacy may give the person a felling of immortality Spiritual connection Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 2 What verbal or nonverbal cues could the nurse identify to determine how a dying person is coping with the tasks of death? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Grief Grief Process Culture, Religion, and Death Normal Grief Responses Dysfunctional Grieving See Tables 16-1,16-2,16-3 and Boxes 16-1 and 16-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 3 How does death by suicide affect the normal grieving process in survivors? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Role of the Health-Care Worker Focus of care is on the patient and the family unit Cultural competence is the key to successful communication and support See Table 16-4. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 4 In some cultures, loud vocalizations accompany the death of a loved one. What interventions may be used to accommodate these families in their distress if death occurs in a hospital or other health care institution? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Tasks of the Family Preparing for a funeral Eulogy Reorganization of roles Respond to needs of young children Assess resources Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Grief Early In The Life Cycle Pregnant Women Infants Children Adolescents Young Adults See Figure 16-2 and Box 16-3. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 5 How can nurses and health care workers intervene if the survivor has no close family or other apparent support system? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 6 Feelings of loss and grief due to a miscarriage are often overlooked by health care providers. What assessments should be made by the nurse and what interventions could be done to help the mother and family cope with this loss? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. The Healing Process Reintegration and Adjustment Mastering Tasks Leading Toward Grief Healing Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 7 What would you say about “letting-go” to a friend who has recently lost a spouse? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Helping Grieving Survivors Condolence Grief experience is life changing Goal is to move successfully into a new life that includes many changes Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 8 How would you respond to someone who asks you what to say to or do with the newly bereaved? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.