1. Dr. BC Farnham & Elizabeth R. Pugh, LBSW.
Understanding Grief and its Impacts on Patients, Family Members and Medical Staff
Dr. BC Farnham & Elizabeth R. Pugh, LBSW.
This program is made possible through a collaborative community-education partnership between The Consortium for Advancements in Health & Human Services, Inc. and the presenting agency. The primary goal of this effort is to increase public awareness and access to hospice care, through the provision of community-based education. Contact Hours are awarded to professionals who complete this program by The Consortium for Advancements in Health & Human Services, Inc.

2. Important Information
This education program for healthcare professionals was developed by The Consortium for Advancements in Health and Human Services, Inc. (CAHHS) and is facilitated by the presenting agency via a community education partnership agreement. CAHHS is a private corporation and is solely responsible for the development, implementation and evaluation of its educational programs. There is no fee associated with receiving contact hours for participating in this program titled, Understanding Grief and its Impacts on Patients, Family Members and Medical Staff. However, participants wishing to receive contact hours must offer a signature on the sign-in sheet, attend the entire program and complete a program evaluation form.
The Consortium for Advancements in Health and Human Services, Inc. is an approved provider of continuing nursing education by the Alabama State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. The Consortium for Advancements in Health & Human Services, Inc., is approved as a provider of continuing education in Social Work by the Alabama Board of Social Work Examiners, #0356, Expiration Date: 10/31/2018.
In most states, boards providing oversight for nursing and social work recognize contact hours awarded by organizations who are approved by another state's board as a provider of continuing education.  If you have questions about acceptance of contact hours awarded by our organization, please contact your specific state board to determine its requirements. Provider status will be listed on your certificate.
CAHHS does not offer free replacement certificates to participants. In the event that CAHHS elects to provide a replacement certificate, there will be a $20.00 administrative fee charged to the individual who requests it.

3. Learning Objectives:
Participants completing this program will be able to:
Review the definitions of grief and anticipatory grief.
Review how grief effects patients, family members and medical staff.

4. What is Grief? Grief is your emotional reaction to a significant loss.
Grief is a natural part of life.
Grief is the typical reaction to death, divorce, job loss, a move away from friends and family, or loss of good health due to illness.

5. Grief Hurts Because of the Love Behind It

6. What is Anticipatory Grief?
Anticipatory grief is grief that happens in advance of an impending loss.
Anticipatory grief may be felt for a loved one who is sick and dying.
Anticipatory grief helps to prepare for the final loss.

7. Grief You feel grief all over Physical Emotional Spiritual
Psychological
Social

8. How does grief feel?
Just after a death or loss, one may feel empty and numb, as if they are in shock.
Physical Changes include:
Trembling
Nausea
Trouble breathing
Muscle weakness
Dry mouth
Trouble sleeping and eating

9. How does grief feel?
One may become angry. This can be at a situation, a particular person, or just angry in general.
One may feel guilt
Guilt is often expressed as
I could have, I should have, I wish I would have
People in grief may have strange dreams or nightmares, be absent-minded, withdraw socially, or lack the desire to return to work.

10. How does grief feel?
During grieving one may also experience moments of:
Relief
Peace
Happiness

11. Everyone grieves differently
Grieving is a personal and individualized experience. How one grieves depends on many factors to include:
Personality
Coping style
Life experience
Faith
Nature of the loss

12. Everyone grieves differently
The grieving process takes time and healing happens gradually.
There is no “normal timetable for grieving”
Some start to feel better in weeks or months. For some the grieving process is measured in years.

13. Grief is a Journey
Grieving is not a straight line, but a series of steps forward, sideways, upside down, and backwards until recovery is reached.

14. Tasks of Grieving

15. Every person who experiences a death or a loss must complete a four-step grieving process
Accept the loss
Work through and feel the physical and emotional pain of grief
Adjust to living in a world without the person or item lost
Move on with life

16. Grief & Depression
Distinguishing between grief and clinical depression isn’t always easy.
Grief is a roller coaster and involves a wide variety of emotions and a mix of good and bad days.
Symptoms that suggest depression, not just grief:
Intense pervasive sense of guilt
Thoughts of suicide or preoccupation with dying
Feelings of hopelessness or worthlessness
Slow speech and body movements
Inability to function at work, home, and/or school
Seeing or hearing things that aren’t there

17. How Grief Affects You as a Professional
Causes you to look at your own mortality
Causes either:
Hardening of the heart
More sensitive heart
Produces growth:
Emotionally and spiritually

18. Six Common Responses to Patient Loss
Tears
Attempt to hold feelings in
Anxiety
Desire to talk about patient’s death with another team member
Temptation to just laugh it off and act as if everything is fine
Need for time to process

19. How to Help Team Members Manage Grief
Listen, Listen
Presence
Understanding

20. Dealing with Bereaved Families
Pitfalls or Things To Avoid
“I know how you feel”
“He’s in a better place”
“It’s part of God’s plan”

21. Myths and Facts about Grief:
MYTH: The pain will go away faster if you ignore it.
FACT: Trying to ignore your pain or keep it from surfacing will only make it worse in the long run. For real healing it is necessary to face your grief and actively deal with it.
MYTH: It’s important to “be strong” in the face of loss.
FACT: Feeling sad, frightened, or lonely is a normal reaction to loss. Crying doesn’t mean you are weak. You don’t need to “protect” your family or friends by putting on a brave front. Showing your true feelings can help them and you.

22. Myths and Facts about Grief:
MYTH: If you don’t cry, it means you aren’t sorry about the loss.
FACT: Crying is a normal response to sadness, but it’s not the only one. Those who don’t cry may feel the pain just as deeply as others. They may simply have other ways of showing it.
MYTH: Grief should last about a year.
FACT: There is no right or wrong time frame for grieving. How long it takes can differ from person to person.

23. References
Coping with grief and loss: Support for grieving and bereavement (n.d.). Retrieved August 5, 2010 from: Helpguide.org website mental/grief_loss.html
Grief and grieving: Managing sadness and depression signs (2009). Retrieved August 5, 2010 from WebMD website: tc/grief-and-grieving-topic-overview
How to deal with grief. (n.d.). Retrieved August 5, from National Mental Health Information Center website: publications/allpubs/ken /