1. Types of Loss Material loss: loss of physical object or surroundings
Relationship loss : end of opportunities to relate
Functional loss: loss of muscular or neurological function
Role loss: loss of specific social role or identity
Intrapsychic loss: loss of what might have been
Systemic loss: disturbance of social system

2. Reactions to Loss Denial, shock Anger and guilt Sadness and depression
Reconciliation and acceptance
Reattachment

3. Shock/Denial
Associated with feelings of numbness, disbelief,
disorientation, sleeplessness, searching.
Anger/Guilt
Associated with restlessness or over activity alternating with apathy, fury, blaming self & others, reproach, recrimination, fantasies of violence and retaliation. Ambivalence/mood swings.

4. Sadness/depression
Associated with exhaustion, poor general health, diminution of senses, failure to care for self, weeping regression, loss of confidence.
Acceptance/reconciliation
Return of energy & senses, realism good & bad of lost person or experience
Occasional good days, jokes; feeling of coming back to life

5. Reattachment
Feeling of ‘coming back’ to oneself, ability to join others, renewal of energy and identity; able to take initiative

6. Factors affecting responses to loss
Individual resilience
Level and quality of support from others
Previous experience of managing losses well
The meaning or sense made of the loss
Number of previous experiences of loss