GRIEF AND LOSS

 Lossis a universal
experience that occurs
throughout life span

 Griefis a form of sorrow

involving feelings, thoughts,
and behaviors caused by
bereavement
 GRIEF AND LOSS

 Responses to loss are strongly

influenced by one’s cultural
background
 The grief process involves a
sequence of affective, cognitive,
and psychological states as a
person responds to, and finally
accepts a loss.
 Loss and grieving
 LOSS= something valuable
is gone
 GRIEF= total response to
emotional experience
related to loss
 BEREAVEMENT=
Subjective response by
 GRIEF AND LOSS
Stages of Grieving (Kubbler-Ross)
 Denial- refuses to believe that the
loss has occurred
 Anger- the individual resists the
loss and may “act out” feelings.
 Bargaining- the individual attempts
to make a deal in an attempt to
postpone the reality of loss.
 Depression- overwhelming feeling
of loneliness and withdrawal from
others
 Acceptance- the individual comes
to terms with loss, or impending
loss, psychological reactions to loss
Loss and grieving
Stages of Grieving by Kubbler-
Ross
DABDA
DENIAL= refusal to believe
ANGER= hostility
BARGAINING= feeling of guilt, fear
of punishment
DEPRESSION= withdrawn
behavior
ACCEPTANCE= comes to terms
 Loss and grieving
Stages Behaviors

D Refuses to believe
that loss is
A happening
Retaliation
B Feelings of guilt,
punishment for sins
D Laments over what
has happened
A Begins to plan like
wills, prosthesis
 Death and Dying
AGE
(Kozier) Beliefs
Infancy to 5 years old NO clear concept of
Death
5 to 9 years It is Reversible,
Understands DEATH is
temporary sleep
FINAL but can be
9-12 years AVOIDED
Death is INEVITABLE
Understands own
12-18 years mortality
Fears a lingering Death

18-45 Attitude is influenced by

religion
45-65 years Experiences peak of death
anxiety
65 and above Death as multiple
meanings
Nursing
responsibilities In
Death and dying
 Nurses need to take time
to analyze their own
feelings about death
before they can
effectively help others
with terminal illness
 Nursing
responsibilities In

Death and dying
The major goals for the dying
clients are:
2. To maintain PHYSIOLOGIC
and PSYCHOLOGIC support
3. To Achieve a dignified and
peaceful death
4. To maintain personal control
 Loss and Death
RESPONSIBILITIES
 Provide Relief from loneliness,
fear and depression
 Help clients maintain sense of
security
 Help clients accept losses
 Provide physical comfort
 LOSS ,GRIEVING AND
DEATH
 DEATH CONCEPTS
– 1-5 – IMMOBILITY AND INACTIVITY
Wishes and unrelated action
responsible for action
– 5-10 – final but can be avoided
– 9-12 – understands own mortality
and fears death
– 12 – 18 – fears and fantasizes
avoidance
– 18-45 – increased attitude
awareness
– 45-65 – accepts mortality
 Interventions
 D – SUPPORTIVE

 A- PROVIDE STRUCTURE AND

CONTINUITY

 B – LISTEN AND ENCOURAGE

 D- ALLOW EXPRESSION AND PROVIDE

FOR SAFETY

 A- ENCOURAGE PARTICIPATION