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Loss. Physical (loss of something tangible) Psychosocial: (loss of something symbolic or intangible). Change : always constitutes loss. Developmental change Normal change and growth Competency-based loss. Secondary loss.

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Loss

Physical (loss of something tangible)

Psychosocial: (loss of something symbolic or intangible)


Change always constitutes loss
Change: always constitutes loss

  • Developmental change

  • Normal change and growth

  • Competency-based loss


Secondary loss
Secondary loss

  • A loss that coincides with or develops as a consequence of the initial loss.

  • (examples: loss of income when spouse dies, loss of concept of self as healthy when serious illness occurs)


Grief mourning
Grief & Mourning

  • Grief: the process of experiencing the psychological, behavioral, social, and physical reactions to the perception of loss.

  • Mourning: the work of adapting andchanging as a result of the loss


Grief
Grief

  • Experienced in four major ways: psychologically, behaviorally, socially, physically

  • A continuing development

  • A natural reaction

  • Expected with all types of loss

  • Dependent upon the individual’s perception of the loss


Mourning
Mourning

  • Reacting to separation from the deceased

  • Modification of roles, skills, identity

  • Learning to live in a healthy way without the deceased


Myths misconceptions
Myths & Misconceptions

  • Grief declines steadily over time

  • The mourner must put the loss out of mind

  • Intensity and length of mourning are a testimony to love

  • Grief involves only the loss of the person

  • Mourning is complete in a year

  • Time is a healer


Danger don t rigidly apply grief theory
Danger: don’t rigidly apply grief theory

  • Commonalities exist

  • Idiosyncratic variations occur

  • It’s not a static state, but rather a process of many changes over time


Kubler ross stages
Kubler-Ross’ Stages

  • Denial

  • Anger

  • Bargaining

  • Depression

  • Acceptance


Why think about death
Why think about death?

  • To give meaning to human existence

  • To encourage productivity & enjoyment of life

  • To prepare for ultimate acceptance of death


Ways to prepare
Ways to prepare:

  • Be close to someone who is facing death with inner peace

  • Plan financially

  • Develop solid support

  • Incorporate religious beliefs into life


How can we help
How can we help???

  • Denial: support without reinforcing

    • Stay physically present

    • Offer regressive care (food, drink, safety)


How can we help1
How can we help???

  • Anger

    • Provide anticipatory guidance

    • Don’t take it personally

    • Meet needs that precipitate anger


How can we help2
How can we help???

  • Bargaining

    • Provide information for decision-making

    • Offer resources and referrals


How can we help3
How can we help???

  • Despair

    • Supportive listening

    • Touch

    • Avoid cliches

    • Assess risk of harm to self


How can we help4
How can we help???

  • Acceptance

    • Assist in planning

    • Utilize cultural practices

    • Allow expression of feelings

    • Accept changes in feelings

    • Support groups for patient & families


Hospice care
Hospice Care

  • A philosophy of caring for the dying

  • Curing vs. Caring

  • Criteria for moving to hospice care


Helpful hints
Helpful hints:

  • Don’t ask whether I’m ‘over it’. I’ll never be ‘over it’.

  • Don’t tell me he’s in a better place. He isn’t here.

  • Don’t say “At least he isn’t suffering”. I wonder why he had to suffer at all.

  • Don’t tell me you know how I feel unless you have had the same experience.

  • Don’t tell me ‘God doesn’t make mistakes’; you mean God did this on purpose???

  • Don’t tell me ‘God doesn’t give more than we can handle’. I don’t feel like I am “handling” it.


Please just say
Please just say:

  • That you are sorry.

  • That you miss him too, if you do.

  • That you will listen.


As we learn to help
As we learn to help:

  • “Birds make great sky circles of their freedom. But how do they learn it? They learn by falling, and by falling they’re given wings.


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