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Mental Health Nursing II NURS 2310. Unit 5 The Bereaved Individual. Key Terms Loss = the experience of separation from something of personal importance Grief = deep mental and emotional anguish that is a response to the subjective experience of loss of something significant

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mental health nursing ii nurs 2310

Mental Health Nursing IINURS 2310

Unit 5

The Bereaved Individual

Key Terms
  • Loss = the experience of separation from something of personal importance
  • Grief = deep mental and emotional anguish that is a response to the subjective experience of loss of something significant
  • Mourning = psychological process through which the individual passes on the way to successful adaptation to the loss of a valued object
  • Denial = refusal to acknowledge a loss; serves to protect individual from the reality of the loss
Key Terms (cont’d)
  • Hospice = provides palliative and supportive care to meet the special needs of people who are dying and their families
objective 1
Objective 1

Exploring the types of loss

Significant others
    • Related to death, divorce, or separation
  • Illness or debilitating condition
    • Loss of physical and/or emotional wellness
    • Loss of personal independence
  • Developmental or maturational changes
  • Decrease in self-esteem
    • Related to inability to meet own expectations or those of others (whether real or perceived)
  • Personal possessions
    • Symbolizes familiarity and security
    • Represents loss of material extension of self
objective 2
Objective 2

Recalling the stages of grief as outlined by Kubler/Ross

Stage 1: Denial
    • Shock and disbelief
  • Stage 2: Anger
    • Envy and resentment
  • Stage 3: Bargaining
    • Not usually visible or evident to others
  • Stage 4: Depression
    • Full impact of loss is experienced
  • Stage 5: Acceptance
    • Feelings of peace regarding loss

5 Stages Video

objective 3
Objective 3

Identifying behaviors noted in each of the Kubler/Ross stages of grief

Denial  The reality of the loss is not acknowledged; individual can not believe loss has occurred

Anger  Anger may be directed toward self or displaced on loved ones, caregivers, or God

Bargaining  Individual makes a “bargain” with higher power in attempt to reverse or postpone the loss

Depression  Feelings of sadness prevail; desperation; disengagement from lost entity

Acceptance  Resignation; the focus is on the reality of the loss

objectives 4 and 5
Objectives4 and 5

Reviewing specified

types of grief


Identifying the behaviors

representative of anticipatory,

resolved, and maladaptive grief

Anticipatory grief = the occurrence of grief work before an expected loss
  • Facilitates process of mourning
  • Decreases length and intensity of response
  • Emotional disengagement from the entity

Resolved grief = completion of the process of mourning

  • Individual can look back on relationship with lost entity and accept both pleasures and disappointments
  • Increased energy and desire to pursue new situations and relationships
Maladaptive grief = inability to progress satisfactorily through the stages of grieving to achieve resolution
  • Individual usually fixed in the denial or anger stage of the grief process
  • May involve pathological grief responses
    • chronic or prolonged response = intense preoccupation with memories of lost entity for many years after loss has occurred
    • delayed/inhibited response = continued denial of loss; may manifest through anxiety disorders
    • distorted response = continued anger related to loss; behaviors exaggerated out of proportion
objective 6
Objective 6

Applying the nursing process to the client experiencing bereavement

Assessment  Abbreviated (limit to essential data); specific to culture, age

Diagnosis  Grieving R/T actual or perceived loss; anticipatory grieving R/T terminal illness

Planning  Clarify own feelings; watch for overburdening/transference of feelings; referral to outside resources

Implementation  Open discussion of feelings; nonjudgmental listening; demonstrate respect for need to talk or not to talk; encourage realistic hope

Evaluation  Review of completed grief work