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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 IINURS 2310

Unit 5

The Bereaved Individual

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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

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Key Terms (cont’d)

  • Hospice = provides palliative and supportive care to meet the special needs of people who are dying and their families

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Objective 1

Exploring the types of loss

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  • 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

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Objective 2

Recalling the stages of grief as outlined by Kubler/Ross

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  • 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

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Objective 3

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

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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

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Objectives4 and 5

Reviewing specified

types of grief


Identifying the behaviors

representative of anticipatory,

resolved, and maladaptive grief

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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

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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

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Objective 6

Applying the nursing process to the client experiencing bereavement

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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