BEHS 380 Survivors’ Loss and Grief
BEHS 380 Survivors’ Loss and Grief
Grief, Bereavement, and Mourning
The loss of a loved one is a universal devastating emotional experience for the bereaved. Grief, bereavement, and mourning are connected concepts that relate to this loss but have different meanings. Grief is an individual’s natural and painful emotional response to loss, especially of a loved one, and is characterized by presentations such as tearfulness, intense sadness or sorrow, and insomnia (Mughal et al., 2021). Mourning is the process of adapting to life after loss and is characterized by the outward expression of grief (Mughal et al., 2021). This also encompasses cultural and religious traditions surrounding death. Bereavement refers to the grieving and mourning period following the loss of a loved one. The normal grieving process resolves after approximately one year once the affected individual adapts to the loss, failure to which leads to complicated grief disorder. This disorder may necessitate therapeutic interventions does to the implications of intense and prolonged grief on mental health and consequent impaired functional status.
Theory Addressing the Grieving Process
Various theories have attempted to address the grieving process. This includes the widely embraced stage theory by Dr. Kübler-Ross. This theory posits that there are five stages of grief namely; denial, anger, bargaining, depression, and acceptance (Oates et al., 2022). The bereaved individual initially feels no connection and denies the occurrence of the loss and the associated feelings as a masking coping mechanism. Healing and adaptation to the loss cannot commence at this stage until the individual realizes that the loss is real. Once the numbness subsides, the individual is angered by the reality of the loss. The outbursts from the anger may be directed at anything or anyone such as the healthcare professionals who were attending to the deceased. Bargaining then sets in whereby the bereaved attempts to find ways to go to normalcy and is usually characterized by what-if statements. Depression then follows and may be manifested through withdrawal, emptiness, sadness, and suicidal thoughts in extreme cases. Acceptance of the loss as the new reality then follows. Two additional stages have been integrated into this theory. These are shock or disbelief upon receiving the information regarding the loss which occurs before denial, and testing before acceptance as one comes up with solutions to adapt to the new reality of loss.
Social Factors that Influence Grieving
Various factors affect how individuals experience and express their grief. These include a history of past psychiatric treatment, marital status, level of closeness with the deceased, length of hospital stay, the patient’s age, the number of children, and socioeconomic status (Güven et al., 2022). The availability of social support, family conflicts surrounding the demise, level of education, place of death, and utilization of hospice and palliative care also influences the grieving process (Mason et al., 2020). Cultural and religious beliefs can also determine the response to the loss. It is important to understand the role and impact of each factor to appropriately help the bereaved through the grieving process. This will also guide targeted measures to support the bereaved in healthy coping and adaptation to the loss.
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Strategies to Cope with Grief
Three copying strategies by bereaved individuals have been identified. These include supportive, avoidant, and active emotional coping mechanisms (Fisher et al., 2020). Avoidant coping through adaptive behavior such as self-distraction and substance abuse is associated with negative implications on the intensity and outcomes of the grieving process (Fisher et al., 2020). Active emotional coping and supportive coping should thus be fostered for better outcomes. This is achieved through the adoption of certain strategies such as the provision of adequate clarification and information about the loss, establishing trusting mutual relationships, giving assurance throughout the grieving process, and supporting death preparedness during end-of-life care (Mughal et al., 2022). The provision of strong social support is also pivotal in adequately dealing with and coping with the loss of a loved one (Cacciatore et al., 2021). Grieving individuals should not be rushed but given adequate time to address their emotional reactions.
Cacciatore, J., Thieleman, K., Fretts, R., & Jackson, L. B. (2021). What is good grief support? exploring the actors and actions in social support after traumatic grief. Plos One, 16(5). https://doi.org/10.1371/journal.pone.0252324
Fisher, J. E., Zhou, J., Zuleta, R. F., Fullerton, C. S., Ursano, R. J., & Cozza, S. J. (2020). Coping strategies and considering the possibility of death in those bereaved by sudden and violent deaths: Grief severity, depression, and posttraumatic growth. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00749
Güven, B. B., Maden, Ö., Satar, A. D., & Ersoy, A. (2022). Factors affecting the emotional reactions of patient relatives who receive news of death: A prospective observational study. BMC Psychology, 10(1). https://doi.org/10.1186/s40359-022-00763-2
Mason, T. M., Tofthagen, C. S., & Buck, H. G. (2020). Complicated Grief: Risk Factors, Protective Factors, and Interventions. Journal of social work in end-of-life & palliative care, 16(2), 151–174. https://doi.org/10.1080/15524256.2020.1745726
Mughal, S., Azhar, Y., Mahon, M. M., & Siddiqui, W. J. (2022). Grief Reaction. In StatPearls. StatPearls Publishing.
Oates, J. R., & Maani-Fogelman, P. A. (2022). Nursing Grief and Loss. In StatPearls. StatPearls Publishing.