Chapter 36 - Loss/Grief

Loss can be…

Infertility, amputations, unwanted Dx, impending death

Necessary Loss

• it will be replaced by something BETTER

(natural & positive)

Maturational Loss

• necessary as it occurs across the life span

  • 1st day of preschool

  • missing 2nd grade teacher

  • graduating college

Situational Loss

• unpredictable

  • car crash with permanent injury

Actual Loss

• cant see/hear/or feel a person/object

  • amputations

  • death of family member

  • job loss

Perceived Loss

• defined by the person experiencing the loss

• OVERLOOKED often!!

  • friend rejecting you

Mourning

• how an person expresses grief

Shivah (Jewish Tradition)

• all ADL’s come to a stop for seven days

Bereavement

• sad period after a death

Anticipatory Grief

• b4 the loss

  • dementia pt’s

  • brain dead pt’s

Disenfranchised Grief

• relationship wasn’t crazy close

  • family may not support the reaction

Ambiguous Loss

• veggie state loss

• physically gone, still looking

Complicated Grief

• prolonged grief

  • chronic grief

  • exaggerated grief

  • delayed grief

  • masked grief

Chronic Grief

• yrs to decades

Exaggerated Grief

• self-destructive behaviors due to loss

  • HIGH SUICIDE RISK

Delayed Grief

• triggered by a SECOND loss, not the 1st one

  • second loss

  • failing an exam

Masked Grief

• masked my physiological SS such as headache/heartburn/rashes/tachycardia

Grief Across Developmental Stages

• masked by changes in

  • sleeping/eating habits

  • bowel/bladder changes

  • level of social engagements