THE MULTIPLE LAYERS OF GRIEFSep 21, 2021
Taylor RN BY: Chaplain Phyllis B. Taylor, RN
Grief is acute sorrow or deep sadness caused by loss, misfortune or disaster. It is very personal. It is also a back and forth process. With loss of health comes the sense that the body is untrustworthy. There may be the loss of spontaneity, the ability to plan for things in the future, role reversals and financial worries. For the family there is the loss that comes with the knowledge that the one they love can no longer do the things they used to do, the impact of that on their lives and, depending on the illness, the death of that person. If on was incarcerated during a loved one’s illness or unexpected death the grief process is even more intense.
STAGES OF GRIEF
- Shock and denial. This cannot be happening to me.
- A sense of reality. This really is true. With this can come a feeling of loss of control and the concern the griever is going “crazy.”
- The goal is acceptance and regaining control of one’s life.
TASKS OF GRIEF (Dr. J. William Worden)
- To accept the reality of the loss
- To experience the pain of grief.
- To adjust to the new environment of one’s life.
- To withdraw emotional energy from the past and begin to live in the present reality.
ISSUES OF GRIEF WITH ILLNESS OR DISABILITY
- Physical pain and its impact on the patient, family and caregiver.
- Financial issues.
- Role reversals.
- Sexuality issues.
- Unique issues when death is the result of murder, suicide and abuse.
- Other losses difficult to validate: divorce, child custody, chronic illness, mental illness, unemployment, abortion, infertility, dementia and incarceration.
THOSE AT RISK FOR COMPLICATED GRIEVING
- People who feel they have not had enough support or who actively withdraw from support that is offered.
- A person with no spiritual beliefs or with beliefs that are rigid.
- Those with a particularly dependent relationship with the one who has died.
- Those with a tremendous sense of anger.
- Those who have been taught not to show emotion or who have trouble asking for help.
- Those who are depressed or who have never processed a past experience of loss.
FACTORS INFLUENCING GRIEF
- Relationship with the deceased. Unique issues if the death is a child or parental figure.
- Sudden death. No time to say “Good-bye.” “I forgive you” or “I thank you.”
- Violent death. This includes murder and accidents.
- Ambiguity of the loss, e.g. death by Alzheimers, death of an abuser.
- Multiple losses where grief piles up.
“The bearing of pain, distress, injury and grief…” Webster’s New World Dictionary
“The stat of severe distress associated with events that threaten the intactness of the person.” Eric Cassel
TYPES OF SUFFERING
- Spiritual- Is there any meaning in what is happening? Why me? Why someone I love? Is there still a God or Higher Power who cares?
- Social- Am I a burden to my family? How do I deal with role reversals?
- Sexuality- Am I fully masculine or feminine?
- Financial- How will I pay for my care and my medications? What happens when I can no longer work? What is the impact on my family financially? How do I pay for fines?
FUNDAMENTAL QUESTIONS THAT COME FROM SUFFERING
- Who was I before my illness? Disability? Incarceration? What did my life mean? Was I selfish? Giving? Did I care for myself? Others?
- Who am I now?
- Who will I become? Will I be a blessing or a burden? Loved or resented?
- What do I need? From whom? When?
Underlying all these questions is the fundamental one of whether I am still loveable or ow worth to my family, friends, myself and, if spiritual or religious, to God?
SOME COPING MECHANISMS FOR PATIENTS, FAMILIES AND CAREGIVERS
- Support groups
- Trying to stay in the present and not focus just on what the future might bring.
- Learn to adjust to changes.
- Redefine what is of value…not what you do but who you are.
- Find meaning in what is happening.
- Find hope. Explore what is LOST. Explore what is LEFT. Explore what is POSSIBLE.
- Find those who can accompany you in your pain and suffering so you are not isolated and alone.
Want to learn how to be a better friend to someone experiencing loss?
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