Grief Notes 2 Flashcards
Any grief extending over a long period of time without resolution is known as
- Abnormal
- Complicated
- Unresolved
Types of complicated or abnormal or unresolved grief:
- Complicated (Chronic, Unresolved) grief
- Delayed grief
- Exaggerated grief
- Masked grief
Those suffering from chronic grief exhibit reactions that are excessive and extended in duration. The grief appears to never be resolved or come to a satisfactory conclusion.
Complicated (Chronic, Unresolved) grief
Suppressed and inhibited and postponed responses to a loss are characteristics of delayed grief.
Delayed Grief:
Person appears to be “overacting” to the death when they are suffering from exaggerated grief.
Exaggerated Grief
Someone suffering from masked grief experiences difficulty from symptoms and/or behaviors and make no connections to the loss of the loved one. Once discovered and discussed, improvement usually follows.
Masked Grief
Differences between Masked and Exaggerated Grief
- Exaggerated grief: the patient KNOWS the symptoms began around time of the death and are the results of the death experiences.
Differences between Masked and Exaggerated Grief
- Masked grief: the patient DOES NOT associate the symptoms they are experiencing with a death. Once the connection is made, usually there is improvement.
FACTORS THAT MAY COMPLICATE GRIEF
- Relational
- Circumstantial
- Historical
- Personality
- Social
- Concurrent Stresses
- Communication
Nature of the attachment: strength and security of the attachment, ambivalence in the relationship, conflicts with the deceased, dependent relationships
Relational
Mode of death: Natural (long or short duration), accidental, suicide, homicide
Circumstantial
Were there previous complicated grief reactions?
This is especially important when there were incidents of earlier death events.
Historical
Personality variables: age and gender of the survivor, person’s coping style, attachment style, cognitive style, self-esteem and person’s beliefs and values
Personality
Lacking a social support network contributes to complicated grief, especially if the death occurs as a result of a “socially unspeakable” cause.
Social variables: support availability, support satisfaction, social role involvements, religious resources and ethnic expectations
Social
What else is going on in the life of the person experiencing complicated grief?
Divorce?
Loss of job?
Problems with children?
Concurrent Stresses
Lack of communication certainly complicates grief. Families are stressed when communication is poor or non-existent with and/or about the deceased.
Communication
What does the funeral director do?
- The funeral director needs to be aware of these factors and how they may affect the grieving person.
- The funeral director must recognize these grief reactions may require a referral and the intervention of a certified grief counselor/therapist.
- Aftercare resource information can provide information about locally available certified personnel.
SPECIAL TYPES OF LOSSES:
SUICIDE
SUICIDAL GESTURE
SUICIDAL IDEATION
– a deliberate act of self destruction
SUICIDE
– unsuccessful suicide attempt
SUICIDAL GESTURE
- thoughts about committing suicide
SUICIDAL IDEATION
studied thousands of cases of suicide to demonstrate his theory that a person commits suicide because of the influence of society. His theory on suicide includes four (4) types.
EMILE DURKHEIM
4 TYPES OF SUICIDE (EMILE DURKHEIM)
- ANOMIC SUICIDE
- FATALISTIC SUICIDE
- ALTRUISTIC SUICIDE
- EGOISTIC SUICIDE
when a person commits suicide during times of adverse conditions such as war or financial hardship, when rules of society don’t apply
ANOMIC SUICIDE
because one feels over-regulated or over-controlled. They feel there is no other way out
FATALISTIC SUICIDE
due to a high sense of group involvement or out of a sense of duty for a cause (suicide bombers)
ALTRUISTIC SUICIDE
due to feelings of being a loner or feelings that one does not fit into society
EGOISTIC SUICIDE
Term derived from the Greek words for “well/good” and “death”
EUTHANASIA
– withholding of life sustaining drugs or treatment, such as kidney dialysis, from a patient who is terminally ill
PASSIVE EUTHANASIA
– taking active measures, such as Dr. Kevorkian did, to end the life of a terminally ill patient
ACTIVE EUTHANASIA
– historically an inn for travelers especially one kept by a religious order; also used to indicate a concept designed to treat patients with a life limiting condition, palliative case, keeping the patient comfortable versus curative case
HOSPICE
CHILDREN AND GRIEF / CHILDREN AND DEATH (GROLLMAN??)
A CHILD UNDERSTANDING OF DEATH
- BIRTH – 3 YEARS – no comprehension
- 3 – 5 YEARS – unable to understand the finality of death; death is like sleep or like taking a long journey
- 5 – 9 YEARS – may understand that death is final but may not accept it as something that happens to everyone, often personify death
- 9+ YEARS – understands that death is final
EXPLAINING DEATH TO CHILDREN (BE SPECIFIC!): WHAT NOT TO SAY: • Make believe stories • Something you wouldn’t believe • Mother has gone on a long journey • God took dad away • Presents are in heaven • Grandma is dead cause she was sick • To dies is to sleep
EXPLAINING DEATH TO CHILDREN (BE SPECIFIC!):
- Share your own religious convictions
- Speak in concrete terms rather than philosophical ones
- Grant permission to cry or express feelings
- Acknowledge when you do not know the answer
CHILDREN ND FUNERALS:
The funeral is an important occasion in the life of the family. A child should have the same right as other members of the family to attend the funeral, offer his or her last respects and express love and devotion. Not only is it correct to permit a child to attend a funeral, but approximately the age of seven, a child should be encouraged to attend
GRIEF AND FAMILY SYSTEMS (WORDEN)
- Functional position or role the deceased played in the family?
- Emotional integration of the family
- How families facilitate or hinder emotional expression
– the individual’s ability to adjust to the psychological and emotional changes brought on by a stressful event such as the death of a significant other
ADAPTATION
– the feelings and their expression
AFFECT
– a state of tension, typically characterized by rapid heartbeat, shortness of breath and other similar ramifications of arousal of the autonomic nervous system; and emotion characterized by a vague fear or premonition that something undesirable is going to happen
ANXIETY
– grief extending over a long period of time without resolution
COMPLICATED GRIEF
– a learned emotional response to death-related phenomenon which is characterized by extreme apprehension
DEATH ANXIETY
– inhibited, suppressed or postponed response to a loss
DELAYED GRIEF REACTION
– feelings such as happiness, anger or grief, created by brain patterns accompanied by bodily changes
EMOTIONS
– strong emotion marked by such reactions as alarm, dread and disquieting
FEAR
– the state of being prevented from attaining a purpose; thwarted; the blocking of the satisfaction of a perceived need by some kind of obstacle.
FRUSTRATION
– historically an inn for travelers, especially one kept by a religious order; also used to indicate a concept designed to treat patients with a life-limiting condition
HOSPICE
– occur when persons experience symptoms and behaviors which cause them difficulty but they do not see or recognize the fact that these are related to the loss
MASKED GRIEF
– a strong emotion characterized by sudden and extreme fear
PANIC
– a defense mechanism used in grief to return to more familiar and often more primitive modes of coping
REGRESSION
– preoccupied and intense thoughts about the deceased
SEARCHING
– the sudden and unexpected death of an apparently healthy7 infant, which remains unexplained after a complete autopsy and a review of the circumstances around the death
SUDDEN INFANT DEATH SYNDROME (S.I.D.S.)
– a deliberate act of self destruction
SUICIDE
– a conscious postponement of addressing anxieties and concerns
SUPPRESSION
