Grief & Loss
Normal reactions to loss of good health
Loss, and the anticipation of loss, is a hallmark of a terminal illness. Loss is progressive and, for many diseases, relentless.
Losses experienced include:
- Loss of a sense of a healthy body
- Loss of family role
- Loss of future plans, goals or dreams
- Loss of employment
- Loss of strength, physique
- Loss of a sense of personal control
- Loss of function
- Loss of certainty
All these losses bring with them changes that the person with a terminal illness has to incorporate into a constantly changing lifestyle.
Reactions to the losses experienced with a terminal illness are varied and form no pattern . Some reactions are:
- Stoic acceptance
- Denial and shock – this can’t be happening to me
- Anger and resentment – why is this happening to me?
- Fear, anxiety and panic – what will I do?
- Self doubt and blame – if only…
- Withdrawal and a sense of hopelessness
Behaviours resulting from these reactions include:
- Crying, fatigue, exhaustion, aggression
- Sleep problems, headaches, exacerbated disease symptoms, change in appetite
- Poor concentration and memory, loss of motivation, difficulty making decisions
- Social withdrawal
What can be done?
Listen and encourage talk. Encouragement to talk about losses as they occur can assist the patient to come to terms with their losses. Although it should never be assumed, unresolved loss can contribute to symptoms that are difficult to control.
Sometimes you are the only person the patient has to talk about his/her losses. Discussion can lead to the development of strategies to deal with the losses. An invitation to the patient for a follow-up visit to discuss his/her feelings when going through a seemingly difficult time can assist in the resolution of the grief experienced. Referral to a specialist nurse, social worker, counsellor may be appropriate depending on the circumstances.
Once the health care professional understands more about the patient and his/her personal circumstances, it may be useful to work together to find a ‘good listener’ in the patient’s social network. This person(s) can offer support to help the patient move through the multiple losses experienced.
Further information for helping patients and families face losses can be found under Grief and loss.
Grief
Grief is the normal reaction to loss of someone who has been significant in our life. Grief can be expressed in many ways and outward expressions of grief can last for variable lengths of time.
In the past there has been a tendency to categorise grief as normal and abnormal, or, as appropriate as opposed to an inability to ‘move on’ or ‘let go’. These understandings of grief have been questioned and somewhat inconsistent with an understanding of grief as an emotion we learn to live with and incorporate into life.
In a review of the literature for the Victorian Department of Human Services Review of specific grief and bereavement services (2004) it is stated “…most people can function effectively after bereavement utilising their social supports and possibly some low level interventions, counselling or support groups. However, for five to 10 percent of bereaved people experiencing complex grief there is a need for specific grief therapy delivered by specialist providers.”Practitioners who recognise that a patient carer or family member is at risk for complicated bereavement may consider referring the patient to a specialist palliative care service to ensure bereavement follow-up.
Further information for helping the bereaved can be found under Grief and loss