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Death & Dying; Dealing with Loss and Grief

Grief impacts us holistically…. These five needs overlap.. Social, Physical, Cognitive, Emotional, Spiritual. Coping with Loss and Grief. Grieving is a common and natural reaction to any loss that brings on strong emotions. .

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Death & Dying; Dealing with Loss and Grief






Presentation on theme: "Death & Dying; Dealing with Loss and Grief"— Presentation transcript:

Slide1

Death & Dying; Dealing with Loss and GriefSlide2

Grief impacts us holistically…

These five needs overlap.

Social, Physical, Cognitive, Emotional, SpiritualSlide3

Coping with Loss and Grief

Grieving is a common and natural reaction to any loss that brings on strong emotions.

Acknowledging and understanding your grief will help you begin the healing process. Slide4

What is Loss?

Losses may include:

Death of a loved one

Divorce or separation of parents

Moving to a new town or new school

Separation from a loved one

Loss or death of a petLoss or theft of something valuable or specialBreakup of a romantic relationship

Loss of jobLoss of a sporting competition

How we Cope with LossAn individual deals with all types of losses in a normal process.A broad range of emotions after a loss include:

DenialAnger

SadnessConfusion and helplessness

Guilt

Insecurity and fear

Eventually we reach the acceptance and resolution of the loss. However, some losses are hard to accept. The idea is to incorporate the loss, moving forward knowing the loss has happened and taking from it what we can.Slide5

The Grieving Process

Elisabeth

Kübler

-Ross noted that the grieving process includes

stages of grief.

A variety of reactions that may surface as an individual makes sense of how a loss affects him or her

Denial or Numbness

Emotional Release

Anger

Bargaining

Depression

Remorse

Acceptance

Hope

Stages of GriefSlide6

Positive Coping Strategies

Be patient. Each person will go through the grieving process at his or her own pace.

Talk to others.

Ask for help.

Keep up a normal routine.

Eat a healthy diet.Write in a journal.

Get plenty of rest.Exercise.Participate in enjoyable activities.Maintain friendships.

Do something nice for another person.Practice stress management techniques.Deep breathing.

Visualization.Slide7

Physical responses:

Appetite (eating) disturbances

Energy, fatigue, lethargy

Sleep disturbance

Cold (especially for children)Anxiety (sweating, trembling, etc.)Gastrointestinal disturbanceCompromised immune response; increased illnessSlide8

Intellectual

Confusion; “What is real?”

Difficulty concentrating; ex. Read the same page several times

Short attention span; ex. Can’t finish a 30 minute TV program

Difficulty learning new material; short term memory loss; ex. Income taxesDifficulty making decisionsSlide9

Social…

Withdrawal

Isolation

Searching

AvoidanceIrritabilitySelf absorptionClinging/dependenceSlide10

Emotional…

Angry

Depressed

Sad

CryingIrritableAfraidLonelyRelieved/Guilty/RegretfulSlide11

Spiritual…assumptive beliefs are challenged…

The question “Why” reverberates

Where was God?

If God is all powerful, why allow this?

If God loves me, how could this be?Prayers weren’t answered…Slide12

Common and Unique…

Death and grief are unique.

Each person’s experience is his or hers alone.

Each experience is unlike any other.

So, I can never know exactly how someone else feels.Slide13

Grief Takes Time

Whole first year is one loss after another

Beware of special occasions and holidays all year

Uncomplicated mourning is normally 2-3 years

Complicated mourning may be a 5-7 year process.Grief continues for a lifetime through major life milestones.Slide14

Terms seen in the literature:

Absent grief (prolonged)

Delayed grief

Inhibited grief

Pathological mourningChronic MourningDysfunctional grief

Unanticipated griefConflicted griefDistorted griefUnresolved grief

Grief with mental disordersGrief with physical disordersSlide15

Disciplines that deal with grief…

Chaplain/pastor

Social Workers/Counselors

Nurse/Physician

Other medical professionals (PT….)Teachers/Coaches

Lawyers/AccountantsEveryoneSlide16

Grief is Work

Experience the reality of the loss

Experience the pain of the loss

Adjust to an environment without the deceased

Withdraw emotional energy from the deceased and invest it in new relationship(s)Slide17

Complicated Grief/Mourning

Multiple losses

Severe trauma

Violent death

Concurrent mental illnessAxis 2 traitsIsolationGuiltLife Skill DeficitsParents who lose children

grief that does not follow the “normal course” or process to successful completion.Slide18

What exactly are we talking about?

The first and most pressing question in a crisis is: What just happened?

Immediately following is the question: How can I manage right now?

Finally, the larger questions of grief and meaning are formulated.

What

Happened?

How will I

Manage

It?

How do I

Go on?Slide19

How can I help?

First focusing on basic needs: Shelter, safety, sustenance, information, protection

Second, allowing those affected to begin to figure out what happened…tell their story, process the event and its meaning for them.

Always validate and normalize the responses ….listen carefully…reflect the language Slide20

As a Minister…..

Hearing the story will help you assess the needs and the strengths of each person

Listen each time as though it is the first time you heard the story

Assess strengths…support system available to the survivor

Assess spiritual beliefs/source of strengthBe careful of trite, glib religiousitySlide21

Grieving Adults Need….

Permission to feel

Awareness that grief lasts a lifetime

Help with marital differences in grief

Help with remaining childrenConcrete help with finances, tasks, etc.Slide22

Grieving Children Need:

Information at their age level

Preparation

Inclusion in caregiving

Inclusion in family ritualPresence of a trusted adultLong term attentionSlide23

Remember the five areas of focus

Physical Needs: warm foods and clothing; increased susceptibility to illness

Emotional Needs: Grief bursts of emotion

Social Needs: Few peers can relate. Consider a group experience.

Cognitive: Difficulty with concentration, learning new material, attention span. Be sure the teacher knows.Spiritual: Beware of the trite phrases that confuse and

frighten…in heaven; God took her; God needed an angel.Slide24

And then there are teens….

Listen, listen, listen

Provide contact with peers

Affirm feelings; model seeking support

Give them something positive to DOEncourage activities they enjoy with othersSlide25

When is it time for referral?

Consider grief complications…ie suddenness of the death, troubled relationship, violence, arousal of fear

Consider support available

Consider coping skills and other stressors

Consider length of difficulty…i.e. duration of distressAlways assess for suicidal ideation. Slide26

Sudden Death

Acute Natural Causes

Accidental Death

Disaster

Deaths –Natural/Mass ViolentWar DeathsMurderSuicideSlide27

Suicide

Shneidman

(1972) “I believe that the person who commits suicide puts his psychological skeleton in the survivor’s emotional closet.

Rando, 1993, p. 523Slide28

Suicide and complications

Feelings of responsibility

Cultural responses leading to guilt and shame

Anger at the deceased

Fear re becoming suicidalNo opportunity for closureSlide29
Slide30

Attitudes Toward DeathSlide31

Attitudes towards death and dying

American society tends to deny the reality of death.

Previous experiences with death

Circumstances of death

Cultural factors can significantly influence patients’ reactions to their illness and the dying process.

There are many different religions and belief systems across the world. Each holds an individual view of death and mourning.Slide32

Gypsy FuneralSlide33

Muslim FuneralSlide34

Ancient Native American BurialSlide35

Hindu BurialSlide36

Jewish BurialSlide37

Motorcycle FuneralSlide38

Police Funeral Slide39

New Orleans FuneralSlide40

Chinese Funeral in Chinatown NYSlide41

Video Cultural Perspectives

The Egyptians Book of the Dead

Hindu, Islam, Jewish, Christian, Buddhist, Native AmericanSlide42

http://www.youtube.com/watch?v=kWX7XFgeucA&feature=related

Slide43

http://www.youtube.com/watch?v=zoqSGbn9ToI Slide44

http://www.youtube.com/watch?v=UfCFEzurIP4&feature=related

Slide45

http://www.youtube.com/watch?v=eLZWaZKFQnA&feature=related

Slide46

http://www.youtube.com/watch?v=DcORQXesoZc&feature=related