c



  
Amy C. Chavarria, RN, MSN, MBA, HCM, CCE
 c
= a an actual or potential ituation in
which omething that i valued i
changed, no longer available, or gone.
= Body image
= Significant other
= Sen e of well-being
= A job
= Per onal po e ion ,
= Belief
= Sen e of elf
 c

= at i an ?
???.
= Normal in ??

? cycle.
= May be ?
?? with fore-warning or
?
?? with no warning.
= Material lo i of a ?object.
=   lo ha no phy ical
form.
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=  Ñ a lo that other can

recognize.
=  Ñ a lo that i
experienced by 1 per on but cannot be
verified by other (p ychological).
=  ! Ñ i a lo t experienced
before the lo actually occur .
 u
c

= "  Ñ lo cau ed by

pecific ituation that are not
anticipated or predicted.
 u
c

=  # Ñ lo e that occur

in the proce of normal development;
they can be anticipated and prepared
for
 u
GRaE

=Phy iological and =at i manife ted in
p ychological =Thought
re pon e to lo .
=
eeling
=The total re pon e
to the emotional =Behavior
experience. =at i e ential for
=The grief re pon e good mental and
i overwhelming phy ical health.
di tre or orrow.
 u

BEREAVEMENT

=State of de olation.
=The ubjective re pon e.
 u

MOURNaNG
=Socially pre cribed behavior after the
lo of omeone
=at i a proce through which grief i
eventually re olved or altered.
=a influenced by culture, piritual
belief , and cu tom .
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uu
=???$
ÑAnxiety ÑSkin ra he
ÑDepre ion ÑExce ive weating
ÑWeight lo ÑMen trual di turbance
ÑDifficultie wallowing ÑPalpitation
ÑVomiting ÑChe t pain
Ñ
atigue ÑDy pnea
ÑHeadache ÑAltered libido,
ÑDizzine concentration, pattern of
Ñ
ainting eating, leeping, activity
ÑBlurred vi ion and communication
M u 

uu

= at can have a po itive re olution that

can enrich the individual with new

= an ight
= Value
= Challenge
= Openne
= Sen itivity
 u



= %%&' Ñ the normal

grief reaction i brief but genuine.
=  !&' Ñ experienced
in advance of the event.
= "'("&' Ñ occur
when a per on i unable to
acknowledge the lo to other per on .
 u



= " &' Ñ i grief that i

extended in length and/or everity;
= Same S&S of healthy grief
= But may have difficulty expre ing
the grief
= May deny the lo
= Or grieve beyond expected time.
 u



= (%&' Ñ many of normal

ymptom are uppre ed, and other
effect , including omatic, are
experienced in tead.
= !"' &' Ñ unhealthy,
pathological grief.
uu uuuuc 


= A perceived need to be brave and in

control
=
ear of lo ing control in front of
other
= Endurance of multiple lo e , uch
a the lo of an entire family, which
i too overwhelming to contemplate
uu uuuuc 


= Ambivalence toward the lo t per on

= Extremely high emotional value
inve ted in the dead per on.
= Uncertainty of the lo .
= Lack of upport y tem .
  c

=?)Ñ ?
=Shock and Di belief
=Developing Awarene
=Re titution
=Re olve
=adealization
=Outcome
  c

=?)Ñ " *??+

=Refu e to accept the lo
=Ha tunned feeling
=Accepting the ituation intellectually,
but denie it emotionally
  c

=?)Ñ ??
,???

=Reality of lo begin to penetrate
con ciou ne
=Anger may be directed at agency,
nur e , or other
=?)Ñ ?  
=Conduct ritual of mourning
(funeral, etc.)
  c

=?)Ñ ? ? 

=Attempt to deal with painful void.
=Still unable to accept new love object
to replace lo t per on or object
=May accept more dependent
relation hip with upport per on
=Think over and talk about
memorie of the lo t object
  c

=?)Ñ ?- 

=Produce image of lo t object that i
almo t devoid of unde irable feature
=Repre e all negative and ho tile
feeling toward lo t object
=May feel guilty and remor eful about
pa t incon iderate or unkind act to
lo t per on
  c

=?)Ñ ?- . $/

=Uncon ciou ly internalize admired
qualitie of lo t object.
=Reminder of lo t object evoke fewer
feeling of adne
=Reinve t feeling in other
  c
=?)Ñ 
?
=Behavior influenced by everal factor
=amportance of lo t object a ource of
upport
=Degree of dependence on relation hip
=Degree of ambivalence toward lo t
object
=Number and nature of other
relation hip
=Number and nature of previou grief
experience
  c
= *?)# ?.*?0 
?
?/
= Numbne
= Yearning
= Di organization
= Reorganization
  c

=*?1Ñ 
?
=Brief
=Trauma o overwhelm that he/ he mu t
u e denial a a defen e
=*?1Ñ !?
=La t everal month
=anten e p ychological di tre
=Thought focu ing on the decrea ed
  c

=*?1Ñ  - 

=Severe depre ion
=Social withdrawal
=Lack of intere t in people and activitie
=*?)Ñ ? - 
=Being 6-9 month after lo
=Gradual renewal of intere t in people
and acitivite
=Retrun of a en e of meaning
  c

=&?+?# ?
=Shock- La t hour to Several
Day
=Prote t-1-3 Month
=Di organization-3-6 month
=Reorganiztion-6 month to 1 year
  c

= 2 ?3 )"? +

= Denial
= Anger
= Bargaining
= Depre ion
= Acceptance
  c

= 2 ?3 )3 ?

= Refu e to believe that lo i
happening
= a unready to deal with practical
problem
  c

= 2 ?3 )Ñ ?

= Client/family may direct anger at
nur e or taff about matter that
normally would not bother them
= May direct anger toward fate, God,
or family member
  c
= 2 ?3 )Ñ %
= Occur a the client eek to delay
the dreaded event
= Seek to bargain to avoid lo
= Bargain with God for more time,
and, in return, promi e to do
omething to repay God for thi
favor
= May expre feeling of guilt or fear of
puni hment for pa t in , real or
imagined
  c

= 2 ?3 )Ñ ?
? 

= Occur when client acknowledge
the reality and inevitability of the
impending lo
= Grieve over what ha happened and
what cannot be
= May talk freely or may withdraw
  c

= 2 ?3 )Ñ ?
?

= Come to term with lo
= Begin to detach from upportive
people
= May have decrea ed intere t in
urround
= May wi h to begin making plan
 cc 
u

=  & - lowed and di organized

re ulting finally in reali tic memorie
= #   - blocking and emotional
outbreak to finally having plea ure
= (!" - numb or hyperactive to
renewed vigor
= "  - pa ive and unaware of
other to renewed relation hip
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= '"
= No concept of life or death.
= Older infant can en e ecurity
and upport per on .
= Realize eparation and
experience anxiety.
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 u

=  "( "
= Cognitive power are evident at 18-
24 month which inten ifie
eparation anxiety.
= A toddler gain more autonomy
they become more independent
but can till fear of abandonment.
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 u

= "( "
= Pre chooler ee death a
rever ible and avoidable.
= They ee them elve a exi ting
and are aware that they can cea e
to exi t.
= They can di tingui h between alive
and being dead, they cannot gra p
the univer ality, inevitability or
finality of it.
 c
 u
= (
= Perceive death a unnatural,
rever ible and avoidable.
= anfluenced by tho e around them
and their perception /behavior .
= Children who live in an un afe
environment view it differently
from children who feel afe and
ecure.
 c
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=  "
= Believe it will not happen to them.
= Have a higher level of cognitive
development and view death almo t
like adult .
= Anxiety producing - thought of death
are overwhelming.
= Have a higher ri k for poor grief
outcome than adult .
 c
 u

= 
= Grieve more inten ely and more
continuou ly than children.

= Middle-aged adult have more

table life tyle
 c
 u

= 
= Experience numerou lo e .
= May be at higher ri k for poor
outcome .
uuc 
= Meaning of the lo .
= Circum tance of the lo .
= Religiou belief and cultural
practice .
= Per onal re ource and tre or .
= Subcultural re ource and tre or .
= Previou experience.
= Emotional tability.
 uu
=  ##'" " .430?/
= Exce ive or per i tent expre ion of
affect.
= anability to expre joy.
= Clinical ymptom of depre ion.
= anability to form new relation hip .
= anability to peak of the decea ed without
inten e emotion.
= Hearing or eeing the decea ed.
=
eeling of emptine or meaningle ne .
 uu
= " ##"'"
%! 5!"3 !"' 
= Leaving the decea ed¶ room and
belonging intact.
= Reporting phy ical ymptom imilar to
tho e the decrea ed ha before death.
= Talking about the lo a if it ju t
happened.
= anability to remember or talk about the
decrea ed.
= Being preoccupied with thought of the
decrea ed.
= Talking or acting a if the decrea ed were
till alive.
 u
=Subjective =Weeping
=Phy ical =Outbur t of anger
a e ment =Emotional
=Dejected phy ical blunting
appearance =Unkempt
=Slowed motor appearance, leep
function di turbance
 uu

=(( #  
=Client teaching.
=Working through grief tage .
=Encouraging upport group .
 uu

= '"" (

=andividual
=Support

=((#2% (
"

    


   

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