Question

Introduction on communicating through the grief process

Answer 1

The grief process is a common situation in healthcare settings. A health care personnel must be prepared well in advance to manage such situations. There are many situations which can cause grief reaction such as death, loss of freedom, chronic illness, permanent disabilities of life.

According to Kubler Ross, there are 5 stages in the grief process.

Denial: Characterized by the refusal of loss, shock and disbelief. This stage act as push to mobilize defence mechanism.
Anger: Anger towards others or self is the next reaction to loss.
Bargaining: Trying to bargain with god or another superpower to postpone the loss
Depression: After realizing the loss. The person may go to a state of depression.
Acceptance: Recognition of loss and acceptance of it. Can think about future life after the loss.

The grief process is a normal psychological adaptation to lose. When it goes smoothly without any problem, person’s wellbeing is ensured. The main duty of the healthcare personnel is to allow the process to naturally unfold.

Complications:

Chronic Grief: Grief process occurs beyond the expected duration and the severity of symptoms is greater

Delayed Grief: When suppression of emotions or a delayed reaction of grief occurs.

Effective communication is an essential tool to help the patient in the grief process.

To develop an effective communication the care provider should :

Recognize the situations causes difficult communication.

Describe therapeutic communication strategies

Identify common errors in communication

The purpose of effective communication at times of loss or grief to develop a therapeutic relationship with the client and family that can be helpful in their grief. It is commonly seen that nurses may feel uncomfortable in handling the grief.

Nurses can encourage the expression of emotions. The safe expression of negative feelings helps in the grief process and helps to relieve distress, decrease intrusive thoughts. It also aids the nurses to better understand person’s emotional experiences. Expressing distress reduces the isolation and promotes intimacy. The empathic responses from others and motivates the mourner to cope more effectively.

Sometimes the nurse should accept the avoidance of grief. The client may not express the emotions until the time she is able to grieve. Anticipatory grief also must be considered while taking care of mourner.

The nurse can utilize the help of other family members while helping the client to cope with grief. Even the empathic listening can help is the grief process. Other family members of the mourner also should be well prepared to accept the grief.

Nurses can help even long after a loss has occurred. The mourner's opportunities to talk about the loss diminish with the time. Other family members and support system have overcome it and they may expect the mourner to achieve the same.

Health care providers often believe that speaking about death and dying will upset clients and families. When the topic is discussed they may cry and express emotional pain. The nurse must explain other family members also that it is a normal response and which can aid in grief reaction. Consider the individuals with compassion. Consoling behaviours should be not in a way to interfere with the client’s expression of emotions. Accept the feelings that arise as it is. The main duty of a nurse is to help the mourner is to accept the reality of the loss. Acceptance time may vary from individual to individual. The patient must be given the opportunity to relate his or story of the loss and the mourner benefits by facing the loss and gradually progressing toward acceptance.

Experiencing and expressing intense emotions is essential for normal grief process. The nurse can encourage the client to talk about the lost person and thereby aid the client in expressing emotions like crying, guilt and remorse.

The nurse can assess the coping by monitoring the progress of life of the client. Adjustment to normal life without the dear one shows the acceptance and the normal grieving process.