Loss, Grief, and Bereavement
• Loss and its movement toward grief begin at the time the diagnosis of cancer is identified.
• Loss is defined by Guillaume (2004) as a loss of a possession or multiple possessions.
• Patients with cancer experience loss from both physical and emotional aspects, which includes roles, role identity, appearances, performance (job and personal), and relationships.
• Grief begins when losses become permanent or the reality of the situation overcomes the event.
• As situations change, continuing bereavement may be necessary to allow adjustment to losses that may be permanent or move to a serious outcome. They may also include altered or final losses for caregivers and spouses.
BEREAVEMENT
Affected By
• Support systems (children, organizations, family)
• Relationship and significances to person or event
• Religious/spirituality, culture
• Events from diagnosis to death
• Role in family and community
• Personal value system (body image, self-concept)
• Role in family internal/external
• Perception of the loss, esteem, identity
Characteristics
• Decreased interest and motivation in usual tasks
• Inability to concentrate or remember normal events
• Restlessness, agitation, mood changes
• Decreased ability to accomplish tasks
• Avoiding thinking about or talking about the events, changes, or losses
• Increased in use of psychoactive substances
• Talking about event or loss repeatedly and to excess
• For caregivers, repeated need to revisit circumstances or illness and their outcomes
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