Grief and Loss

Grief is the multidimensional response—emotional, cognitive, physical, behavioural, social, and spiritual—to a significant loss. Death is a common trigger, but grief can also follow loss of health, independence, a relationship, a pregnancy, a role, a home, or an expected future. Loss disrupts attachment, routines, identity, and the person’s picture of what life was supposed to be. That disruption can produce yearning, sadness, anger, guilt, difficulty concentrating, fatigue, sleep or appetite changes, and periods of autonomic arousal. These responses may come in waves rather than follow a steady decline. A reminder, anniversary, familiar place, or practical task can briefly intensify distress even after functioning has begun to improve. Grief is not a fixed sequence of stages. The Kübler-Ross stages are sometimes used to describe possible experiences, but they are neither universal nor linear and should not be imposed during assessment. One family member may talk openly, another may become quiet, and a third may focus on practical tasks; none of these responses alone proves that the person is coping well or poorly. The experienced nurse looks first at the person’s safety...