BEREVEMENT AND MENTAL HEALTH psychiatry f

Psychiatry

1. BEREVEMENT AND MENTAL HEALTH BY: BRIAN OBONYO –HNR/0060/2021 MICHELLE MAIYO _HNR/5003/2021

2. DEFINATION LOSS -is anything that is perceived as such by the individual. The separation from loved ones or the giving up of treasured possession for whatever reason , the experience of failure, either real or perceived are all experienced as loss. Example, a significant other (person or pet) through death, divorce or separation for any reason GRIEF - deep mental and emotional anguish that is a response to the subjective experience of loss of something significant MOURNING - is the psychological process or stages through which the individual passes on the way to successful adaptation to the loss of a valuable object or person.

3. THEORETICAL PERSPECTIVE ON LOSS AND BERIEVEMENT STAGES OF GRIEF Behavior patterns associated with the grief response include many individual variation. However, sufficient stimulants have been observed to warrant characterization of grief as a syndrome that has a predictable course and expected resolution. Some may reach acceptance only to revert to earlier stages while some may not complete the stages ELISABETH KUBLES-ROSS These was when she worked with dying patients Denial. The individual has difficulty believing the loss has occurred. He or she may say (no! it is not true! or it is not possible!) The stage protects the induvial against psychological pain of reality.

4. Cont. Anger. This is the stage when reality sets in. Feelings associated here include sadness, guilt, shame, helplessness and hopelessness. Self blame or blaming of others may lead to feeling of anger toward self and others. Anxiety levels may be elevated. Bargaining. At this stage in the grief response, the individual attempt strive to bargain with God for a second chance or for more time. The person acknowledges the loss or impending loss, but holds out hope for additional alternation e.g. if only I could Depression. Here the individual mourns for that which has been or will be lost. It is a very painful stage, during which the individual must confront feelings with having lost someone or something of value(reactive depression) or feelings associated with an impending loss (preparatory depression) Acceptance. At this time, the individual has worked through the behavior associated with other stages and accepts or is resigned to the loss. Anxiety decreases and methods for coping with the loss have been established. The client is less preoccupied with what has been lost and increasingly interested in other aspects of the environment. The person may become quiet or withdrawn.

5. LENGTH OF THE GRIEF PROCESS Stages of grief allow bereaved persons an orderly approach to the revolution of mourning. Each stage presents tasks that must be overcome through a painful experiential process. The length of grief process depend on; the individual and can last a number of years without becoming maladaptation. A number of factors can influence the eventual outcome of the grief response. It becomes more difficult if; The bereaved person was strongly dependent on or perceived as an important means of physical or emotional support The loss is that of a young person. Longer in young than old The state of the persons physical or psychological health is unstable at time of loss The bereaved person perceives some responsibility for the loss The grief response may be facilitated if the individual has support from spouse to assist through the mourning phase or if one has the opportunity to prepare for the loss

6. ANTICIPATORY GRIEF Is the experiencing of feelings and emotions associated with the normal grief response before the loss actually occurs. It has some problems in the case of a dying individual when death occurs prematurely. The dying person feels loneliness and isolation Anticipatory grief may serve as a defense for some individual to ease the burden of loss when it actually occurs. MALADAPTIVE BEHAVIOUR TO LOSS There are 3 types of pathological grief, namely; Delayed or inhibited grief Exaggerated or distorted grief Chronic or prolonged grief

7. Cont. DELAYED/ INHIBITED GRIEF Refers to the absence of evidence of grief when if ordinarily would be expected. It is potentially pathological because the person is simply not dealing with the reality of loss. One remains fixed in the denial stage of the grief process. Sometime for many years. The grief process may be stimulated spontaneously. Overreaction to another persons loss may be one manifestation of delayed grief and may cause a delay to satisfying living

8. Cont. DISTORTED/EXAGGERATED GRIEF RESPONSE Here all symptoms associated with normal grieving i.e. feelings of sadness, helplessness, hopelessness, powerlessness, anger and guilt are exaggerated and render individual dysfunctional in terms of management of daily life. Individual remain fixed in the anger stage of grief response. It may be as well turned to the environment or the anger is turned inward on self. CHRONIC/ PROLONGED GRIEF A prolonged process may be considered maladaptation when certain behaviors are exhibited.

9. DIFFERENCE BETWEEN NORMAL GRIEF AND MALADAPTIVE GRIEF NORMAL Self esteem is intact May openly express anger Experiences a mixture of good and bad days Able to experience moments of pleasure Accept support and comfort from others Maintain feeling of hope May express guilt feeling over some aspect of loss May experience transient physical symptom CLINICAL DEPRESSION Disturbed self esteem Does not directly expose anger Persistent state of dysphoria Anhedonia is prevalent Does not respond to social interactions Feelings of hopelessness prevail Has generalized feeling of guilt Expresses chronic physical symptom

10. NURSING DIAGNOSIS Risk for complicated grieving related to loss of a valuedentity Risk for spiritual distress related to complicated grief process