Stages of Grief

End of Life Care (EOL)

It is the term currently used for issues related to death and dying. The institute of medicine defines “end of life” as the concluding phase of a normal life span, although life can end at any age. The time from diagnosis of a terminally illness to death varies considerably depending on the patient’s diagnosis and extent of disease. EOL care focuses on physical and psychological needs at the end of life for the patient and the patient’s family.

Goal for EOL care:

o   Provide comfort and supportive care during the dying process.

o   Improve the quality of the remaining life.

o   Help ensure a dignified death.

Definition of Grief

• It is emotional response to loss
• Intense sorrow caused by loss of loved one (especially by death)
• The physical and emotional responses to the death, separation or loss of a beloved person or thing.

“Grief is defined as an emotional response to an external and consciously recognized loss; self-limiting and gradually subsiding within a reasonable length of time.”

Types:

• Normal grief:
• Physical : hollowness in stomach, lightness in chest, heart palpitations.
• Emotional : numbness, relief, sadness, fear, anger and gait.
• Cognitive: disbelief, confusion, inability to concentrate.
• Complicated grief:
• Chronic grief: normal grief reactions over very long periods of time
• Delayed grief: normal grief reactions are suppressed or postponed.
• Exaggerated grief: self destructive behaviour.
• Marked grief: unaware that behaviors are a result of the loss.

Stages of Grief

Stage 1: - Feeling emotionally numb is often the 1st reaction to a loss, and may last for a few hours, days or longer.If some ways, this numbness can help you get through the practical arrangements and family pressures that surround the funeral, but if this phase goes on for too long, it could be a problem.

Stage 2: - The numbness may be replaced by a deep yearning for the person who has died.You may feel agitated and angry, and find it difficult to concentrate, relax or sleep, may also feel guilty, dwelling on arguments you had with that person or on emotions and words you wished you had expressed.

Stage :3 - This period of strong emotion usually gives way to bouts of intense sadness, silence and withdrawal from family and friends. During this time, you may be prone to sudden outbursts of tears, set off by remainders and memories of the dead person.

Stage :4 - Overtime, the pain sadness and depression starts to lesson you begin to see your life in a more positive light again, although it is important to acknowledge that you may not completely overcome the feeling of loss.

Stage:5 - The final phase of grieving is to let go of the person who has died and more with your life. This helps sadness to dear, and energy levels to return to normal.

Coping with the Grieving Process

• Ask for help and support from family, friends or a support group.
• Encourage them to express whatever they are feeling, be it anger, guilt or sadness.
• Accept that some things like death are beyond our control.
• Avoid making major discussions on the event.
• Ask the person to give their self the time and space to grieve.
• Sometimes, the grieving process is especially difficult. Certain factors can make a difficult bereavement more likely:
• Being male
• Several previous bereavements
• A history of mental illness.
• A dependent relationship with the person who has died, or a relationship where you had troubled or negative feelings about the deceased.
• Low self esteem
• A lack of support from family and friends.