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SEMESTER 5 UNIT- 1 Grief and Bereavement.pptx
- 1. CHILD HEALTH NURSING– I GRIEF AND BEREAVEMENT Mr. Sachin Sharma Assistant Professor Child Health Nursing Department SEMESTER-V UNIT-1
- 2. Objectives • Definition • Causesand types • Five Stages of children grief • Symptoms of grief • Factor influence of grief response • Grief in difference age group • Grief management for children.
- 4. GRIEF • Grief: "Grievingis a walking through unknown territory. Familiar internal and external stabilities disappear in a whirlwind of changing thoughts, feelings and emotional flux". OR • Grief दुःख : Powerful emotional reaction to separation or loss.
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- 6. MOURNING • Mourning: विलाप(mawn·uhng) " Mourning means the feeling or expression of deep sorrow or grief, especially following the death of someone loved. It often includes specific behaviors or outward signs such as wearing black clothes or observing a period of social withdrawal to show respect for the deceased.
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- 8. BEREAVEMENT • Bereavement: "Bereavementis the period of grief following the death of a loved one". OR • Bereavement शोक (buh·reev·muhnt): State of being deprived of someone by death.
- 9. Causes and Typesof Loss • Death of loved ones or family members • Relationship break-ups • Loss of health or declining health • Loss of friendship • Illness of loved one • Death of pet
- 10. Five Stages ofGrief (Kubler-Ross, 1969) • Denial: "This cannot happen to me" • Anger: "Why is this happening?" • Bargaining: "Make this not happen and I will..." • Depression: "I am too sad to do anything" • Acceptance: "I am at peace with what happened"
- 11. Stages of Children'sGrief (Part 1) • Disorganization: Regression, temper tantrums, lack of concentration, mood swings • Transition: Hopelessness, helplessness, despair, withdrawal, aggression, giving up in school
- 12. Stages of Children'sGrief (Part 2) • Reorganization: Painful feelings expressed, emotional energy fades, more energy for moving forward and resolving grief
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- 14. Physical Signs ofGrief • Insomnia and interrupted sleep • Tight muscles (chest and throat) • Loss of appetite
- 15. Psychological & SocialSigns • Psychological: Preoccupation with loss, anger, fantasies, guilt. • Social: Withdrawal from activities, decreased work productivity
- 16. Factors Influencing GriefResponse
- 17. Factors Influencing GriefResponse • Emotional support from caregiver. • Caregiver's ability to communicate. • Ability to understand. • Cognitive and intellectual development. • Normal age and developmental level. • Concept of loss. • Circumstances surrounding the loss. • Relationship with deceased and grieved. • Emotional reaction for separation. • Religious and cultural belief system. • Previous experience of loss.
- 18. Length of GriefProcess • It depends upon the individual. • Without being maladaptive, it can last for number of years. • In children, acute phase of grieving usually lasts for 6-8 weeks.
- 19. Grief in differenceage group
- 20. Infant Understand death Expressinggrief • Unable to understand the concept of death. • May feel parents are sad, tense and altered routine pattern. • Sleeping more than usual • Excessive crying • Reduced activity • Eat less • Loss weight
- 21. Toddler Understand death Expressinggrief • Separation anxiety, • Cannot understand the true concept of death. • Unable to differentiate death from temporary separation. • Reduced activity even, stop talking also. • Fearfulness • Sleeping problems • Eating problems • Show anger by biting, hitting, tears, etc.
- 22. Preschooler Understand death Expressinggrief • Thinks death is temporary. • Believe that their beloved one will get up soon. • Superstitions like death considered as spirit, ghost or person who can harm them. • Fear of being rejected • Nightmares • Temper tantrums • Hyperactivity • Regression • Crying spell • Sleep disturbance • Abdominal cramping • Phobia • Show anger by aggression on friends, breaking toys, etc.
- 23. Schooler age children Understanddeath Expressing grief • Understand the concept of death. • Accept that death is universal truth. • Deny sadness • Hide tears • Anger • Guilt • Shameful • Anxiety and sleeplessness • Fearful • Lack of attention • Change in eating and sleep habits • Lack of activities
- 24. Adolescents Understand death Expressinggrief • Able to distinguish illness and death. • Capable to understand intellectually. • Sense to understand effect of death on others. • Severe depression • Show denial • Other response is same as school-age children.
- 25. Management of grieffor children
- 26. Infant to 3years 1. Advise the parents to hold and cuddle their child with love. It will help to alleviate child's anxiety and fear of separation. 2. Observe child's activities carefully. 3. Allow the child to respond to the particular situation. 4. Do not alter the familiar routine. 5. If child show the regressive behavior be tolerant always. 6. Listen to the child and answer every question.
- 27. Preschooler 1. Be honestwith the child always. 2. Listen to the child attentively. 3. Answer the questions carefully and honestly. 4. Stay with the child as much as possible. 5. Assure the child that she/he will not be alone. 6. Provide play activities to child. 7. Try to follow usual routines. 8. Allow the child to explore their emotions through play, talk, creative activities. 9. Behave calmly and patiently with aggressive behavior of child. 10. Divert the mind of child with music or television.
- 28. Schooler age children 1.Provide peer support to child. 2. Maintain usual daily routine and supportive working environment. 3. Spend time with child and try to communicate as much as possible. 4. Listen to the child carefully and answer every question honestly. 5. Maintain a sense of belonging and control. 6. Play with the child or provide play activities. 7. Avoid argumentative behavior. 8. Promote the sense of safety to reduce fear of child.
- 29. Adolescents 1. Encourage caregiverto remain with child. 2. Promote a sense of safety and belonging for the child and decrease anxiety. 3. Help the child to explore feelings. 4. Help to understand child's perceptions in order to provide appropriate interventions. 5. Share grief and feelings with the child. 6. Communicate openly with child. 7. Share internet resources. 8. Facilitate contacts with friends.
- 30. Summary • Definition • Causesand types • Five Stages of children grief • Symptoms of grief • Factor influence of grief response • Grief in difference age group • Grief management for children.
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