Nursing Foundations · Loss, Death & Grief

Loss, Death & Grief

Lossdefinition

The experience of losing something valued; may be actual, perceived, or anticipated.

in simple words: Loss is when something you value is gone or will be gone.

Anticipatory loss

Awareness that a loss will occur in the future.
Grieving before the actual loss.
Common in terminal illness.

Actual loss

Loss has already occurred.
Can be identified by others.
Timing: past or present.

Perceived loss

Felt by the individual.
Intangible; may not be recognized by others.
Internal experience.

Loss, Death & Grief · Nursing Foundations

Grief, Bereavement, Mourning

Griefdefinition

The individualized, internal, subjective response to a loss, whether real, perceived, or anticipated.

in simple words: Grief is the private emotional experience after a loss.

Bereavementdefinition

The objective state of having experienced a loss through death, during which grief and mourning occur.

in simple words: Bereavement is the state of having lost someone.

Mourningdefinition

The outward, social, and cultural expression of grief, such as funerals or wearing black.

in simple words: Mourning is how grief is shown publicly.

Resiliencedefinition

Ability to adapt well and recover quickly from stress, adversity, or trauma.

in simple words: Bouncing back from difficult events; a learnable process.

Hardinessdefinition

A personality trait marked by commitment, control, and viewing challenges as opportunities.

in simple words: A trait that helps withstand stress; differs from resilience (recovery process).

Loss, Death & Grief · Nursing Foundations

Kübler-Ross Stages

Kübler-Ross's five stages of dying describe the emotional responses to loss. They may not be linear and can be revisited. The stages are denial, anger, bargaining, depression, and acceptance.

DABDA

Denial
Anger
Bargaining
Depression
Acceptance

Order of stages

DenialShock and disbelief
AngerFrustration, 'Why me?'
BargainingNegotiating to postpone loss
DepressionSadness, grieving impending loss
AcceptanceComing to terms with loss

Loss, Death & Grief · Nursing Foundations

Post-Mortem Changes

Rigor mortisdefinition

Stiffening of muscles after death, beginning about 2 to 4 hours post-mortem.

in simple words: Muscle stiffening due to ATP depletion; peaks around 12 hours and resolves over 24-48 hours.

Livor mortisdefinition

Post-mortem discoloration from blood settling in dependent body parts under gravity.

in simple words: Blood pooling after death.

Algor mortisdefinition

Cooling of the body after death until it equals ambient temperature.

in simple words: Body cooling after death.

Factors affecting rigor mortis

Cold surroundings delay the onset of rigor mortis and prolong its duration; heat accelerates onset and resolution. Post-mortem care such as positioning the body, closing eyes and mouth, and inserting dentures is done before rigor mortis sets in.

Loss, Death & Grief · Nursing Foundations

Palliative & End-of-Life Care

Palliative caredefinition

Supports patients with terminal or serious illness and their families, aiming to improve quality of life.

in simple words: Holistic care for serious illness; not restricted by age; goal is symptom relief, not cure.

Hospice caredefinition

A specialized model of care for individuals in the last phases of an incurable disease, focusing on comfort and quality of life.

in simple words: For terminally ill patients (prognosis ≤6 months); accepts death as normal.

Therapeutic communication

Ventilation is the free expression of feelings; the nurse listens without interruption. Offering self—making oneself available—conveys empathy. If a grieving family stays silent, remain present in silence. Avoid communication blocks like telling them how to feel or false reassurance.