Stages of grief process

1. GRIEF
 Grief is the painful psychological and
physiologic responses to loss.
 These response often includes helplessness,
loneliness, hopelessness, sadness, guilt,
anger.
 It effects physical, cognitive, behaviour,
emotional, social and spiritual aspects of the
individual.

2. SYMPTOMS OF GRIEF
 PHYSICAL: Weakness, anorexia, feeling of choking, shortness of breath, tightness
of chest, dry mouth, gastro-intestinal disturbances, insomnia etc.
 COGNITIVE: Difficulty in concentration, hallucinations.
 BEHABIOURAL: Inability to perform even basic activities of daily living,
restlessness, disorganized behaviour.
 AFFECTIVE SYMPTOMS: Sadness, guilt, anger, major depression.

3. STAGES OF GRIEF PROCESS BY
KUBLER ROSS(1969)
Denial
Anger
Bargaining
Depression
Acceptance

5. A. DENIAL OR ISOLATION
In this stage, the client denies that he or she will die,
may repress that is discussed and may isolate self from
reality.
This person may think “ They made mistakes in the
diagnosis.” They may not come to the hospital.

6. B. ANGER
The client expresses range and hospitality in the anger
stage and adopts a “Why me”? Attitude.

7. C. BARGAINING
The client tries to barter for more time.
“ If I can live up to my grandson’s marriage, I will be
satisfied. Just let me live until then”.

8. D. DEPRESSION
In this stage, the client goes through a period of grief
before death.
This is a time of quiet desperation and disengagement
from all associations with the lost entity.

9. E. ACCEPTANCE
The final stage brings a feeling of peace regarding
the loss that has occurred.
Focus is on the reality of the loss and its meaning
for the individuals affected by it.

10. Contd…..
 All in individuals do not experience each of these stages in
response to a loss, nor do they necessarily experience them in
this order.
 Some individuals grieving behaviour may fluctuate, and even
overlap between stages.

11. NURSING INTERVENTION
 Provide an open accepting environment.
 Encourage ventilation of feelings and listen actively.
 Provide various diversional activities.
 Provide teaching about common symptoms of grief.
 Bring together similar aggrieved persons, to encourage
communication, shares experiences of loss and offer companionship,
social and emotional support.