Grief and its manifestations

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Summary

This article summarises the main theories of grief and how it manifests itself. The main stages in the grieving process are examined by reviewing the literature. It is important that nurses have some knowledge of the potentially complicated process involved in grieving to offer help and support to bereaved persons.

Key words

* Bereavement

* Grief

These key words are based on subject headings from the British Nursing Index. This article has been subject to double-blind review.

Aim and intended learning outcomes

The aim of this article is to help nurses develop an understanding of the grief process and how it is experienced by those who suffer the loss of a loved one. For nurses to offer support to bereaved people, it is important that they understand the concept of grief, its attributes and its consequences.

After reading this article you should be able to:

* Define the terms 'grief, 'loss' and 'bereavement'.

* Explain the need for nurses to develop their knowledge of the grieving process.

* Summarise the relationship between attachment theory and loss.

* Articulate how individuals react to loss.

* Identify the need for support for bereaved persons.

Introduction

The word 'grief is derived from the Latin gravare, meaning to burden or to cause distress. The Oxford English Dictionary (1989) defines grief as a great sadness caused by trouble or loss and a heavy sorrow. Synonyms of grief are anguish and heartache, while the antonym is joy. Other terms such as 'loss' and 'bereavement' are also used when referring to grief. Loss is the action of losing or having lost something, while bereavement relates to the loss of a person by death.

The concepts of loss, grief and bereavement are born out of the seminal work of Lindemann (1944), who noted that grieving persons developed coolness in their relationships with others, displayed heightened irritability and anger, and withdrew socially, despite the efforts of others to maintain the relationship and demonstrate support.

According to...