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DYING AND DEATH: COPING WITH LOSS
The losses resulting from the death of a loved one may be extremely difficult to cope with. The dying person, as well as close family and friends, frequently suffers emotionally and physically from the impending loss of critical relationships and roles. Words used to describe feelings and behavior related to losses resulting from death include bereavement, grief, grief work, and mourning. These terms are related but not identical in meaning. Understanding them may help in comprehending the emotional processes associated with loss and the cultural constraints that often inhibit normal coping behavior.
Bereavement is generally defined as the loss or deprivation experienced by a survivor when a loved one dies. Because relationships vary in type and intensity, reactions to losses also vary. The death of a parent, a spouse, a sibling, a child, a friend, or a pet will result in different kinds of feelings. In the lives of the bereaved or of close survivors, \"holes\" will be left by the loss of loved ones. We can think of bereavement as the awareness of these holes. Time and courage are necessary to fill these spaces.
A special case of bereavement occurs in old age. Loss is an intrinsic part of growing old. The longer we live, the more losses we are likely to experience. These losses include physical, social, and emotional losses as our bodies deteriorate and more and more of our loved ones die. The theory of bereavement overload has been proposed to explain the effects of multiple losses and the accumulation of sorrow in the lives of some elderly people. This theory suggests that the gloomy outlook, disturbing behavior patterns, and apparent apathy that characterize these people may be related more to bereavement overload than to intrinsic physiological degeneration in old age. Grief is a state of mental distress that occurs in reaction to significant loss, including one\'s own impending death, the death of a loved one, or a quasi-death experience. Grief reactions include any adjustments needed for one to \"make it through the day\" and may include changes in patterns of eat-g, sleeping, working, and even thinking.
When a person experiences a loss that cannot be openly acknowledged, publicly mourned, or socially supported, coping may be much more difficult. This type of grief is referred to us disenfranchised grief. It may occur among those who miscarry, are developmentally disabled, or are close friends rather than relatives of the deceased. It may also include those relationships that are not socially approved, such as those between extramarital lovers or homosexual couples. When society does not assign significance to a high-grief death, grieving is made more difficult for the bereaved.
The term mourning is often incorrectly equated with the term grief. Grief refers to a wide variety of feelings and actions that occur in response to bereavement. Mourning, in contrast, refers to culturally prescribed and accepted time periods and behavior patterns for the expression of grief. In Judaism, for example, \"sitting shivah\" is a designated mourning period of seven days that involves prescribed rituals and prayers. Depending on a person’s relationship with the deceased, various other rituals may continue for up to a year.
In some cases, people are so overwhelmed by grief that they do not return to normal daily living. Support and counseling should be sought when this occurs. Doctors, nurses, psychologists, psychiatrists, and clergy may be helpful in solving problems associated with the loss of a loved one.
Symptoms of grief vary in severity and duration, depending on the situation and the individual. However, the bereaved person can benefit from emotional and social support from family, friends, clergy, employers, and the traditional support organizations, including the medical community and the funeral industry. The larger and stronger the support system, the easier readjustment is likely to be.
Religion provides comfort to many dying and grieving people. Although some people question the existence of an afterlife, others gain support from religious beliefs that provide a purpose and meaning to life. By accepting dying as a part of the continuum of life, many people are able to make necessary readjustments after the death of a loved one. This holistic concept, which accepts dying as a part of the total life experience, is shared by both believers and nonbelievers.
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GENERAL HEALTH
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