Idaho State University
Grief transpires across all ages and is an aspect of all cultures (Jacob, 1993). Is a reaction to a situation of loss or impending loss, which can result from the loss of a loved one, or loss of something treasured (Dunn, 2004). There have been numerous research articles and publications in the medical field to aid in defining and managing the aspects of grief. Nevertheless, many aspects of grief still remain unknown (O’Mallon, 2009). Frequently, articles focus in the area of the grief experiences after the loss of a loved one, or treasured items. However, grief can manifest prior to loss of something or someone, such as in the instance of the diagnosis of terminal illness regarding a loved one (Dunn, 2004). This is referred to as anticipatory grief. Family members can go through the grief reaction prior to the death of a loved one once the diagnosis of terminal illness has been given. This is a time when, not only, a good support system is important, but heightened awareness of the heath care provider is necessary. Grief can manifest itself with both physical and mental complications, and requires a holistic approach of care (Field et al., 2008). Definition of the concept
To begin to understand what grief is it is important to first know the foundation, and definition of the word. Grief is derived from the Latin word gravare; which roughly translates to burden or cause distress (Dunn, 2004). The Oxford dictionary defines grief as “great sadness caused by trouble or loss and a heavy sorrow (Oxford dictionary, 1989, p. 209).” Greenstreet, (2004) defines grief as a response that is individual and involves physical, emotional, social, cognitive, and spiritual aspects, and makes the assumption it is a reaction, which ensues according to a perceived loss.
In psychology Freud first defined grief as “the subtle but progressive retreat of energy that is connected to the individual who has experienced a loss to the object that has been lost (Jacob, 1993, p. 1787). As a concept, grief contains attributes including dynamic, individualized, normal, and pervasive, which further helps to define grief as a dynamic, normal, individualized course that permeates all portions of the individual experiencing loss (Jacob, 1993). The concept of grief is considered dynamic because the process does not progress in predictable manner. This signifies that although an individual may feel resolution to certain personal aspects of grief they may again come to light at another time. In addition, grief is also individualized and the specific milieu of life experiences and relationships may impact how a person reacts. Lastly, grief is pervasive and can influence many aspects of the individual life. This can result in the symptoms of fatigue, somatic complaints, hostility, guilt, denial, depression, social isolations, apprehension, and the sensation of being alone (Cowels, 1996). Another aspect of grief can result from of impending loss and is referred to as anticipatory grief, which is defined as “ encompassing the process of morning, coping, interaction, planning, and psychosocial reorganization that are a response to the awareness of the impending death and the recognition of associated losses (Zilberfein, 1999, p. 69).”An example can be a family member that has been diagnosed with terminal cancer, but can be a result of any illness or condition in which there is a significant possibility of death. Many aspects of anticipatory grief mimic that of grief that is a result of loss, and it is frequently overlooked (Al-Gamal & Long, 2010). Anticipatory grief was initially highlighted by Lindemann to illustrate the evolution of grief before a loved one has died (Al-Gamal & Long, 2010). It is the occurrence of the process of grieving prior to the actual loss, and can be experienced by the family member and the individual that is dying. It is...