Types and Stages of Grief and Comfort Care

Stages of Grief

• Non-linear Process: Patients may experience these stages in a non-sequential manner.
• Stages:
  1. Denial: Shock and disbelief (e.g., not accepting a loved one's diagnosis).
  2. Anger: Feeling that the situation is unfair (e.g., "Why is this happening?").
  3. Bargaining: Making deals for more time or better circumstances (e.g., "Let him live until my wedding").
  4. Depression: Deep sadness and withdrawal.
  5. Acceptance: Coming to terms with the situation; not necessarily feeling okay about it but integrating the grief into life.

Types of Grief

• Anticipatory Grief: Grieving a loss that is impending but has not yet occurred (e.g., terminal illness diagnosis).
• Normal Grief: Uncomplicated grief lasting 6-12 months without impairing daily function.
• Complicated Grief: Persistent grief lasting over a year, impairing the ability to function (e.g., unable to move on with daily life).
• Disenfranchised Grief: Grief not publicly acknowledged (e.g., miscarriage, death of an extramarital lover).

Types of Comfort Care

• Palliative Care:
  • Focuses on symptom and pain management.
  • Applicable for both curative treatments and chronic conditions.
  • Aimed at enhancing quality of life and reducing suffering.
• Hospice Care:
  • For terminal illnesses with an estimated life expectancy of less than six months.
  • Focuses on symptom management and comfort as the patient approaches the end of life.
  • Does not require a DNR status.
  • Patients can remain on hospice care longer than six months if necessary, or be discharged if their condition improves.

Key Takeaways

• Palliative Care: Symptom and pain management for both chronic conditions and terminal illnesses.
• Hospice Care: Care for terminally ill patients, focusing on comfort and symptom management rather than cure.

Additional Information

• Upcoming Content: Effects of immobility, deep vein thrombosis, and nursing care for immobility.