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Grief, Bereavement, and Coping With Loss (PDQ®)

  • Last Modified: 08/20/2014

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Overview

Health care providers will encounter bereaved individuals throughout their personal and professional lives.[1] The progression from the final stages of cancer to the death of a loved one is experienced in different ways by different individuals. Every person is unique, and thus there will be many individual differences in grief experiences. Most people will experience common or normal grief and will cope well; others will experience more severe grief reactions such as prolonged or complicated grief and will benefit from treatment. Some may even find that the cancer experience, although it is difficult and trying, may lead to significant personal growth.

Coping with death is usually not an easy process and cannot be dealt with in a cookbook fashion. The way in which a person will grieve depends on the personality of the grieving individual and his or her relationship with the person who died. The cancer experience; the manner of disease progression; one’s cultural and religious beliefs, coping skills, and psychiatric history; the availability of support systems; and one’s socioeconomic status all affect how a person will cope with the loss of a loved one via cancer.

This summary first defines the constructs of grief, bereavement, and mourning. It then distinguishes the grief reactions of anticipatory grief, normal or common grief, stage models of normal grief, and complicated or prolonged grief. Psychosocial and pharmacologic treatments are explained. The important developmental issues of children and grief are presented, and a section on cross-cultural responses to grief and mourning concludes the summary.

The following information combines theoretical and empirical reviews of the general literature on grief, bereavement, and mourning [2-5] and is not specific to loss via cancer. Where available, studies that have focused on cancer are emphasized.

In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. The evidence and application to practice related to children may differ significantly from information related to adults. When specific information about the care of children is available, it is summarized under its own heading.

References
  1. Casarett D, Kutner JS, Abrahm J, et al.: Life after death: a practical approach to grief and bereavement. Ann Intern Med 134 (3): 208-15, 2001.  [PUBMED Abstract]

  2. Stroebe MS, Hansson RO, Schut H, et al., eds.: Handbook of Bereavement Research and Practice: Advances in Theory and Intervention. Washington, DC: American Psychological Association, 2008. 

  3. Stroebe MS, Hansson RO, Stroebe W, et al., eds.: Handbook of Bereavement Research: Consequences, Coping, and Care. Washington, DC: American Psychological Association, 2001. 

  4. Bonanno GA, Kaltman S: The varieties of grief experience. Clin Psychol Rev 21 (5): 705-34, 2001.  [PUBMED Abstract]

  5. Jacobs S: Pathologic Grief: Maladaptation to Loss. Washington, DC: American Psychiatric Press, Inc., 1993.