Bereavement and grief


Normal grief

  • Normal reaction to loss (bereavement)
  • Sadness more specific to thoughts of the deceased
  • ”Waves” of grief at reminders
  • Self-esteem usually preserved
  • Functional decline less severe
  • Thoughts of dying involve wish to join the deceased; active suicidality uncommon
  • Intensity decreases over time
  • Illusions or hallucinations of the deceased (considered normal if the individual does not believe that they are real)
    • This is normal in children. Children under age 6 do not understand the finality of death and may believe that it is temporary or reversible.

Persistent complex bereavement disorder

  • Definition: a mental disorder characterized by an unusually prolonged period of grief and/or mourning (lasting at least 12 months in adults and 6 months in children) resulting in severe distress and functional impairment.

End-of-life counseling


SPIKES protocol

The SPIKES protocol is a set of recommendations to help practitioners communicate bad news to patients.Pasted image 20240331204205.png