Bereavement is a state of severe loss and deprivation of emotionally invested relationships with, for example, a person, ideal, thing, place, dream, activity, sense of self, security, or status. Grief is the emotional, mental, physical, behavioral, and spiritual response to bereavement; it is also the means to healing. This chapter focuses upon bereavement and grief due to death, attending to their impact upon healthcare providers; the grief process including nuances peculiar to children; disenfranchised grief; and some guidelines in communicating with others. The content is limited in that it is primarily from a Western cultural perspective.

Impact of bereavement and grief upon healthcare providers

Bereavement and grief impact healthcare providers in a number of ways. First, we observe our patients and their loved ones experiencing anticipatory and actual bereavement and grief. In the context of lost health, patients and their families may experience anew losses from their past – death of a loved one, a broken intimate relationship. Furthermore, they may experience losses of control, modesty, innocence and security, normal daily routine. In the face of life-threatening illness, they anticipate the loss of life (i.e., loss of existence, of experiences, of relationships, of dreams).

Second, we as healthcare providers also experience bereavement and grief. When a patient dies, we may experience not only the loss of a person with whom we have worked and for whom we have cared, but we may also experience our own sense of confidence in our ability to care for and take care of others diminished.