Part 11 Flashcards
The ‘many small deaths of life’ (Weenolsen 1988) are known as:
A. major losses
B. stressors
C. minor losses
D. all the above
C. minor losses
Weenolsen describes minor losses as ‘the many small deaths of life’ (1988 p 21) that can affect us profoundly because they represent larger losses.
The feeling of loss by someone through the experiences of another person is known as ________ loss.
A. indirect
B. actual
C. internal
D. imposed
A. indirect
Weenolsen (1988) describes how loss can occur through the experiences of another person. She notes, for example, the grief that parents can experience through the losses affecting their children, such as serious illness, school difficulties, failed relationships or family problems.
Health-related situations such as dementia, addictions, mental illnesses and head injury involve what sort of loss?
A. Imposed loss
B. Actual loss
C. Ambiguous loss
D. Confused loss
C. Ambiguous loss
One type of ambiguous loss is experienced when a loved one is perceived as physically present but psychologically absent. Health-related situations such as dementia, addictions, mental illnesses and head injury involve this type of ambiguous loss.
Nonfinite loss is contingent on:
A. lifestage development
B. passage of time
C. lack of synchrony between lived experience and hope and expectations
D. all the above
D. all the above
Bruce and Schultz (2001) developed the term nonfinite loss through their clinical and research encounters with families of children with developmental disabilities. They recognised that these parents experienced ongoing loss and grief as the impact of their child’s disability unfolded throughout the lifespan. Nonfinite loss is contingent on three elements: lifestage development; passage of time; and a lack of synchrony between lived experience and hopes and expectations.
The four phases of grieving (numbness; yearning to recover the lost person; disorganisation and despair; and reorganisation) were referred to by:
A. Parkes
B. Bowlby
C. Lindeman
D. both a and b
D. both a and b
Parkes (1972, 1988) and later Bowlby (1980) referred to four phases associated with grieving.
Sanders’s model of grief includes:
A. numbness, yearning to recover the lost person, disorganisation and despair, and reorganisation
B. emancipation from bondage to the deceased, readjustment to the environment without the deceased and the formation of new relationships
C. denial, anger, bargaining, depression and acceptance
D. shock, awareness of loss, conservation-withdrawal, healing and renewal
D. shock, awareness of loss, conservation-withdrawal, healing and renewal
Sanders’s (1999) model proposed five phases in the mourning process: shock, awareness of loss, conservation-withdrawal, healing and renewal.
A more active view of mourning developed by William Worden is known as:
A. nonfinite loss
B. grief process
C. task model
D. all the above
C. task model
Psychologist William Worden argued for a more active view of grieving and developed a widely accepted task model of mourning. Worden (2010) states that a task model fits better with the concept of ‘grief work’ as described by Freud and Lindemann; that is, grievers need to act to move through the grief process.
Agitation, crying, social withdrawal, sleep disturbances, sighing, restlessness and overactivity are:
A. behavioural reactions to grief
B. cognitive reactions to grief
C. avoidance reactions
D. feelings of grief
A. behavioural reactions to grief
Grievers may engage in a range of behavioural reactions. Common behaviours include agitation, crying, social withdrawal, sleep disturbances, appetite changes, absentminded behaviour, avoiding reminders of the deceased, searching and calling out, sighing, restless overactivity, and visiting places or carrying objects that remind one of the deceased.
The latest edition of the Diagnostic and Statistical Manual (DSM-5) will include a new psychiatric disorder named:
A. prolonged grief disorder
B. complicated grief disorder
C. persistent complex bereavement-related disorder
D. none of the above
C. persistent complex bereavement-related disorder
Over time, various diagnostic terms have been suggested for complicated grief, including complicated grief disorder (Horowitz et al 1997), traumatic grief (Prigerson et al 1997, Prigerson & Jacobs 2001b) and prolonged grief disorder (Prigerson et al 2008). As a result of this work, the DSM-5 Task Force of the American Psychiatric Association (APA) has proposed a new diagnosis, persistent complex bereavement-related disorder, in Section III of DSM-5. The task force has placed persistent complex bereavement-related disorder in an appendix, with the expectation that further research will occur ‘to develop the best empirically-based set of symptoms to characterize individuals with bereavement-related disorders’ (APA 2012).
Some cognitive reactions to grief are:
A. disbelief, confusion
B. decreased self-esteem, hallucinations
C. decreased concentration, memory problems
D. all the above
D. all the above
Cognitive reactions to loss can include disbelief, confusion, problems with memory and concentration, lowered self-esteem, hopelessness, sense of unreality, preoccupation with thoughts of the deceased, sense of presence and hallucinations.
The concentration on and dealing with processing of some aspect of the loss experienced itself, most particularly with respect to the deceased person, is the definition of:
A. loss orientation
B. dual process model
C. restoration orientation
D. none of the above
A. loss orientation
This orientation includes the traditional view of grief work, with its focus on relationship or bonds to the deceased person and the ruminations about the deceased, life together, circumstances surrounding the death and yearning for the deceased. Loss orientation is usually more evident in early bereavement, although it can dominate the griever’s attention periodically over time.
The intense, pervasive and recurring sadness that is a normal reaction to significant loss of normality is sometimes called:
A. disenfranchised loss
B. ambiguous loss
C. chronic sorrow
D. none of the above
C. chronic sorrow
Olshansky (1962) first described chronic sorrow as the intense, pervasive and recurring sadness observed in parents of children with an intellectual disability. Other studies have examined chronic sorrow among parents of premature infants (Fraley 1986), parents of children with both physical and intellectual disabilities (Kratochwil & Devereux 1988, Damrosch & Perry 1989), and mothers of children with spina bifida (Burke 1989). Chronic sorrow, while often continuing through one’s
life, is considered ‘a normal reaction to the significant loss of normality in the affected individual or the caregiver’ (Burke et al 1992 p 232).
Health professionals should recommend extra help if their patients maintain continuing bonds or sustain their relationship with the lost person because, in healthy grieving, the griever needs to ‘let go’.
A. True
B. False
B. False
The importance of ‘staying connected’ has been reinforced in the work on continuing bonds. Klass et al (1996) present the findings of various theorists and researchers that support the value for grievers in sustaining their relationship with the lost person. They, too, question the usefulness of grievers having to ‘let go’. These ways of continuing bonds can play a significant ongoing function, even when high levels of grief resolution are reported.
Health professionals should not interfere with the grief process of their patients or their families.
A. True
B. False
B. False
The appreciation that grievers express for the concern, care and support shown by others during times of significant loss clearly indicates there is benefit from such helping actions. For this reason health professionals need to be willing to offer support to grieving patients and families while being respectful of those who do not wish assistance.
Loss in healthcare settings is only about when someone dies and how that affects the family.
A. True
B. False
B. False
Loss, in one form or another, will affect all of us – whether we are patients or health professionals.
