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NSG22104 MENTAL HEALTH MATERIAL LOSS
AND GRIEF STUDY GUIDE
Mourning rituals
● Mourning is the outward expression of grief
○ Rituals of mourning include having a wake, sitting
shiva, holding religious ceremonies, and arranging
funerals
NSG221.04.01.02
Areas of loss after death of loved one
● Loss of security and a sense of belonging
○ loss of a loved one affects the need to love and the feeling of
being loved
○ accompanies changes in relationships, such as birth,
marriage, divorce, illness, and death
■ as the meaning of a relationship changes, a person
may lose roles within a family or group.
● Loss of self-esteem:
○ Any change in how a person is valued at work or in
relationships or by him or herself can threaten self-
esteem
○ may be an actual change or the person’s perception of a
change in value
○ Death of a loved one, a broken relationship, loss of a job,
and retirement are examples of change that represent loss
and can result in a threat to self-esteem
● Loss related to self-actualization:
○ an external or internal crisis that blocks or inhibits striving
toward fulfillment may threaten personal goals and
individual potential
○ When we realize our goals in life will never materialize
○ These are losses that the person will grieve
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NSG221.04.02.01
Stages of Grief Kubler Ross
1. Denial
a. shock and disbelief regarding the loss.
2. Anger
a. may be expressed toward God, relatives, friends, or health
care providers.
3. Bargaining
a. occurs when the person asks God or fate for more time to
delay the inevitable loss.
4. Depression
a. results when awareness of the loss becomes acute.
5. Acceptance
a. occurs when the person shows evidence of coming to terms
with death.
NSG221.04.02.01
Rando- tasks of grieving
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1. Recognize: Experiencing the loss, understanding that it is real, and
that it has happened
2. React: Emotional response to loss, feeling the feelings
3. Recollect and re-experience: Memories are reviewed and relived
4. Relinquish: Accepting that the world has changed (as a result of
the loss) and that there is no turning back
5. Readjust: Beginning to return to daily life; loss feels less acute and
overwhelming
6. Reinvest: Accepting changes that have occurred; reentering
the world, forming new relationships and commitments
● *Grieving tasks or mourning, bereaved person faces involve
active rather than passive participation
○ sometimes called “grief work” because it is difficult and
requires tremendous effort and energy to accomplish
NSG221.04.02.02
Cultural considerations after death
1. Hmong (people of a mountainous region of Southeast Asia)
a. believe that the deceased person enters the next world
appearing as she or he did at the time of death
b. may lead to a request for removal of needles, tubes, or
other foreign objects before death
2. African Americans
a. many mourning rituals are tied to religious traditions due
to their history of being slaves to European American and
Christian groups
b. Typically, the deceased is viewed in church before being
buried in a cemetery.
c. Mourning may also be expressed through public prayers,
black clothing, and decreased social activities
d. mourning period may last a few weeks to several years
e. Catholic and Episcopalian services, hymns may be sung,
poetry read, and a eulogy spoken
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f. Baptist and Holiness traditions may involve singing, speaking
in other languages, and liturgical dancing
3. Muslim Americans
a. Islam does not permit cremation
b. important to follow the 5 steps of the burial procedure,
which specify washing, dressing, and positioning of the
body
i. 1st step is the traditional washing of the body by a
Muslim of the same gender
4. Haitian Americans
a. Some practice vodun (voodoo), also called “root medicine.”
i. Derived from Roman Catholic rituals and cultural
practices of western Africa (Benin and Togo) and
Sudan
ii. practice of calling on a group of spirits with whom one
periodically makes peace during specific events in life
2
Downloaded by jason mark ()
NSG22104 MENTAL HEALTH MATERIAL LOSS
AND GRIEF STUDY GUIDE
Mourning rituals
● Mourning is the outward expression of grief
○ Rituals of mourning include having a wake, sitting
shiva, holding religious ceremonies, and arranging
funerals
NSG221.04.01.02
Areas of loss after death of loved one
● Loss of security and a sense of belonging
○ loss of a loved one affects the need to love and the feeling of
being loved
○ accompanies changes in relationships, such as birth,
marriage, divorce, illness, and death
■ as the meaning of a relationship changes, a person
may lose roles within a family or group.
● Loss of self-esteem:
○ Any change in how a person is valued at work or in
relationships or by him or herself can threaten self-
esteem
○ may be an actual change or the person’s perception of a
change in value
○ Death of a loved one, a broken relationship, loss of a job,
and retirement are examples of change that represent loss
and can result in a threat to self-esteem
● Loss related to self-actualization:
○ an external or internal crisis that blocks or inhibits striving
toward fulfillment may threaten personal goals and
individual potential
○ When we realize our goals in life will never materialize
○ These are losses that the person will grieve
Downloaded by jason mark ()
,2
NSG221.04.02.01
Stages of Grief Kubler Ross
1. Denial
a. shock and disbelief regarding the loss.
2. Anger
a. may be expressed toward God, relatives, friends, or health
care providers.
3. Bargaining
a. occurs when the person asks God or fate for more time to
delay the inevitable loss.
4. Depression
a. results when awareness of the loss becomes acute.
5. Acceptance
a. occurs when the person shows evidence of coming to terms
with death.
NSG221.04.02.01
Rando- tasks of grieving
1
Downloaded by jason mark ()
,3
1. Recognize: Experiencing the loss, understanding that it is real, and
that it has happened
2. React: Emotional response to loss, feeling the feelings
3. Recollect and re-experience: Memories are reviewed and relived
4. Relinquish: Accepting that the world has changed (as a result of
the loss) and that there is no turning back
5. Readjust: Beginning to return to daily life; loss feels less acute and
overwhelming
6. Reinvest: Accepting changes that have occurred; reentering
the world, forming new relationships and commitments
● *Grieving tasks or mourning, bereaved person faces involve
active rather than passive participation
○ sometimes called “grief work” because it is difficult and
requires tremendous effort and energy to accomplish
NSG221.04.02.02
Cultural considerations after death
1. Hmong (people of a mountainous region of Southeast Asia)
a. believe that the deceased person enters the next world
appearing as she or he did at the time of death
b. may lead to a request for removal of needles, tubes, or
other foreign objects before death
2. African Americans
a. many mourning rituals are tied to religious traditions due
to their history of being slaves to European American and
Christian groups
b. Typically, the deceased is viewed in church before being
buried in a cemetery.
c. Mourning may also be expressed through public prayers,
black clothing, and decreased social activities
d. mourning period may last a few weeks to several years
e. Catholic and Episcopalian services, hymns may be sung,
poetry read, and a eulogy spoken
Downloaded by jason mark ()
, 4
f. Baptist and Holiness traditions may involve singing, speaking
in other languages, and liturgical dancing
3. Muslim Americans
a. Islam does not permit cremation
b. important to follow the 5 steps of the burial procedure,
which specify washing, dressing, and positioning of the
body
i. 1st step is the traditional washing of the body by a
Muslim of the same gender
4. Haitian Americans
a. Some practice vodun (voodoo), also called “root medicine.”
i. Derived from Roman Catholic rituals and cultural
practices of western Africa (Benin and Togo) and
Sudan
ii. practice of calling on a group of spirits with whom one
periodically makes peace during specific events in life
2
Downloaded by jason mark ()
