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.