Understanding the Impact of Loss & Grief on our Patient’s Well Being: Learning How to Take a Loss History

Understanding the Impact of Loss & Grief on our Patient’s Well Being: Learning How to Take a Loss History

Whatever it is that I have lost (or must give up) I must grieve. If I do not do my grieving about the old hurts and insults, then, when I am faced with a here and now grief experience, I will end up having to dredge up all that old energy along with the current experience.
Elaine Childs-Gowell

On a daily basis, medical students, residents, physicians and other healthcare providers care for patients who are experiencing a life challenge or have experienced various losses; yet we may be completely unaware that our patient has been significantly impacted by a loss and is grieving. These include the loss of body image, loss of body function, loss of mental function, loss of health through various illnesses or disease, loss of sexual function, loss of plans, hopes and dreams for the future and loss of independence. Physicians and healthcare providers may also inflict loss on patients with medications, treatments and surgical procedures. Many of the losses faced in medicine evoke a grief response. Therefore it is important that we learn to recognize the signs and symptoms of the normal grief response to distinguish grief from medical disorders and enable the proper diagnosis. Treating those suffering from loss, without being aware of the grief response can have detrimental affects on medical diagnoses, treatment plans and therapeutic responses.

Understanding Loss & Grief

Loss–the disappearance of something cherished by an individual i.e. person or property–is a byproduct of living. Most people have experienced some type of personal or professional loss at some point in their life. There are also many losses that occur during “routine” medical diagnoses or procedures resulting in a patient grieving in addition to his or her medical diagnosis. This is particularly true if the patient is adjusting to being diagnosed with a life-threatening or terminal illness, a chronic medical condition, the loss of a limb or a breast, the loss of a child, the loss of mobility, hearing, sight etc. Many times these losses are never publicly announced or acknowledged such as the case of a miscarriage or abortion, death of a relative by suicide or various types of physical or emotional abuse. Instead the person endures very private sorrows that can impact his/her health and well being.

Grief is the normal reaction to a loss. During this process the grieving person may experience significant and subtle changes that can impact his/her physical, emotional, mental, behavioral and spiritual health thereby compromising overall well being. Experiencing a loss or a life challenging upsets the normal balance and reduces a person’s energy. Therefore, grieving is the highly energy requiring process a person goes through while restoring the balance and energy in his or her life. Grieving losses is an important step for restoring balance, because, according to Elaine Childs-Gowell, if we don’t grieve the old losses, when faced with a new loss, we will have to use our energy to face the past as well as the current loss.

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