A disorder that occurs after the death of a signiﬁcant other, in which
the experience of distress accompanying bereavement fails to follow
normative expectations and manifests in functional impairment
• Decreased functioning in life roles
• Decreased sense of well-being
• Grief avoidance
• Longing for the deceased
• Low levels of intimacy
• Persistent emotional distress
• Preoccupation with thoughts of the deceased
• Searching for the deceased
• Verbalization of anxiety; distress about the deceased; detachment
from others; self-blame; disbelief, mistrust, failure to accept the
death; feeling dazed, empty, in shock, or stunned; persistent
• Death of a signiﬁcant other
• Lack of social support
• Emotional instability
• Sudden death of signiﬁcant other
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
The patient will
• Express appropriate feelings of loss, guilt, fear, anger, or sadness.
• Identify the loss and describe what it means to him.
• Appropriately move through stages of grief.
• Maintain healthy patterns of sleep, activity, and eating.
• Verbalize understanding that grief is normal.
• Use healthy coping mechanisms and social support systems.
• Seek fulﬁllment through preferred spiritual practices.
• Begin planning for future.
SUGGESTED NOC OUTCOMES
Grief Resolution; Life Change; Psychosocial Adjustment
INTERVENTIONS AND RATIONALES
Determine: Identify previous losses and assess for depression. Older
patients may experience losses frequently and without adequate
recovery time before the next loss. Multiple losses contribute to
Perform: Help patient identify an area of hope in his or her life.
Focusing on a life purpose may decrease anger and feelings of frus-
Help patient focus realistically on changes the loss has brought
about. This will assist patient in forming plans for the future and
improving social relationships.
Help patient formulate goals for the future to place loss in
perspective and move on to new situations and relationships.
Attend: Encourage patient to express grief and feelings of anger,
guilt, and sadness. Inability to express these feelings may result in
Encourage journaling to express grief and loss. Writing and
exploring feelings is an active process, which may assist in grieving.
Encourage patient and family to engage in reminiscing to give
purpose and meaning to the loss and assist in maintenance of self-
Manage: Contact patient’s preferred spiritual leader, if patient
desires, to provide relief from spiritual distress.
Refer patient to community support systems to help him deal with
his bereavement and grief process.
SUGGESTED NIC INTERVENTIONS
Coping Enhancement; Counseling; Emotional Support; Family Ther-
apy; Grief Facilitation Work
Szanto, K., et al. (2006, February). Indirect self-destructive behavior and overt
suicidality in patients with complicated grief. Journal of Clinical Psychiatry,