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Kaiser Permanente Medical
Center
Medical Grand Rounds - Diablo
Service Area
Identifying Loss(es) and
the Grief Response in our Patients
Nov 21, 2001: Learning Objectives
Loss is a common experience that every person
encounters at sometime during his or her life; it does not discriminate
for age, race, sex, education, economic status or nationality. Grief is
the normal reaction to the loss. Unrecognized acute loss or unresolved
long-standing grief can mimic many medical conditions. A grieving person
can undergo both significant and subtle changes impacting their physical,
emotional, mental, and spiritual states. They may experience a variety
of somatic complaints: fatigue, insomnia, pain, gastro-intestinal symptoms,
chest pressure, palpitations, stomach pains, backaches, panic attacks,
or increased anxiety; these potentially medically serious complaints require
a through evaluation to exclude potentially serious medical disorders before
a grief response or depression can be diagnosed. Additionally depressive
manifestations and symptoms of distress can be part of a normal grief response
following a loss or a prolonged bereavement response.
Current or prior losses are not something typically
screened for when asking patient’s their medical history. In addition the
impact of a loss e.g. medical diagnosis, loss of limb, loss of mental or
physical capacities on the patient or their family is frequently not considered
in evaluating the health of the patient. Failing to identify a loss and
the subsequent grief response may result in a poor response to therapy
because the underlying diagnosis was not identified.
Learning Objectives:
Major Objectives
Recognize different types of losses that can occur
in everyday living and the additional losses that are suffered with medical
diagnoses.
Identify the signs and symptoms of acute grief and
common presentations of complicated grief.
Distinguish grief from depression and identify the
warning signs and symptoms of unresolved grief that might require further
evaluation.
Additional Objectives
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Incorporate a loss history into medical evaluations.
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Define the various types of grief, loss, bereavement
and mourning.
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Identify several of the common myths associated with
grief and loss.
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Describe the common physical of the acute grief response
and prolonged grief response following a loss and how to distinguish these
from common medical conditions.
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Acquire the ability to recognize grief-related illnesses.
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Understand why there has been an increase in the
incidence of complicated mourning.
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Learn about resources and coping strategies for aiding
grieving patients.
This Kaiser Permanente Medical Grand Rounds was presented to an estimated
150 physicians in the Diablo Service Area in person and via teleconferencing
to several additional satellite locations on November 21, 2001.
Failing
to identify a loss and the subsequent grief response may result in a poor
response to therapy because the actual underlying diagnosis [grief] was never identified.
Kirsti A. Dyer,
MD, MS
See the Emergency
911 Page for links to immediate resources
if you are feeling helpless,
hopeless, overwhelmingly depressed, or suicidal.
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