the body while the person is alone. To leave the body
alone after death is disrespectful. The family of the
deceased may request to cover the body with a sheet.
The eyes of the deceased should be closed and the
body should remain covered and untouched until
family, a rabbi, or a Jewish undertaker can begin
rites.Although organ donation is permitted, autopsy
is not; burial must occur within 24 hours unless de-
layed by the Sabbath.
Nurse’s Role
The diverse cultural environment of the United States
offers the sensitive nurse many opportunities to indi-
vidualize care when working with grieving clients. In
extended families, varying expressions and responses
to loss can exist depending on the degree of accultur-
ation. Rather than assuming that he or she under-
stands a particular culture’s appropriate grieving
behaviors, the nurse must encourage clients to dis-
cover and use what is effective and meaningful for
them. For example, the nurse could ask a Hispanic
or Latino client who also is a practicing Catholic if
he or she would like to pray for the deceased. If an
Orthodox Jew has just died, the nurse could offer to
stay with the body while the client notifies relatives.
As the insensitive or inflexible pressures of ac-
culturation have caused people to lose, minimize, or
modify some specific culture-related rituals, they
have consciously put others aside. Many Americans,
however, have experienced a renewed and deepened
awareness of the need for meaningful mourning
through ritual. An example of such an awareness is
the creation of the AIDS quilt. The planting of a flag
in the chaotic debris at Ground Zero during the im-
mediate aftermath of the terrorist attack on the World
Trade Center in September 2001 signaled the begin-
nings of such a ritual. As bodies were recovered and
removed, the caring diligence and attentive presence
of those facilitating their transport continued this
meaningful rite of passage. Through the media, the
United States and much of the world became com-
panions in grief. This grieving process is arduous,
but the rites in its passage are evolutionary. For ex-
ample, creation of a memorial at Ground Zero will be
an essential aspect of integration of the country’s
loss. At the time of this writing, plans for a memorial
are just beginning. In April 2000, a memorial was ded-
icated for the 168 persons who died in the bombing of
the Alfred P. Murrah Federal Building in Oklahoma
City. During the ceremony, a police chaplain deliv-
ered a message to grieving family and friends to “Live
in the present, dream of the future.” Memorials and
public services play an important role in the healing
process.
DISENFRANCHISED GRIEF
Disenfranchised griefis grief over a loss that is
not or cannot be acknowledged openly, mourned pub-
licly, or supported socially. Three categories of circum-
stances can result in disenfranchised grief:- A relationship has no legitimacy.
- The loss itself is not recognized.
- The griever is not recognized.
In each situation, there was an attachment fol-
lowed by a loss that leads to grief. The grief process
is more complex because the usual supports that
facilitate grieving and the healing process are absent
(Lenhardt, 1997).
In our culture, kin-based relationships receive
the most attention in cases of death. Relationships
between lovers, friends, neighbors, foster parents,
colleagues, and caregivers may be long lasting and
intense, but people suffering loss in these relation-
ships may not be able to mourn the loss publicly with
the same social support and recognition as family
members. In addition, some relationships are not
always recognized publicly or sanctioned socially.
Possible examples include same-sex relationships,
cohabitation without marriage, and extramarital
affairs.
Some losses are not recognized or seen as socially
significant; thus, accompanying grief is not legit-
imized, expected, or supported. Examples in this cat-
egory include prenatal death, abortion, relinquishing
a child for adoption, death of a pet, or other losses not
involving death such as job loss, separation, divorce,
and children leaving home. Though these losses can
lead to intense grief, other people may perceive them
as minor (Lenhardt, 1999).
People who experience a loss may not be recog-
nized or fully supported as a griever. For example,
older adults and children experience limited social
recognition for their losses and the need to mourn.
As people grow older, they “should expect” others
their age to die. Adults sometimes view children as
“not understanding or comprehending” the loss and
can assume wrongly that their children’s grief is
minimal. Children also may experience the loss of
a “nurturing parental figure” from death, divorce,
or family dysfunction such as alcoholism or abuse.
These losses are very significant, yet they may not
be recognized.
Nurses may experience disenfranchised grief
when their need to grieve is not recognized. For ex-
ample, nurses who work in areas involving organ do-
nation or transplantation are involved intimately
with the death of clients who may donate organs to
another person(s). The daily intensity of relation-
ships between nurses and clients/families creates
248 Unit 3 CURRENTSOCIAL ANDEMOTIONALCONCERNS