12 GRIEF ANDLOSS 259
continued on page 260continued from page 258Critical Component of Support—questions
to explore with the client:
- Who in the client’s life needs to be pre-
sent to offer adequate support for the
client? - How can resources be established to
offer optimum support for the client?
Critical Component of Coping—questions to
keep in mind during planning and imple-
mentation of care:
- How has the client handled past crises?
- How can the client use skills that
have helped in the past for this current
situation? - Considering the phase of his or her
grieving process, how is the client’s
current experience a reflection of ade-
quate coping?
IMPLEMENTATION
Rationale
Your presence demonstrates interest and caring.
Telling the client you will return conveys your
support. The client may need emotional support
to face and express uncomfortable or painful feel-
ings. Confronting the client or pushing him or her
to express feelings may increase anxiety and lead
to further denial or avoidance.Discussing the loss on this level may help to make
it more real for the client.Expression of feelings can help the client to iden-
tify, accept, and work through his or her feelings
even if these are painful or otherwise uncomfort-
able for the client.Nursing Interventions *denotes collaborative interventions
After establishing rapport with the client, bring
up the loss in a supportive manner; if the client
refuses to discuss it, withdraw and state your
intention to return. (“I can understand that you
may not want to talk with me about this now.
I will come to talk with you again at 11:00. Maybe
we can talk about it then.”) Return at the stated
time, then continue to be as supportive as possi-
ble rather than confronting the client.
Talk with the client realistically about his
or her loss; discuss concrete changes that the
client must now begin to make as a result of
the loss.
Encourage the expression of feelings in ways
the client is comfortable—for example, talking,
writing, drawing, crying, wailing, or yelling.
Convey your acceptance of these feelings and
means of expression. Offer the client verbal
support for attempts to express feelings.