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Home StrategiesGrief |
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Generally, grief is associated with the death of a loved one. In fact, it can be seen to be relevant to the bad news situation in that the patient is facing the loss of good health and the associated restrictions on his/her life, which are imposed by the disease and treatment. Relatives may also be facing loss as they adapt to changes in a loved one's life, which will affect their own lives, and possibly the way they feel about the patient. It is not uncommon for a relative to say "He isn't the man I know anymore".
If bad news has been given sensitively and at the recipient's pace, acceptance should follow. This is the first stage in working through grief, because until acceptance is reached, the emotional pain of loss cannot be felt.
Handling the pain, of the perceived losses of serious illness, can
be very hard for the patient and family. Hopes and dreams may need
to be modified or abandoned, and functioning, both physical, socially
and psychologically may change. This can lead to "difficult" behaviour
as the individual rails against fate, and to the expression of anger
(see  Handling
anger, guilt and blame).
The doctor can help by taking an empathetic approach and encouraging the patient to talk through his concerns. What will not help is "normalising" with statements such as "You will soon adapt. Everyone in your situation goes through these feelings" This may be a fact but, for the patient, these feelings are unique. A more helpful response could be "I can see that you are having difficulty in coming to terms with the changes in your life. Would it help to talk?", because this gives the opportunity to express feelings and begin to put them into perspective.
When the patient has reached acceptance of their current situation, and worked through the frustration and other emotions associated with loss, they may be ready to make new plans, which can be realised in the changed circumstances.
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Denial
