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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 patientís 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
    • Incorporate a loss history into medical evaluations.
    • Define the various types of grief, loss, bereavement and mourning.
    • Identify several of the common myths associated with grief and loss.
    • 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.
    • Acquire the ability to recognize grief-related illnesses.
    • Understand why there has been an increase in the incidence of complicated mourning.
    • 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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    Last update July 20, 2002