Factors Influencing The Loss and Grief Responses
Spiritual beliefs and practices greatly influence both a person's reaction to loss and subsequent behavior. Most religious groups have practices related to dying, and these are often important to the client and support people. To provide support at a time of death, nurses need to understand the client's particular beliefs and practices.
The gender roles into which many people are socialized in the United States and Canada affect their reactions at times of loss. Men are frequently expected to "be strong" and show very little emotion during grief, whereas it is acceptable for women to show grief by crying. Often when a wife dies, the husband, who is the chief mourner, is expected to repress his own emotions and to comfort sons and daughters in their grieving.
Gender roles also affect the significance of the body image changes to clients. A man might consider his facial scar to be "macho", but a woman might consider hers ugly. Thus the woman, but not the man, would see the change as a loss.
The socioeconomic status of an individual often affects the support system available at the time of loss. A pension plan or insurance, for example, can offer a widowed or disabled person a choice of ways to deal with a loss; a person who is confronted with both severe loss and economic hardship may not be able to cope with either.
The people closest to the grieving individual are often the first to recognize and provide need emotional, physical and functional assistance. However, because many people are uncomfortable or inexperienced in dealing with losses, the usual support people may instead withdraw from the grieving individual. In addition, support may be available when the loss is first recognized, but as the support people return their usual activities, the need for ongoing support may be unmet. Sometimes, the grieving individual is unable or unready to accept support when it is offered.
Cause of the Loss or Death
Individual and societal views on the cause of loss or death may significantly influence the grief response. Some diseases are considered "clean", such as cardiovascular disorders, and engender compassion, whereas others may be viewed as repulsive and less unfortunate. A loss or death that is beyond the control of those involved may be more acceptable than one that is preventable, such as drunk driving accident. Injuries or deaths occurring during respected activities, such as "in the line of duty", are considered honorable, whereas those occurring during illicit activities may be considered the individual's just rewards.