conclusion of grief essay

Essay on Grief

Students are often asked to write an essay on Grief in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Grief

Understanding grief.

Grief is a deep sadness we feel when we lose something or someone important to us. It’s a natural response to loss.

Types of Grief

There are different types of grief. Anticipatory grief happens before a loss, while normal grief comes after a loss. Complicated grief lasts a long time and makes it hard to live normally.

Dealing with Grief

Everyone deals with grief differently. Some people cry, some people get angry, and some people feel numb. It’s okay to feel these emotions. It’s important to talk about your feelings and ask for help if you need it.

250 Words Essay on Grief

Grief is a complex, multifaceted emotional response to loss, particularly to the loss of someone or something that has died, to which a bond or affection was formed. It is a universal experience that transcends culture and society, yet it is intensely personal and unique to each individual.

The Five Stages of Grief

Elisabeth Kübler-Ross’s model of the five stages of grief – denial, anger, bargaining, depression, and acceptance – is widely recognized in the field of psychology. This model, however, doesn’t necessarily depict a linear progression. Individuals may experience these stages in varying orders or even revisit certain stages multiple times.

The Complexity of Grief

Grief is not merely a series of emotional states but also involves cognitive, physical, and social disruptions. It often leads to questioning one’s beliefs, physical symptoms like fatigue or insomnia, and changes in social dynamics.

Grief as a Process of Healing

Despite the pain, grief is a necessary process of healing and adaptation. It allows individuals to reconcile their loss, adjust to a new reality, and eventually find a way to move forward. It’s important to remember that there’s no right or wrong way to grieve, and each person’s journey through grief is unique.

In conclusion, grief is a complex and deeply personal process that involves more than just emotional pain. It’s a universal yet unique experience, a series of stages that don’t always follow a linear path, and a necessary process of healing and adaptation. Understanding the nature of grief can help us better navigate our own experiences of loss and provide empathetic support to others in their times of sorrow.

500 Words Essay on Grief

Introduction to grief.

Grief is a universal human experience, a natural response to loss that transcends culture and language. It is a multifaceted response to loss, particularly to the loss of someone or something that has died, to which a bond or affection was formed. It is an emotional, physical, and social reaction that varies from person to person and reflects one’s personal loss experience.

The complexity of grief is often underestimated. It is not a linear process with a defined endpoint but rather a cyclical journey of highs and lows. The Five Stages of Grief model proposed by Elisabeth Kübler-Ross — denial, anger, bargaining, depression, and acceptance — while widely accepted, is not exhaustive nor does it necessarily follow a sequential order.

Grief is a deeply personal and subjective experience. It is influenced by a myriad of factors, including the nature of the loss, the grieving individual’s personal characteristics, their coping mechanisms, and their social support network. It is not solely a psychological process but also involves physiological responses such as changes in appetite and sleep patterns, fatigue, and somatic complaints.

Grief in the Light of Culture and Society

Cultural and societal norms play a significant role in shaping the grieving process. Societies have prescribed rituals and customs related to mourning that provide a framework to express grief and offer communal support. However, these cultural scripts can also limit the expression of grief, especially when they demand a quick return to normalcy or discourage the expression of certain emotions.

In Western societies, grief is often privatized and pathologized, creating a culture of silence around it. This can lead to disenfranchised grief, a term coined by Kenneth Doka, where a person’s grief is not acknowledged or validated by society. This can occur in instances of non-normative losses, such as the loss of a pet, or when the grieving individual does not conform to societal expectations, such as men expressing grief openly.

The Healing Process

Healing from grief is not about forgetting the loss or returning to a pre-loss state, but rather about finding ways to live with the loss. It involves creating a new normal where the loss is integrated into the individual’s life. Grief counseling and support groups can facilitate this process by providing a safe space to express grief, validate the individual’s loss experience, and develop coping strategies.

In conclusion, grief is a complex, multifaceted response to loss that is deeply personal and influenced by a myriad of factors. It is a testament to our capacity for love and attachment, and thus, an integral part of the human experience. Understanding grief in all its dimensions can foster empathy and compassion, ultimately creating more supportive and understanding environments for those who are grieving.

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If you’re looking for more, here are essays on other interesting topics:

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Essays About Grief: Top 5 Examples Plus 7 Prompts

Discover our guide with helpful examples of essays about grief and inspiring writing prompts to help you begin writing about this sensitive and emotional topic.

Grief is a human being’s normal but intense and overwhelming emotional response to painful events like the death of a family or friend, disasters, and other traumatic incidents. To cope, we go through five stages of grief : denial, anger, bargaining, depression, and acceptance. 

Writing about grief can trigger strong emotions. However, many also find acknowledging the subject helpful in processing their feelings. Grief is a sensitive topic that covers morals and beliefs. It requires empathy and awareness. 

5 Essay Examples

• 1. Death And Stages Of Grief  by Anonymous on IvyPanda.Com

2. Loss And Grief by Anonymous on GradesFixer.Com

3. coping with grief by writer faith, 4. the main stages of overcoming grief by anonymous on ivypanda.com, 5. stages of grief and people’s perception of grief based on age by anonymous on gradesfixer.com, 1. what is grief, 2. the best way to handle grief, 3. grief and depression, 4. when grief becomes dangerous, 5. books about grief, 6. a personal experience with grief, 7. art inspired by grief, 1. death and stages of grief   by anonymous on ivypanda.com.

“… Ignoring various philosophical and religious views, death can practically be interpreted as a complete cessation of the body’s vital functions. When faced with the death of loved ones, as well as with other traumatic events, a person usually experiences grief.”

This essay expounds on the five stages of grief defined by Elisabeth Kübler-Ross and what people go through in each phase. The author uses the story of the philosopher Nicholas Wolterstorff who lost his son Eric in an accident. The piece further discusses how Nicholas went through each stage, including believing in God’s promise that his son would have eternal life in heaven. The writer believes that grief doesn’t usually follow an order and sometimes appears random. Such as in Wolterstorff’s situation, where he experienced depression before the bargaining phase.

Looking for more? Check out these essays about losing a loved one .

“The loss of a loved one will always be a painful personal journey, and a coping experience that no one is ready for or can prepare for till it happens. The after effect or grief is always personal for everyone that loses a loved one.”

The author presents different poems that reflect her loss and sadness for her mother’s passing. She connects to the poem “ The Courage That My Mother Had ” and values the things her mother left behind. There are times when grieving individuals think they are healed, but one event can bring back the pain in an instant. The writer believes that grief doesn’t end after the acceptance phase. It’s because whenever we think of our loved ones who have already passed away and relive the memories we had of them, we always wish they were still with us.

“Grief is an emotion that unfortunately, we all come to experience at some time or another. However, that terrible feeling can open the door to acceptance and appreciation. Mourning and reflecting upon a tragic event can cause one to look at an issue through a different perspective, and maybe even help them to accept it.”

Faith’s essay demonstrates how tragedies can cause people to unite and support each other. Processing grief teaches the bereaved to be stronger and appreciate the people who offer comfort and encouragement. It also teaches us not to take anything for granted by cherishing even the simple things in life. Faith sees grief and terrible events as negative experiences, but they can lead to positive results that steer people to be grateful.

“Grief is one of the most complicated processes which is to be combated. Some people are able to cope with grief individually, others need assistance. There are even cases when people need professional help to cope with grief.”

The essay contains various passages that discuss the five stages of grief. The author believes denial is the root of grief in all phases. The author supposes that people can overcome grief through several methods, such as reading the bible, getting support from family and relatives, accepting the loss, and learning to live with it.

“The intensity and duration of grief may depend on many factors, such as the personality of the individual, the relationship to the deceased, and the circumstances of the death. Unexpected, sudden, or accidental death can be extremely shocking. Death of one’s child at any age is difficult to accept.”

The essay discusses how various factors, such as relationship, age, and cause of death, affect grief’s intensity and duration. It mentions that grief can last years and that losing a child at any age is the most challenging case to accept. 

The author presents various scenarios showing how these elements influence the state of grieving. For example, a person grieving the loss of their spouse may hear their voice and feel their presence in the room. 

7 Prompts for Essays About Grief

Simply defining grief in your essay won’t make it stand out among the rest. To make your piece enjoyable, describe grief in a way that probes your readers’ feelings and imagination. You can personify grief or compare it to another familiar feeling to give you an idea. For example, you can say grief is a stranger persistently reaching out to you to make you remember hurtful memories.  

We deal with grief in our own way; some take it in their stride, while some become a wreck. Use this prompt to enumerate excellent ways to deal with this heavy emotion. Ask yourself what you’ll do if you can’t get over grief and research thoroughly. Pick the most effective methods of overcoming grief and support your findings with relevant data.

There are many effects of grief, and depression is one of the most significant. Loneliness can negatively affect how a person thinks and acts, but grief makes depression worse. Write an essay with a series of situations that show how grief can lead to depression and ways to prevent it.

Here are some essays about depression to give you an idea of how to write this topic.

Grieving is a normal reaction to losing a loved one but it can turn dangerous when the individual grieving stops normally functioning for at least a year after the death. For this prompt, include reasons people break and let grief consume them, such as extreme depression and fatigue. Add signs and symptoms that can help others detect when someone’s grief becomes unsafe for the individual and the people around them.

In your essay, recommend books, documentaries, or movies detailing grief. These books can be accounts of those who already went through the grieving process and are sharing their experiences. For example, Every Word You Cannot Say by Iain S. Thomas is a delicate book that guides readers into acknowledging their feelings. Detail why these books are helpful for people grieving and recommend at least three books or other forms of media that the reader can use to cope.

Share an encounter you had with grief. Describe what you felt and narrate how you grappled with the situation. For instance, if you have ever helped someone suffering from grief, explain the step-by-step method you used and why you decided to help that person. Even if you don’t have any personal experience with grief, you can interview someone who has gone through it. Remember that it’s a delicate subject, so your questions should be diplomatic.

There are many mediums people use to process their strong feelings. One is through creating art. When writing your essay, list arts made by grief or inspired by grief. Add comments on how the artist managed to relay the loss and grief through the art. You can also share your favorite art you think best depicts grief. Like Vincent Van Gogh’s 1890 painting called “ Sorrowing Old Man .”Learn about transition words for essays to improve your work.

Maria Caballero is a freelance writer who has been writing since high school. She believes that to be a writer doesn't only refer to excellent syntax and semantics but also knowing how to weave words together to communicate to any reader effectively.

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Sheryl Sandberg’s essay on grief is one of the best things I’ve read about marriage

by Amanda Taub

When my closest friend got married a few years ago, I asked her if anything felt different after the ceremony. "Yes," she said. "Realizing that my best-case scenario is now that I die first." Her tone was flip, and we both laughed. But there was truth to what she said.

I love my husband so much that I hesitate to write about him — it feels unseemly, like bragging. It is impossibly painful to even imagine life without him: his presence is the source of my greatest joy in life, just as the idea of losing him is one of my worst fears. The best-case scenario is that I die first.

Sheryl Sandberg lost her beloved husband, Dave Goldberg, 30 days ago. To mark that occasion, she has written one of the best essays I have ever read about what it feels like to confront that terrible fear, and to deal with the profound grief that comes from losing someone you love. Her description of her grief since Goldberg's death feels true not just as a statement of what it is like to lose someone you love, but also what it means to deeply love someone, and the value that our loved ones hold in our lives.

A childhood friend of mine who is now a rabbi recently told me that the most powerful one-line prayer he has ever read is: "Let me not die while I am still alive." I would have never understood that prayer before losing Dave . Now I do. I think when tragedy occurs, it presents a choice. You can give in to the void, the emptiness that fills your heart, your lungs, constricts your ability to think or even breathe. Or you can try to find meaning. These past thirty days, I have spent many of my moments lost in that void. And I know that many future moments will be consumed by the vast emptiness as well. But when I can, I want to choose life and meaning.

Strangely enough, the perfect companion piece to Sandberg's essay is not about loss, but about the joy of having children. Michelle Goldberg (no relation to Dave Goldberg) wrote in New York Magazine last week about what inspired her and her husband to grow their family.

"Not long ago," she writes , "I learned the Arabic word Ya'aburnee . Literally, 'you bury me,' it means wanting to die before a loved one so as not to have to face the world without him or her in it."

Goldberg realized that those words captured her feelings for her husband, and that having a child would be a way to bring more of him into the world — and a way to hold on to part of him if someday she lost him.

Goldberg and her husband now have two children, and they have enriched her life, she writes, in ways she would never have believed possible. "Before there was one person in the world for whom I would use the word Ya'aburnee , and now there are three."

Reading Sandberg's essay with Goldberg's is a reminder that the pain of loss is a worthwhile price to pay for the joy of love and marriage. Although Sandberg's husband has died, the life they built together still remains. Her essay closes with a moving promise to support what they built, and the children they had together, even as she mourns him:

I can’t even express the gratitude I feel to my family and friends who have done so much and reassured me that they will continue to be there. In the brutal moments when I am overtaken by the void, when the months and years stretch out in front of me endless and empty, only their faces pull me out of the isolation and fear. My appreciation for them knows no bounds. I was talking to one of these friends about a father-child activity that Dave is not here to do. We came up with a plan to fill in for Dave. I cried to him, "But I want Dave. I want option A." He put his arm around me and said, "Option A is not available. So let’s just kick the shit out of option B." Dave, to honor your memory and raise your children as they deserve to be raised, I promise to do all I can to kick the shit out of option B. And even though sheloshim has ended, I still mourn for option A. I will always mourn for option A. As Bono sang, "There is no end to grief . . . and there is no end to love." I love you, Dave.

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• Death And Dying

8 Popular Essays About Death, Grief & the Afterlife

Updated 05/4/2022

Published 07/19/2021

Joe Oliveto, BA in English

Contributing writer

Cake values integrity and transparency. We follow a strict editorial process to provide you with the best content possible. We also may earn commission from purchases made through affiliate links. As an Amazon Associate, we earn from qualifying purchases. Learn more in our affiliate disclosure .

Death is a strange topic for many reasons, one of which is the simple fact that different people can have vastly different opinions about discussing it.

Jump ahead to these sections: 

Essays or articles about the death of a loved one, essays or articles about dealing with grief, essays or articles about the afterlife or near-death experiences.

Some fear death so greatly they don’t want to talk about it at all. However, because death is a universal human experience, there are also those who believe firmly in addressing it directly. This may be more common now than ever before due to the rise of the death positive movement and mindset.

You might believe there’s something to be gained from talking and learning about death. If so, reading essays about death, grief, and even near-death experiences can potentially help you begin addressing your own death anxiety. This list of essays and articles is a good place to start. The essays here cover losing a loved one, dealing with grief, near-death experiences, and even what someone goes through when they know they’re dying.

Losing a close loved one is never an easy experience. However, these essays on the topic can help someone find some meaning or peace in their grief.

1. ‘I’m Sorry I Didn’t Respond to Your Email, My Husband Coughed to Death Two Years Ago’ by Rachel Ward

Rachel Ward’s essay about coping with the death of her husband isn’t like many essays about death. It’s very informal, packed with sarcastic humor, and uses an FAQ format. However, it earns a spot on this list due to the powerful way it describes the process of slowly finding joy in life again after losing a close loved one.

Ward’s experience is also interesting because in the years after her husband’s death, many new people came into her life unaware that she was a widow. Thus, she often had to tell these new people a story that’s painful but unavoidable. This is a common aspect of losing a loved one that not many discussions address.

2. ‘Everything I know about a good death I learned from my cat’ by Elizabeth Lopatto

Not all great essays about death need to be about human deaths! In this essay, author Elizabeth Lopatto explains how watching her beloved cat slowly die of leukemia and coordinating with her vet throughout the process helped her better understand what a “good death” looks like.

For instance, she explains how her vet provided a degree of treatment but never gave her false hope (for instance, by claiming her cat was going to beat her illness). They also worked together to make sure her cat was as comfortable as possible during the last stages of her life instead of prolonging her suffering with unnecessary treatments.

Lopatto compares this to the experiences of many people near death. Sometimes they struggle with knowing how to accept death because well-meaning doctors have given them the impression that more treatments may prolong or even save their lives, when the likelihood of them being effective is slimmer than patients may realize.

Instead, Lopatto argues that it’s important for loved ones and doctors to have honest and open conversations about death when someone’s passing is likely near. This can make it easier to prioritize their final wishes instead of filling their last days with hospital visits, uncomfortable treatments, and limited opportunities to enjoy themselves.

3. ‘The terrorist inside my husband’s brain’ by Susan Schneider Williams

This article, which Susan Schneider Williams wrote after the death of her husband Robin Willians, covers many of the topics that numerous essays about the death of a loved one cover, such as coping with life when you no longer have support from someone who offered so much of it. 

However, it discusses living with someone coping with a difficult illness that you don’t fully understand, as well. The article also explains that the best way to honor loved ones who pass away after a long struggle is to work towards better understanding the illnesses that affected them. 

4. ‘Before I Go’ by Paul Kalanithi

“Before I Go” is a unique essay in that it’s about the death of a loved one, written by the dying loved one. Its author, Paul Kalanithi, writes about how a terminal cancer diagnosis has changed the meaning of time for him.

Kalanithi describes believing he will die when his daughter is so young that she will likely never have any memories of him. As such, each new day brings mixed feelings. On the one hand, each day gives him a new opportunity to see his daughter grow, which brings him joy. On the other hand, he must struggle with knowing that every new day brings him closer to the day when he’ll have to leave her life.

Coping with grief can be immensely challenging. That said, as the stories in these essays illustrate, it is possible to manage grief in a positive and optimistic way.

5. Untitled by Sheryl Sandberg

This piece by Sheryl Sandberg, Facebook’s current CEO, isn’t a traditional essay or article. It’s actually a long Facebook post. However, many find it’s one of the best essays about death and grief anyone has published in recent years.

She posted it on the last day of sheloshim for her husband, a period of 30 days involving intense mourning in Judaism. In the post, Sandberg describes in very honest terms how much she learned from those 30 days of mourning, admitting that she sometimes still experiences hopelessness, but has resolved to move forward in life productively and with dignity.

She explains how she wanted her life to be “Option A,” the one she had planned with her husband. However, because that’s no longer an option, she’s decided the best way to honor her husband’s memory is to do her absolute best with “Option B.”

This metaphor actually became the title of her next book. Option B , which Sandberg co-authored with Adam Grant, a psychologist at the Wharton School of the University of Pennsylvania, is already one of the most beloved books about death , grief, and being resilient in the face of major life changes. It may strongly appeal to anyone who also appreciates essays about death as well.

6. ‘My Own Life’ by Oliver Sacks

Grief doesn’t merely involve grieving those we’ve lost. It can take the form of the grief someone feels when they know they’re going to die.

Renowned physician and author Oliver Sacks learned he had terminal cancer in 2015. In this essay, he openly admits that he fears his death. However, he also describes how knowing he is going to die soon provides a sense of clarity about what matters most. Instead of wallowing in his grief and fear, he writes about planning to make the very most of the limited time he still has.

Belief in (or at least hope for) an afterlife has been common throughout humanity for decades. Additionally, some people who have been clinically dead report actually having gone to the afterlife and experiencing it themselves.

Whether you want the comfort that comes from learning that the afterlife may indeed exist, or you simply find the topic of near-death experiences interesting, these are a couple of short articles worth checking out.

7. ‘My Experience in a Coma’ by Eben Alexander

“My Experience in a Coma” is a shortened version of the narrative Dr. Eben Alexander shared in his book, Proof of Heaven . Alexander’s near-death experience is unique, as he’s a medical doctor who believes that his experience is (as the name of his book suggests) proof that an afterlife exists. He explains how at the time he had this experience, he was clinically braindead, and therefore should not have been able to consciously experience anything.

Alexander describes the afterlife in much the same way many others who’ve had near-death experiences describe it. He describes starting out in an “unresponsive realm” before a spinning white light that brought with it a musical melody transported him to a valley of abundant plant life, crystal pools, and angelic choirs. He states he continued to move from one realm to another, each realm higher than the last, before reaching the realm where the infinite love of God (which he says is not the “god” of any particular religion) overwhelmed him.

8. “One Man's Tale of Dying—And Then Waking Up” by Paul Perry

The author of this essay recounts what he considers to be one of the strongest near-death experience stories he’s heard out of the many he’s researched and written about over the years. The story involves Dr. Rajiv Parti, who claims his near-death experience changed his views on life dramatically.

Parti was highly materialistic before his near-death experience. During it, he claims to have been given a new perspective, realizing that life is about more than what his wealth can purchase. He returned from the experience with a permanently changed outlook.

This is common among those who claim to have had near-death experiences. Often, these experiences leave them kinder, more understanding, more spiritual, and less materialistic.

This short article is a basic introduction to Parti’s story. He describes it himself in greater detail in the book Dying to Wake Up , which he co-wrote with Paul Perry, the author of the article.

Essays About Death: Discussing a Difficult Topic

It’s completely natural and understandable to have reservations about discussing death. However, because death is unavoidable, talking about it and reading essays and books about death instead of avoiding the topic altogether is something that benefits many people. Sometimes, the only way to cope with something frightening is to address it.

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• Coping With Grief

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Reflections on the Death of a Loved One

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Understanding the Emotional Landscape: Elisabeth Kübler-Ross’s Stages of Grief

This essay about Elisabeth Kübler-Ross’s work explores her influential model of the five stages of grief: denial, anger, bargaining, depression, and acceptance. Originally applied to terminal illness, this framework has since been used to understand various types of loss. It emphasizes the personal and non-linear nature of grief, promoting empathy and patience. The essay also addresses criticisms and highlights contemporary theories that complement and expand upon Kübler-Ross’s model.

How it works

Elisabeth Kübler-Ross, the pioneering Swiss-American psychiatrist, significantly transformed our understanding of grief through her landmark work, “On Death and Dying,” published in 1969. She introduced the Kübler-Ross model, delineating five stages of grief: denial, anger, bargaining, depression, and acceptance. This model has become a valuable framework for understanding the emotional turmoil experienced during bereavement. Initially conceptualized within the context of terminal illness, these stages have since been broadly applied to various types of loss, offering comfort and insight to many navigating the intricate landscape of grief.

Grief is a deeply personal experience, manifesting uniquely for each individual. The Kübler-Ross model does not dictate a strict, linear progression through sorrow but rather highlights common emotional responses that many encounter. Understanding these stages can foster greater empathy and patience, both for oneself and for others coping with loss.

The first stage, denial, acts as a protective mechanism. When faced with overwhelming news, the mind may initially reject the reality of the situation. This period of shock and disbelief provides a temporary respite, allowing the individual to gradually process the magnitude of their loss. Denial can manifest as numbness, a sense of detachment, or an insistence that “this can’t be happening.” The duration and intensity of this stage can vary, and individuals may revisit it multiple times throughout their grieving process.

As denial recedes, it often gives way to anger. This second stage can be one of the most challenging, both for the individual experiencing it and for those around them. Anger may be directed at oneself, others, or even the person who has been lost. It can also be projected onto unrelated aspects of life, such as one’s job or the healthcare system. This stage is characterized by a deep sense of frustration and helplessness. While difficult to witness, anger is a natural and necessary part of grieving. It signifies that the individual is beginning to confront their loss, grappling with the pain and perceived injustice.

The third stage, bargaining, often involves a desperate search for meaning or a way to regain control. This can manifest as “if only” statements, such as “if only I had sought a second opinion,” or “if only I had been more attentive.” In the context of terminal illness, it might include attempts to negotiate with a higher power for more time or a reprieve. Bargaining represents a recognition of the reality of the loss while still clinging to the hope of reversing it. This stage reflects the inherent struggle between accepting what has happened and yearning for an alternate reality.

Depression, the fourth stage, can be the most profound and enduring. It involves confronting the full weight of the loss, leading to intense feelings of sadness, emptiness, and despair. This stage can encompass a range of emotions, from deep sorrow to feelings of hopelessness and fatigue. Individuals may withdraw from social activities, experience changes in sleep and appetite, and struggle with a pervasive sense of melancholy. It is crucial to differentiate between the natural sadness of grief and clinical depression, which may require professional intervention. This stage underscores the need for compassion and support as individuals navigate through their darkest moments.

The final stage, acceptance, is often misunderstood as a state of happiness or resolution. Rather, it is about coming to terms with the reality of the loss. Acceptance does not mean that the pain has vanished or that the individual is no longer affected by their grief. Instead, it signifies a shift in perspective, where the individual begins to find a way to move forward with their life, carrying the memory of their loss with them. This stage can involve finding new routines, re-engaging with daily activities, and slowly rebuilding one’s life. Acceptance allows for moments of joy and peace to re-enter, even amid the ongoing presence of grief.

It is crucial to recognize that these stages are not rigid or sequential. Individuals may move back and forth between stages, experience multiple stages simultaneously, or skip stages altogether. The Kübler-Ross model serves as a guide rather than a strict roadmap, offering insights into the diverse ways grief can manifest. Each person’s journey through grief is distinct, shaped by their personality, experiences, and the nature of their loss.

Moreover, the model’s application extends beyond personal bereavement. It has been used to understand reactions to various forms of loss, such as the end of a relationship, loss of employment, or a significant change in life circumstances. By acknowledging the emotional responses outlined in the Kübler-Ross model, individuals and those supporting them can navigate these challenging transitions with greater empathy and understanding.

Critics of the Kübler-Ross model argue that it can oversimplify the grieving process, potentially leading to unrealistic expectations about how one “should” grieve. There is also a risk of pathologizing natural emotional responses, suggesting that deviation from these stages indicates abnormal grief. However, Kübler-Ross herself emphasized the fluidity and individuality of grief, cautioning against a rigid interpretation of her model. It is essential to use her framework as a tool for reflection and insight, rather than a prescriptive formula.

In recent years, there has been a growing recognition of the need to expand upon Kübler-Ross’s work to encompass a more comprehensive understanding of grief. Contemporary theories emphasize the continuing bonds individuals maintain with their loved ones, the role of meaning-making in the grieving process, and the diverse cultural expressions of grief. These perspectives complement the Kübler-Ross model, enriching our understanding of the multifaceted nature of loss.

Elisabeth Kübler-Ross’s contributions to the field of thanatology (the study of death and dying) have left an indelible mark on how we perceive and support those in mourning. Her model provides a valuable framework for navigating the emotional landscape of grief, fostering a deeper appreciation for the complex and often tumultuous journey of healing. By embracing the insights offered by the Kübler-Ross model, we can approach our own grief and that of others with greater compassion, patience, and resilience.

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Understanding the Emotional Landscape: Elisabeth Kübler-Ross's Stages of Grief. (2024, May 28). Retrieved from https://papersowl.com/examples/understanding-the-emotional-landscape-elisabeth-kubler-rosss-stages-of-grief/

"Understanding the Emotional Landscape: Elisabeth Kübler-Ross's Stages of Grief." PapersOwl.com , 28 May 2024, https://papersowl.com/examples/understanding-the-emotional-landscape-elisabeth-kubler-rosss-stages-of-grief/

PapersOwl.com. (2024). Understanding the Emotional Landscape: Elisabeth Kübler-Ross's Stages of Grief . [Online]. Available at: https://papersowl.com/examples/understanding-the-emotional-landscape-elisabeth-kubler-rosss-stages-of-grief/ [Accessed: 4 Jun. 2024]

"Understanding the Emotional Landscape: Elisabeth Kübler-Ross's Stages of Grief." PapersOwl.com, May 28, 2024. Accessed June 4, 2024. https://papersowl.com/examples/understanding-the-emotional-landscape-elisabeth-kubler-rosss-stages-of-grief/

"Understanding the Emotional Landscape: Elisabeth Kübler-Ross's Stages of Grief," PapersOwl.com , 28-May-2024. [Online]. Available: https://papersowl.com/examples/understanding-the-emotional-landscape-elisabeth-kubler-rosss-stages-of-grief/. [Accessed: 4-Jun-2024]

PapersOwl.com. (2024). Understanding the Emotional Landscape: Elisabeth Kübler-Ross's Stages of Grief . [Online]. Available at: https://papersowl.com/examples/understanding-the-emotional-landscape-elisabeth-kubler-rosss-stages-of-grief/ [Accessed: 4-Jun-2024]

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Congratulations on reaching the end of this free course, An introduction to death, dying and grief. You started the course by looking at how there are different understandings of death and you considered how language shapes and conveys our ideas and beliefs about death. You then moved on to examining a ‘good death’ in the West and the aspects of the experience that are important for it to be a good death. In Section 3, you considered the debate around assisted dying and learned about the complexity of the debate by considering your own personal values as well as others. In Section 4, you were introduced to ethical dilemmas and the challenge of navigating what is ‘right’ and ‘wrong’ in a consistent way. In the final section, you learned about private and public expressions of grief and bereavement and how popular culture can affect and influence expressions of grief.

We hope that you enjoyed learning about this complex and interesting subject. This OpenLearn course is an adapted extract from the Open University course K220 Death, dying and bereavement [ Tip: hold Ctrl and click a link to open it in a new tab. ( Hide tip ) ] .

If you have been affected by the topics raised in this course, you can call  Macmillan Cancer Support  free of charge on 0808 808 00 00. You can also call Samaritans free from any phone on 116 123 (it will not appear on your phone bill), email  [email protected] , or visit  www.samaritans.org  to find details of your nearest branch. The Motor Neurone Disease Association also provides support to people affected by motor neurone disease in England, Wales and NI - 03457 626262 or visit  The Motor Neurone Disease Association

Home — Essay Samples — Life — Emotions & Feelings — Grief

Essays on Grief

What makes a good grief essay topic.

When it comes to writing a grief essay, choosing the right topic is crucial. A good grief essay topic should be thought-provoking, emotionally engaging, and able to evoke empathy in the reader. It should also be relevant and relatable to the writer's personal experiences or the experiences of others. Here are some recommendations on how to brainstorm and choose a grief essay topic:

Brainstorming: When brainstorming for grief essay topics, it's important to reflect on personal experiences, emotions, and thoughts related to grief. Consider significant events or people in your life that have impacted you emotionally. Think about the emotions and challenges associated with grief and how they have influenced your perspective.

What to consider: When choosing a grief essay topic, consider the emotional impact and depth of the topic. Reflect on the significance of the topic and its relevance to your life or the lives of others. Consider the potential for empathy and connection with the reader.

What Makes a Good essay topic: A good grief essay topic should be emotionally compelling, thought-provoking, and able to evoke empathy in the reader. It should also be deeply personal and reflective of the writer's experiences and emotions. Additionally, a good grief essay topic should be relevant and relatable to a wide audience.

Best Grief Essay Topics

• The impact of grief on mental health
• Coping with the loss of a loved one
• Finding meaning in grief
• The journey of healing after loss
• Grief and the search for closure
• The role of support in grieving
• Expressing grief through art and creativity
• The connection between grief and spirituality
• Grief and the passage of time
• Coping with unexpected loss
• The impact of grief on relationships
• Finding hope in the midst of grief
• Grief in the digital age
• The intersection of grief and identity
• The experience of anticipatory grief
• Grieving for a pet
• The role of rituals in the grieving process
• Grief and the cycle of emotions
• The impact of grief on personal growth
• Grief and the search for meaning

Grief essay topics Prompts

• Write about a specific memory or experience that has shaped your understanding of grief.
• Explore the role of music or art in helping you process grief and emotions.
• Reflect on a personal journey of healing and growth after experiencing loss.
• Consider the impact of cultural or religious beliefs on the grieving process.
• Imagine a conversation with a loved one who has passed away and write about what you would say.

Choosing the right grief essay topic is essential for creating a compelling and impactful piece of writing. By considering personal experiences, emotions, and the potential for empathy, writers can select a topic that resonates deeply with themselves and their readers. Whether exploring the impact of grief on mental health, coping with unexpected loss, or finding hope in the midst of grief, there are countless meaningful and thought-provoking topics to explore in the realm of grief essays.

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Institute of Medicine (US) Committee for the Study of Health Consequences of the Stress of Bereavement; Osterweis M, Solomon F, Green M, editors. Bereavement: Reactions, Consequences, and Care. Washington (DC): National Academies Press (US); 1984.

Bereavement: Reactions, Consequences, and Care.

• Hardcopy Version at National Academies Press

CHAPTER 11 Conclusions and Recommendations

In this chapter, the committee recapitulates its major conclusions and suggests directions for clinical practice and future research. These conclusions and recommendations are organized around the three questions mandated for study.

• WHAT CAN BE CONCLUDED FROM AVAILABLE RESEARCH EVIDENCE ABOUT THE HEALTH CONSEQUENCES OF BEREAVEMENT?

The evidence from clinical experience and several kinds of research— epidemiologic, case follow-up, clinical, and social science—leads to several important conclusions. First, bereavement is associated with appreciable distress in virtually everyone. Second, the distress, which can vary greatly in intensity and in the extent of interference with function, is long lasting. A survivor's way of life can be altered for as long as three years and commonly is disturbed for at least one year. Third, there is tremendous variation in individuals' reactions to bereavement. These reactions consist of a number of intertwined processes—psychologic, social, and biologic. They cannot be neatly plotted in a series of well-defined stages, nor is movement from the impact of the death to the resolution of bereavement likely to be in a straight path. Individuals will vary in terms of speed of recovery and in the amount of back-and-forth movement between phases. Fourth, as has been recorded in myth and literature over the centuries, and as suggested by individual clinical experience, some bereaved persons are at increased risk for illness and even death.

Most bereaved individuals do not become seriously ill or die following the loss of someone close, but there is good evidence linking bereavement to a number of adverse health outcomes for some people. These health consequences include premature mortality, some medical and psychiatric morbidity, and health-damaging behaviors. Following conjugal bereavement, young and middle-aged widowers who do not remarry are at increased risk of mortality for a number of years, especially during the first year. For women, there is some evidence suggesting increased mortality in the second year (but not the first) following bereavement. Higher mortality rates in men are due to increases in the relative risk of death by suicide, accidents, cardiovascular disease, and some infectious diseases. In widows, the relative risk of death from cirrhosis and perhaps suicide increases. The bereaved's increased alcohol consumption, smoking, and use of tranquilizers and other medicines are well documented, especially among people who used these substances prior to the loss. Thus, bereavement appears to exacerbate and precipitate health-compromising behaviors.

During the early, "acute" phase of bereavement, most adults suffer a variety of symptoms, some of which also are characteristic of depression. Yet the constant, painful awareness of loss, together with the relative absence of self-blame, makes it clear that ordinary grief is distinct from depression. Grief may, however, give way to depression; approximately 10 to 20 percent of the widowed are still sufficiently symptomatic a year or more after their loss to suggest real clinical depression. Although this proportion is relatively small, out of the approximately 800,000 people who are widowed each year, this means that 80,000 to 160,000 people suffer serious depression in any given year. The number of depressed individuals following other types of bereavement—death of a child, sibling, or parent—is not known.

There are few good controlled studies linking bereavement to specific disorders. But the diagnosis-specific mortality rates, symptoms, and health behaviors just discussed suggest that bereavement may exacerbate existing illnesses, precipitate depression leading to suicide, aggravate or lead to alcohol abuse that can result in cirrhosis of the liver, and leave people vulnerable to infectious diseases.

Like adults, children exhibit a range of responses immediately following bereavement. Although some researchers have reported that children do not grieve in the same way as adults, a number of grief-like reactions have been noted, such as appetite and sleep disturbances and difficulty in concentrating. Like adults, bereaved children may complain of physical symptoms, especially abdominal pain. They may also withdraw and regress in their behavior. There is general agreement that school functioning—both academic performance and social behavior— are adversely affected by bereavement. Not surprisingly, the way children react to death depends on their age and stage of development.

Enduring psychologic symptoms of neurosis and depression have been observed in community and patient samples of children who have lost a parent or sibling. Several studies report a relationship between childhood bereavement and mental illness, especially depression, in adult life, as well as increased risk of suicide. There is evidence suggesting a link between this type of early loss and adult impairment in sexual identity, capacity for intimacy, and development of autonomy. Thus, at least some bereaved children are at increased risk for a number of adverse consequences. However, current data do not support the impression that the negative results are as widespread or as inevitable as formerly thought. Although the full impact of death on children may not be realized until many years later, many factors subsequent to the death—including the normal developmental push and the adequacy of caretakers—will have major effects on ultimate outcomes.

Almost everyone—adults and children—is distressed when someone close dies, yet the nature of the distress and its manifestations depend on a host of factors relating to characteristics of the bereaved individual and of the deceased, the nature of the death, the nature and meaning of the relationship, and perceptions about the availability and adequacy of social support before and after the death. These factors also influence the outcomes of the bereavement process, including the health outcomes just discussed. Certain biologic, psychologic, social, and situational factors that place individuals at risk or protect them from adversity are apparent prior to the loss, others are related to the death itself, and some become apparent in the early aftermath of bereavement.

Although rigorous studies of these many risk factors have not been conducted, there are several that appear to be good predictors of certain outcomes of bereavement. Poor previous physical health is associated with poor physical health following bereavement. Mental illness, especially depression, is likewise likely to be exacerbated following bereavement and to interfere with normal grieving. Perceived social support is the best replicated predictor of psychosocial adjustment. However, like marriage—which appears to be a protective factor for men against poor health following a spouse's death—it is not clear whether the mere presence of social support leads to good outcomes, or whether people who were emotionally healthy to begin with are able to elicit social support to meet their needs following bereavement.

• ARE THERE PREVENTIVE INTERVENTIONS THAT SHOULD BE MORE WIDELY ADOPTED IN THE HEALTH CARE SYSTEM?

Viewed in its broadest sense, the term "preventive intervention" includes education, assessment, and primary, secondary, and tertiary prevention. From that perspective, there are a number of informal and formal activities that the committee felt should be undertaken with the bereaved in the community and as a part of humane and professionally responsible practice. As discussed in Chapter 9 , the committee's views in this area are based more on its own collective judgment and upon clinical case reports than on definitive research findings.

The committee was struck by the large amount of advice in the literature directed to the public and to health professionals, and by the enormous growth of lay and professional programs to assist the bereaved. Although much of the advice and many of the programs seem to rest on solid conceptual ground, very few studies have been conducted to determine whether these concepts have been translated into appropriate intervention strategies or even to test their effects.

Because of this lack of evidence on the efficacy of the many intervention strategies, the committee cannot recommend that as a matter of public policy any particular approach be more widely adopted at this time. However, the efforts to devise conceptually sound programs to assist the bereaved are to be commended and certainly should not be discontinued. In fact, as discussed in Chapter 10 and in the final section of this chapter, the committee believes it is time to subject various intervention strategies to rigorous study so as to determine their benefit to particular groups of bereaved individuals.

Practice Recommendations

In the committee's view, the well-being of the family and others close to a dying patient is part of health professionals' responsibility in terminal illness. Furthermore, as indicated in Chapter 9 , the committee believes that health care professionals and institutions have a continuing responsibility to assist the bereaved. The education of health care professionals should prepare them to provide information, offer emotional support, recognize the red flags that may signal a need for professional mental health intervention, and be knowledgeable about both lay and professional community resources to which the bereaved can be referred as appropriate and desired. Routine history taking in primary care settings should include questions about recent losses and attention to the individual's adjustment to them.

This is not to suggest that health professionals must routinely engage in long-term counseling of the bereaved. The committee does suggest, however, that within the context of ongoing medical care, professionals have some responsibility—beyond simple human compassion—to become knowledgeable about bereavement and skilled in dealing with it. Unfortunately, in most reimbursement schemes there is a strong disincentive to provide the kind of follow-up activities described in this volume as desirable. The committee hopes that, while progress is being made toward remedying this, institutions will recognize the importance of such activities and will permit health professionals to spend time with the bereaved, even in the absence of direct reimbursement.

That nursing and medical education should prepare health professionals for this role is not a new proposal. It has been a matter of public and professional concern for a number of years. The committee thus endorses efforts to devise training methods that will better equip health professionals to deal with sensitive psychosocial issues, to be aware of their own limitations, and to have the necessary knowledge and skills to make appropriate referrals.

In the committee's view, these skills must rest on the broader foundations that health and mental health education and preparation for the ministry provide in order to be effective. The committee cannot endorse the development and certification of a new profession for "grief counseling" that is separate from existing health and social services.

Until better data are available on variations in grief responses among the members of ethnic and minority groups, health professionals should be aware that the phases, timing, and significance of grieving by individuals of different backgrounds may vary from those reported in studies of persons in the mainstream population. In particular, as discussed in Chapter 8 , the likelihood of the distress following bereavement taking the form of physical symptoms, and the particular bodily complaints, may vary substantially by cultural group and social class. If they are unaware of this possibility, health professionals might conduct needless and costly tests or prescribe unnecessary and potentially harmful treatment. Thus, the committee urges that caution be used in determining deviance from norms, almost all of which have been based on the mainstream Caucasian culture.

It is readily apparent that most bereaved individuals do not need professional mental health treatment. Yet, there are certain symptoms and circumstances of bereavement that are likely to warrant professional intervention for people in all cultural groups. For both adults and children, a prior history of mental illness, especially depression, and the suicide of someone close are likely to render them especially vulnerable and therefore candidates for close professional monitoring following bereavement. Persistent somatic complaints or depressive symptoms that do not lessen in intensity over time may also be signs of difficulty. In children, repeated aggressive or hostile behavior toward others, a prolonged drop in school performance, or regressive and insecure behaviors that persist over time are additional signs that help may be needed. For adults, drug and alcohol abuse, other health-injurious behaviors, difficulty in maintaining social relationships, and an individual's own perception that he or she is not doing well should trigger a professional referral for evaluation. Furthermore, if the occurrence of an individual's symptoms is associated with family dysfunction, it is logical to include family assessment and treatment when dealing with abnormal bereavement states.

In the case of bereaved children, it seems clear there is a potential for long-term, enduring consequences. Whether the best way to handle this vulnerability is with routine, periodic "mental health check-ups" is not clear. Such check-ups might lead both parents and child to believe there will be problems—potentially contributing to a self-fulfilling prophecy. Thus, in the committee's view, it would be better to educate those who interact with children (parents, teachers, pediatricians) to recognize the signs that indicate a need for professional mental health intervention than to have mental health workers routinely involved.

As discussed in Chapters 2 and 10 , a number of drugs are rather commonly prescribed to help ease the pain of bereavement. Many physicians have been hesitant to prescribe medication, particularly tricyclic antidepressants, for patients experiencing grief reactions, even when these are intense, distressing, and disabling. The view is widely held that to suppress the grief experience will have later adverse consequences. Yet no controlled trials have been reported in the literature to assess the long-term or short-term, positive or negative effects of antidepressants on grief. The absence of such trials is all the more striking in view of the fact that clinical reports indicate a substantial proportion of bereaved individuals are often prescribed sedatives and minor tranquilizers, primarily for insomnia. Again, there are no controlled trials of the efficacy of such prescriptions. Quite clearly such studies are needed. In the absence of such data, the committee urges clinicians to exercise caution in prescribing medications for bereaved individuals.

The committee noted with interest the various efforts of health care institutions to assist the bereaved and to support health professionals in their activities in settings made stressful by frequent death. Examples of institutional responses to the soon-to-be bereaved and recently bereaved that appear to be conceptually sound practices include the availability of well-trained social workers and chaplains to assist dying patients and their families, hospital-based support groups for parents who lose a newborn and for relatives surviving other kinds of deaths, liberal visiting hours to allow families to spend time with dying patients, efforts to work with families and patients who prefer to be at home, and sensitivity to families' wishes regarding their presence at the time of death.

Not only must health care institutions be concerned with the wellbeing of patients and their families. They must also pay attention to staff needs, especially in such stressful settings as intensive care units, emergency rooms, and cancer wards, and to the impact of management and organizational practices on staff functioning in such settings. Some mechanisms for monitoring staff emotional response to their work should be formalized. Regular meetings at which staff are encouraged to air their concerns, adequate back-up support from mental health professionals, and clearly delineated roles on health care teams may help alleviate the sense of isolation and overwhelming burden of individual responsibility so commonly reported.

Public Education

Because of the fairly recent historical changes noted in this volume, including institutional care of the dying and geographic mobility of families, most people have little direct contact with death and may not be prepared for its impact on their families. That the public wants information about bereavement is evidenced by the amount of attention paid to this topic in the mass media. In recent years there have been numerous articles, television shows, and radio programs dealing with people's reactions to bereavement. Although there are no studies to document the effects of information on the bereavement process, the committee was struck by the widespread view that thorough information of several types can be beneficial and often seems to be lacking. As discussed in several chapters, people's reactions to bereavement often are so varied, intense, and unexpected that they and those around them may be caught off guard. People expect to feel sad; they do not expect to be angry at the deceased. And yet anger is common. They may be surprised at how quickly their emotions swing from one feeling to another and at their inability to control their moods. Knowing how .they are feeling, they may be surprised that others in the family seem to be reacting so differently. Numerous anecdotes are reported in the literature about the inappropriateness of well-meaning comments offered by friends of the bereaved.

These examples and many others discussed in this volume suggest that people need information to prepare themselves for the death of someone close and to respond sensitively to others in similar situations. As discussed in Chapter 10 , this has been a major activity of many mutual support groups. Because bereavement is and should be handled largely by families and other informal social networks, public education about reactions to bereavement and how they might differ for adults and children, and for mothers and fathers, should be encouraged so that families and friends can provide the best possible support for the bereaved.

• WHAT FURTHER RESEARCH WOULD BE ESPECIALLY PROMISING TO PURSUE?

Throughout this volume, gaps in current understanding about the bereavement process, its outcomes, and the methods to assist the bereaved have been pointed out. Inadequacies in the data base, such as the narrow scope of research, lack of good multidisciplinary studies, and some pervasive methodologic problems, have hampered the development of definitive conclusions. In this section, the committee draws together its key recommendations regarding future research directions that seem especially promising.

Research on the Processes and Outcomes of Bereavement

Important health consequences of bereavement do exist, although they are not evenly distributed in the general population of bereaved people. As discussed in Chapters 2 through 5 and in Chapter 8 , a large number of psychologic, social, situational, and biologic factors have been implicated as contributors to increased risk of adverse consequences. Few of these risk factors have been well studied. Their relative importance is not known, nor is much understood about which factors contribute to which outcomes. These influences are likely to interact in complex ways to place individuals at risk in some ways and protect them in others.

In the committee's view, high priority should be given to research aimed at better documentation and refinement of those factors that place particular individuals or groups at high risk following the death of someone close. Current hypotheses about subpopulations that are at risk for particular adverse consequences should be tested, and prospective studies should be designed to identify characteristics of new subgroups. More definitive knowledge about individual risk factors and their interplay holds the promise of identification of high-risk individ uals and the design of interventions to prevent or mitigate specific negative outcomes.

To accomplish this goal, the scope of research must be broadened. Although there is a vast literature from many different disciplines, most of it is on conjugal bereavement in adults and parental bereavement in children. There are very few data on the nature and consequences of bereavement following the death of a sibling at any age, of a child at any age, or of parents during adult life. Research on specific losses would clarify understanding of the special problems of each. Current understanding of the relationship between bereavement and the nature of the death is also very limited.

Second, the health consequences of bereavement, especially the medical ones, are less well researched for children than for adults who have lost a spouse. Most studies of children are retrospective and have not used control groups. Most are based on responses of children receiving mental health care or, in the case of very young children, are based on observations of institutionalized children. Controlled studies of community samples of bereaved children should be conducted. Professionals' current knowledge does not clearly indicate whether it is bereavement itself or the way a child is dealt with and cared for subsequently that has the most effect on long-term outcomes. Prospective longitudinal studies that follow children for many years could shed some light on this issue.

Third, most of what is known about bereavement comes from observations made in the United States, the United Kingdom, Australia, and Israel. The American literature, but for a few descriptive accounts, is limited almost exclusively to studies of white, usually middle-class, persons. How other socioeconomic, racial, and ethnic groups react psychologically, socially, and biologically to bereavement is not known. Thus, it is unclear how generalizable the current knowledge base is; this makes it difficult to develop intervention strategies that are appropriate to the needs of minority groups. Indeed, as pointed out in Chapter 8 , there is reason to suspect that impoverished ethnic minority group members, recent refugees, and migrants may be at especially high risk for negative health outcomes of bereavement. This topic should be investigated. Such research would benefit from interdisciplinary collaboration of health researchers with anthropologists and with health professionals who share a cultural identity with the groups being studied. Research on these three groups—individuals who have experienced various types of losses, children, and various sociocultural groups—would greatly expand the scope of current knowledge of the impact of bereavement upon specific subpopulations.

To refine this knowledge, research on the biology of grieving is also needed. As discussed in Chapter 6 , grief produces major perturbations in the respiratory, autonomic, and endocrine systems and may substantially alter cardiovascular and immune function as well. Much of the existing biologic research has been concerned simply with documenting these changes in animals and humans. In the committee's view, it is time now to focus on clinically relevant physiologic changes in humans in order to understand better the mechanisms by which reactions to bereavement might result in actual illness.

In particular, more information is needed on the long-term effects of loss in order to understand how physiologic responses change over the course of grieving and how responses to loss compare with other responses to stress. Additional studies are needed on the basic neurophysiologic parameters of grief responses in order to understand more fully the susceptibility of bereaved subjects to disease. The relationship between the responses to loss and responses to other life stresses, and detailed comparisons of neuroendocrine and other biologic changes accompanying grief and depression are needed. Multidisciplinary studies should be conducted of the relationships between the intertwined but not fully congruent behavioral, psychosocial, and biologic processes. This expanded knowledge of physiologic processes following bereavement and their relationship to other responses will contribute to the development of appropriate preventive interventions.

Most studies, whether biologic or psychologic, focus on the first year of bereavement. But because most people now die of chronic illness with forewarning for their families, the period of anticipatory grieving before the death deserves rigorous study. Furthermore, because it seems clear that for many people the grieving process continues beyond a year, studies should track bereaved individuals for a longer period of time. Thus, more prospective longitudinal studies that begin before and run for several years after bereavement are needed.

Traditionally, health consequences have been studied in individuals, but there is a growing realization that the individual's reactions may be based partly on interactions with the individual's most intimate group, which usually is the family. The death of one member will affect each and every other member as well as the family system as a whole. Thus, following bereavement, the changes in roles, relationships, and functioning within the family could lead to symptoms or disease in one or more members. In order to fully understand this process, prospective studies of entire families are needed.

Finally, all research in this field has suffered from certain methodological shortcomings. It has been hampered by the lack of agreement concerning predictor variables and outcomes—what things are appropriate to measure, how to measure them, and what to consider as endpoints. This problem is evident in the epidemiologic, psychosocial, and intervention studies. So long as researchers make idiosyncratic decisions about these issues, comparisons across studies can be made only tentatively. The committee therefore recommends that the National Institute of Mental Health (NIMH) sponsor a conference of scientists from the many professional disciplines involved in bereavement research to develop a consensus about predictors and outcomes so that future studies will be more fully comparable.

Although a great deal is known about various aspects of bereavement and its consequences, most of it is discipline-specific. Isolated findings from psychology and psychiatry and from the biologic, medical, and social sciences each tell part of the story. But until more good multidisciplinary studies are done, the bereavement process and the mechanisms that explain it cannot be fully understood. Without such studies, the interactions between risk factors will remain unclear and it will not be possible to confidently identify groups at high risk. Good cross-disciplinary longitudinal studies also will provide the foundations for intervention strategies that are appropriate to the range of needs of bereaved individuals.

The committee recognizes the difficulties involved in long-term multidisciplinary research. It is hard to get and keep a team of researchers together, and the research is expensive. There are special problems inherent in studying people over time: the situation is not static, many intervening variables cannot be controlled, and there are practical difficulties involved in tracking people for years. Nonetheless, in the committee's view, funding agencies should give high priority to such research because it is only through well-designed, long-term, prospective, multidisciplinary studies that the impact of bereavement will really be understood.

Research on Intervention Strategies

The committee strongly urges that a broad research initiative be undertaken to study the impact of various psychosocial and pharmacologic interventions on the course and consequences of bereavement. Such research should be conducted in the awareness of cultural diversity and individual variations in reaction to bereavement. It should be specific to age, sex, social class, ethnicity, nature of the loss, and phase of bereavement. The impact of interventions on the acute distress of bereave ment, on social as well as biologic functioning, and on health are some of the outcomes that deserve study.

Current knowledge about the four major types of interventions discussed in Chapter 10 —mutual support, hospices, psychotherapy, and drug therapy—does not yield conclusions about the applicability and effectiveness of specific interventions. There is a paucity of good outcome data regarding their efficacy, apparently for several reasons. In the case of the psychotherapeutic approaches, confidentiality and small sample sizes have constrained research. In the case of mutual support groups and hospices, there is typically no one associated with the programs who has research skills and there has sometimes been a reluctance to expose the programs to scrutiny.

Although the committee does not wish to single out any one approach as more deserving of study than another, it notes that there is currently an opportunity to study hospice bereavement programs that should not be ignored. With the amendment of the Social Security Act in 1982, hospice patient care services will now be reimbursed by Medicare for a three-year period. Although bereavement services for families will not be directly reimbursed, hospice programs must include these services in order to qualify for Medicare. Increasingly large numbers of people are being served by hospices and standardized data collection requirements are being established. The diversity of programs should enable the study of various approaches to bereavement intervention in a naturally occurring experiment.

In the committee's view, the Health Care Financing Administration and other branches of the federal government should make bereavement studies one of the priority areas for research during this experimental period. To focus only on terminal care and its costs would be to ignore an integral part of the hospice program and to pass up a rare opportunity to conduct major studies of the preventive possibilities of bereavement support and its associated savings potential. In designing such studies, attention should be paid to possible distinguishing characteristics of families who choose the hospice option; those characteristics could have particular significance following bereavement and, if not identified and controlled for, could confound the results of the efficacy of bereavement interventions.

Although each of the major forms of intervention has certain distinctive features, there is a great variation within each type as well as some similarities among the different approaches. This makes it difficult to draw conclusions about the applicability or efficacy of mutual support groups, hospices, or psychotherapy in general. In addition, the literature often does not specify enough details about the nature of a particular intervention or enough precision about its goals to permit valid comparisons even within one of the broad approaches. Here, as elsewhere, the lack of agreement about which outcomes to measure, and when and how to measure them, has further limited the usefulness of the data that have been collected.

Research initiatives in this area should encourage cooperation between program administrators, clinicians, and researchers from several disciplines so that carefully controlled studies can be conducted. In the case of drug therapies, the lack of research is striking. There have been virtually no controlled trials on the efficacy of commonly prescribed hypnotics and minor tranquilizers or on the use of antidepressants with the bereaved. Neither the immediate nor long-term effects of using drug therapy alone or in conjunction with psychosocial intervention are known.

Finally, the committee recommends that the NIMH establish a special ad hoc research review committee to deal with bereavement studies of all kinds. A broad research initiative in this area requires a review committee that understands the nature and complexity of bereavement; the state of the art in research on the process, outcomes, and interventions; the value of different methods of studying bereavement; and the problems involved in conducting good longitudinal, multidisciplinary research in this area. Although currently many specific gaps exist in our understanding of the bereavement process, it is time to begin to put the entire puzzle together—to link research on mechanisms, processes, and outcomes to the identification of groups at high risk for adverse outcomes, and to determine the best way to help individuals who have lost someone with whom they had close emotional ties.

• Cite this Page Institute of Medicine (US) Committee for the Study of Health Consequences of the Stress of Bereavement; Osterweis M, Solomon F, Green M, editors. Bereavement: Reactions, Consequences, and Care. Washington (DC): National Academies Press (US); 1984. CHAPTER 11, Conclusions and Recommendations.
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