Grief

Description of the main points of 2 different models of grief/loss.

The first model I looked into was Kübler Ross who “Inspired by her work with terminally ill patients” (Kubler 1969) introduced the five stages of grief in 1969. The five stage model consists of  Denial, Anger, Bargaining and depression.

• Denial is described as a defence stage and the refusal to accept what has happened.
• Anger, the stage where a person goes through feelings of fury and may even look for someone to blame.
• Bargaining this is the third stage where a person will turn towards feelings of hope. One example could be turning to a god they believe in to try and negotiate.
• Depression is the stage where a person will start to realise what has happened. Reality hits where a person may experience feelings of helplessness, emptiness and severe sadness.

Acceptance is the final stage of the model where a person starts to come to terms with the situation and accepts what has happened.

The second model I looked at was a grief model by Colin Murray Parkes who like Kübler Ross’ stages; Parkes breaks grief down into different phases.

Shock and Numbness, similar to Kubler’s denial stage this is self-defence phase where a person is not ready to accept the situation.

Yearning and searching a phase of grief where a person experiences painful desire towards, someone, something or a situation.

Disorientation and disorganisation where a person will go through a period of mixed emotions. Like Kubler’s depression stage a person may experience extreme sadness and lack of interest towards life as the reality of the situation sinks in.

Reorganisation and resolution the phase where a person will start to come to terms with grief and loss. Adjusting to the situation and returning to their normal routine.

I personally think Kubler’s theory was easier to understand and also easier to research. Although originally inspired by terminally ill people, this model can be applied to other losses, such as a breakup, loss of job, infertility amongst many more. This model was one where I felt I was immediately able to self-reflect. As I went through the 5 stages each stage brought back a memory to different times of my life where I have experienced grief and loss.

When looking for Colin Murray Parkes theory I found it harder to clarify the phases. Different websites came up with different break downs. The model by Colin describes grief/loss as phases where ‘’ there is no specific or “usual” amount of time in which people experience/complete these phases’’ (Angela Morrow. (2019). The Four Phases and Tasks of Grief) everyone will inevitably experience grief and loss phases at some period of their life.

Overall going through each model made me realise that although experiencing these stages/phases in the past have made me feel empty. I now feel like I have come to terms more that these feelings are completely normal to any grief/loss situation. Looking back at the time I know I wished I had done things differently, or done more for a person because they are now gone. However, now I feel I have made it to the acceptance stage, I feel I did actually always do what I could. When the situation first hit me it became negative and concentrated on what I could have done as opposed to all the things I did do. I still feel bargaining is something that I do fairly often; I turn to tarot cards and spiritual messages for answers I may be looking for.

Grief involves intense sorrow that may be attributed to someone’s death or other situations that may include heartbreaks from a relationship. This may lead to depression, sadness, and suffering negatively impacting an individual’s health (Kubler-Ross, 1969). An example may involve a husband grieving the death of his wife.

Elisabeth Kubler-Ross defined the stages involved in the grief process which include denial, anger, bargaining, depression, and acceptance (Kubler-Ross, 1969). This provides a better understanding to observers as well as healthcare professionals who may be addressing such cases. This paper analyzes Woterstorff’s reflections in Lament for a Son in respect to the five stages of grief.

Five Stages of Grief in relation to Lament for a Son by Nicholas Wolterstorff

Lament for a Son by Nicholas Wolterstorff is a story where the narrator explains the death of his son during mountain climbing. The book explains the grief that the author went through after losing his son as well as the healing process through faith in God (Wolterstorff, 1987).

The author also describes the events using the five stages of grief where the author finally finds joy and comfort through the hope of resurrection. The first stage is witnessed after the author receives a call on Sunday that Eric his son is dead, the narrator is negatively affected, as he believes it is wrong for parents to bury their children as children are the future and should bury their parents (Wolterstorff, 1987). The second stage of anger is witnesses when the author wonders why Eric had to climb the mountain alone.

He starts bargaining if his child would just have been sick so as to say goodbye. At the funeral, he feels the ache of his loss deep in his soul and his passion for life is cooled. This indicates the fourth stage of grief of depression where he also blames himself for failing to protect his child (Kubler-Ross, 1969).

The last stage is experienced when the narrator finds hope of reuniting with his son after resurrection where he will apologize to him for not taking care of him. The family visits Eric’s grave one year later where they compose a requiem in honor of Eric a sign that they have already accepted that their son is no longer with them (Kubler-Ross, 1969).

How Does Wolterstorff Find Joy After His Loss?

Wolterstorff suffers grief due to the loss of his son who died while climbing a mountain alone. The author recalls some the memories of his son which negatively affect him as he blames himself for failing to protect his son. He describes how his son occupied a special part in his heart which leads to the pain experienced after his death (Wolterstorff, 1987).

However, the author finds joy by having hope that he will reunite with his son after resurrection as promised by God through his word in the Bible (John 3:16). He also finds out that Jesus suffers with those who are suffering just as he suffered while on this earth (1 Peter 4:1). This means that God understands what he is going through and is ready to help him overcome the grief of losing his son.

God sent his only son to suffer so that everyone would have eternal life an aspect that frees him from his grief (John 3:16). The author displays the last stage of the grief process by accepting that his son is dead which leads to joy where is able to overcome some of the negative effects associated with grief (Wolterstorff, 1987).

What Is he Meaning and Significance of Death In Light of the Christian Narrative?

From the Christian narrative, death is a transition process to enter into eternal life where individuals will be able to see Jesus. Jesus Christ who is our savior came into this world and died resurrecting on the third day an indication that he has power over death (Shelly & Miller, 2006).

This gives hope to Christians that just as Jesus Christ arose from the dead, all individuals who believe in Him will also overcome death (John 3:16). Death is not a punishment rather a process of life just as one is born. During this process, it is important to care, support one another, and still put our hope on God who loves us so much (Shelly & Miller, 2006).

This means that God understands grief as he too lost his begotten son. He grieves with those that are grieving. Death is not an end of people as the soul does not die and waits upon the end of the world where people will be judged according to their deeds on the earth (Shelly & Miller, 2006).

How Does The Hope of the Resurrection Play a Role In Comforting Wolterstorff?

The author is encouraged after understanding the perspective of resurrection where Jesus resurrected from the dead after three days. Jesus also promises to resurrect us as he has the power of death as well as life (John 16:22). This gives the author reassurance that he will eventually meet with his son where they will be reunited and he will apologize to him. Death was not God’s plan as this came as a result of man’s sin.

However, due to God’s loving nature, he sent his only son to redeem his plan where people would not die but have eternal life (Shelly & Miller, 2006). This enhances his trust on God where the author increases his belief in God. Just as Jesus conquered death, Christians should have hope for a resurrection. This does not prevent Christians from undergoing some of the emotional trauma surrounding death. However, there is the hope that they will eventually reunite with their loved ones (Shelly & Miller, 2006).

References

• Kubler-Ross, E. (1969). On Death and Dying. Abington-on-Thames, UK: Routledge.
• Life Application Study Bible: New King James Version. (2013). Carol Stream, Ill: Tyndale House Publishers.
• Shelly, J. A., & Miller, A. B. (2006). Called to Care: A Christian Worldview for Nursing. Downers Grove, IL: IVP Academic.
• Wolterstorff, N. (1987). Lament for a Son. Grand Rapids, MI: William B. Eerdmans Publishing Company.

Ferryman writes in his poem about depression and sadness. He uses the little boy and the ball to compare to a situation that most of us readers have experienced. The poem isn’t given any specific setting; rather it has very little subjects and objects that leave us, the readers, with a wide imagination. Ferryman uses Symbolism in his poem by writing, “People will take balls, Balls will be lost always, little boy. ” He is comparing the ball to some sort of irretrievable loss that he has experienced. The anguish and agony of losing something so dear to a boy is tough.

Being a child, our toys are what we are most important to us. Ferryman knows the relationship between children and their toys and uses it in such ways to explicate the sorrow that this young boy is feeling. Ferryman expresses so much emotion In this poem that it’s almost difficult not to feel what this young boy is feeling. “What Is the boy now, who has lost his ball,” is how the poem begins, therefore, giving Off sense of mourning and gloom. We get this visual Image that the ball is gone, and that he boy is indefinitely saddened.

Because who wouldn’t be, by losing anything closest to us. Ferryman uses Imagery by saying, “l saw It go merrily bouncing, down the street, and then merrily over-?there It Is In the water! ” At this point, we see that he set us up for disappointment. We knew that the ball was gone, but now It’s clear to where It Is. Lost forever. Throughout, “The Ball Poem,” Ferryman Is talking about a boy, but at first it isn’t known exactly who this boy might be. But at the end of the poem he uses Persona by saying, “l suffer and move, my mind and my heart move…

With all that move me, under the water… Or whistling, I am not a little boy. ” All of this pain, grief, and sorrow happen to be all about him. He’s stating that this boy Is Indeed a reflection of him and his life. John Ferryman experiences, “the epistemology of loss. ” Lonely and Isolated, he has been through a deep and dark time. Through literally elements, Ferryman expresses himself In very Intense and dramatic ways. “The Ball Poem” gave great examples of mysterious losses but losses that all of us can compare to, whether It’s a ball or something more.

We all have things we cherish, and we all either have or will suffer a loss. The Ball Poem By Tameness the sorrow that this young boy is feeling. Ferryman expresses so much emotion in this poem that it’s almost difficult not to feel what this young boy is feeling. “What is sense of mourning and gloom. We get this visual image that the ball is gone, and that to us. Ferryman uses imagery by saying, “l saw it go merrily bouncing, down the street, and then merrily over-?there it is in the water! ” At this point, we see that he set us up for disappointment.

We knew that the ball was gone, but now it’s clear to where it is. Lost forever. Throughout, “The Ball Poem,” Ferryman is talking about a pain, grief, and sorrow happen to be all about him. He’s stating that this boy is indeed a reflection of him and his life. John Ferryman experiences, “the epistemology of loss. ” Lonely and isolated, he has been through a deep and dark time. Through literally elements, Ferryman expresses himself in very intense and dramatic ways. Compare to, whether it’s a ball or something more. We all have things we cherish, and

Describe with examples the kinds of influences that affect children and young people’s development. Background; There are many factors that can influence a child and young person’s development, particularly in relation to their background. The formative years can be termed as crucial in regards to development and any major setback can create many problems for the future. Parents that are going through a marriage breakdown, divorce and separation can be stressful for all involved particularly the children/young person.

They can become emotionally withdrawn and suffer a lack of confidence which can create low self esteem. Due to family upheaval, they may lose focus in their own abilities and suffer mentally. Similarly, children from single parent families may suffer from a lack of a male/female role model which can cause social stigma. Dual parents and lone parents may have to work long hours, leaving little room for direct social, emotional and intellectual support. Becoming part of a new step-family through a parent meeting a new partner can cause friction between children from each side.

This could lead the child/young person to become socially and emotionally withdrawn which could increase the risk of bullying by peers. Having numerous siblings can have an impact on children causing additional needs to be met. Children may feel frustrated with lack of attention within the home and also may be required to assist with siblings needs which could cause social and emotional problems. Additionally, becoming a brother/sister to a new sibling for the first time can be stressful and having to adapt to not being an only child can be difficult at first and can create an emotional strain on the child.

Being part of a social care system through neglect, physical/emotional abuse and loss of parent can prove difficult for children and although this can largely be a positive experience for many, it can also lead to problems within all areas of development particularly in relation to social and emotional areas. Child and Young Person Development TDA 2. 1/2. 1 Background continued…; Having a sick parent/carer can be extremely challenging for children, their social and emotional wellbeing can be affected with having to endure possible social stigma and suffer emotionally if not supported in the correct manner.

Time off from school may cause intellectual issues and additional help may be required. Family bereavement can be extremely traumatic for children even when a child/young person has been prepared. This can create emotional strain and unexpected outbursts of emotion should be expected. Socially, children may feel different from their peers who haven’t experienced bereavement. They may suffer intellectually due to and also concentration and behaviour may be affected when they are in school.

Moving house and/or area can be difficult for children as they have to adjust to a whole new social situation with changing schools and adapting to new routines. Children may become socially introverted and display high levels of emotion. Cultural differences can affect a child/young person through English being spoken as a second language which can cause a lack of confidence at school and additional intellectual support being required. Child and Young Person Development /TDA 2. 1/2. 1 Describe with examples the kinds of influences that affect children and young people’s development.

Health; There can be many health aspects that affect a child/young person’s development. Children become extremely resilient and are often able to manage their conditions very well; however, certain aspects of their development can prove challenging throughout periods of ill health. Children may suffer from conditions such as asthma, which if not well controlled, can cause children to have extended periods of time off from school. This in turn leads to intellectual development being compromised as well as social development due to relationships not being maintained.

Disability in children, whether it be physical or intellectual can be particularly difficult. A child that has a hearing impairment may suffer physically through loss of balance or socially through having to communicate in alternative ways such as sign language/makaton. A physical disability such as Cerebral Palsy can be physically challenging due to being restricted in taking part in certain activities. This can affect social situations due to these restrictions and can affect a child/young person emotionally questioning why they are different causing low self-esteem.

Being diagnosed with a serious illness such as cancer as a child/young person can also prove to lead to developmental issues. All areas of development can be compromised, intellectually, through missing school and being too ill to complete set work. They may suffer physically depending on the specific illness causing them to be weak and/or in too much pain and discomfort to complete physical activities. Socially they may be too ill to interact with others and/or maintain friendships. They may also become emotionally withdrawn and find it difficult to cope with their emotions.

Child and Young Person Development /TDA 2. 1/2. 1 Health continued…. ; Allergies affect many children, particularly food allergies; this in turn can lead to social problems as they may become excluded from certain situations where their allergies are not known. In contrast they may feel a certain social stigma as their allergies are highlighted, for example; when eating lunch at school, they may be required to wear a special badge which shows their allergies, causing them to feel different from their peers.

They have to be more physically aware of their condition and how this can cause changes in their body and manage this accordingly. /TDA 2. 1/2. 1 Describe with examples the kinds of influences that affect children and young people’s development. Environment; Environmental factors can play a huge part in affecting a child/young person’s development. These can vary from cultural factors to living conditions. Children/young people from less advantaged backgrounds who live in poverty can have their development seriously compromised.

They are less likely to have educational support from parents/carers which in turn creates intellectual problems for the child/young person. This is further influenced by having a lack of learning resources available such as access to computers and books. They may become disillusioned with education from an early age which sets them on a path of social and emotional turmoil. Also, they may suffer socially by not being able to participate in certain paid activities offered through school and outside school which means they interact less in physical activities.

They may also feel that they cannot compete with their peers with regards to fashion trends and owning the latest technology. They might not seem to be as physically strong as their peers; parents/carers might experience difficulty in providing healthy, regular meals which can cause problems with their physical well-being. Their emotions can seem quite immature at times and they may well become emotionally withdrawn but also prone to emotional outbursts associated with behavioural difficulties, displaying a lack of attention. Child and Young Person Development /TDA 2. 1/2. 1

In the play King Lear by William Shakespeare, the good children are disowned by their fathers, but they do not stop loving their fathers and they eventually come back to rescue them from their misery. Shakespeare uses characterization of Cornelia and Edgar to show how true children will always love their parents even if they are sinned against. Cornelia is disowned by her father while Edgar is forced to disown himself. Eventually they forgive their fathers and aide in their recovery from insanity. Edger’s and Cordillera’s love for their fathers is so strong that they become the reason for their fathers’ death.

Cornelia is disowned by her father while Edgar disowns himself. Cornelia and Edgar are disowned in two different ways, yet there are many similarities. When Cornelia is asked to address her love for her father King Lear, she is unable to “heave” her heart into her mouth (1, 82-83). The imagery created shows how it is impossible to say how one truly feels. Lear is enraged because his authority’s at risk and therefore, disowns Cornelia: Here I disclaim all my paternal care, Propinquity, and property of blood, And as a stranger to my heart and me Hold thee from this for ever.

The barbarous Scythian, Or he that makes his generation Messes to gorge his appetite, Shall be as well neighboring, pitied, and relieved As thou, my sometime daughter. (1 , 105-112) This passage from the play is rich in imagery. Lear compares him rejecting his daughter to barbarians who eat their own children for dinner. The metaphor shows to which extent Lear hates his own daughter because she can’t express her love for him. Edgar is also disowned by his father but in a different manner. There is never a face-to-face conversation where Gloucester disowns Edgar.

It happens through the circumstances created by Edmund. When Edmund tells his father that Edgar plans to kill him, at first Gloucester is in doubt. But Edmund manages to persuade his father with a fake letter. “Love cools, friendship falls off, brothers divide, in cities mutinies, in countries discords, in palaces treason, and the bond cracked between son and father”(2, 104-107). In this speech, Gloucester mentions that Edgar is no longer his son. Later in the play when Edmund cuts himself and blames it on Edgar.

Gloucester orders his men to find Edgar and kill him. Edgar hides in a tree and decides to disguise himself as a beggar. Edgar says: “Edgar I nothing am” (7, 186). This is a vital point because Edgar acknowledges the fact that he exists no more. It is Just like how King Lear disowned Cornelia, but Edgar disowns himself. He is no longer considers himself as the son of Gloucester; nor does Gloucester accept him as his son. Cornelia and Edgar forgive their parents even after they are betrayed and mistreated; they also, aide in their recovery.

When Cornelia finds out that her sisters betrayed her father and he has gone insane, she invades Brittany with her husband’s army, to find Lear: All blest secrets, All you unpublished virtues of the earth, Spring with my tears, be titan and remedial In the good man’s distress! Seek, seek for him, Lest his ungoverned rage dissolve the life That wants the means to lead it. (18,17-21) The imagery created by Shakespeare shows how passionately Cornelia loves her father and she is willing to nourish the herbs with her tears so they can help her father recover.

When Cornelia and Lear are finally reunited, Lear expresses his newfound humility and begs repentance. “l am a very foolish, fond old man” (21, 58), he tells her sadly, and he admits that she has “some cause” to hate him (21, 72). Cordillera’s moving response, “No cause, no, cause” (21, 73), shows that love and reconvenes is embodied in Cornelia. When Gloucester goes to commit suicide, Edgar also saves his father from death. He pretends that his father Jumped from the cliff and acts as if he is astonished by his s survival. Thy life’s a miracle… /… /Think that the clearest gods, who make them honors/ Of men’s impossibilities, have preserved thee” (20, 55&73-74). Edgar convinces his father, Gloucester that God saved his life because he is not destined to die Just yet. Gloucester regains meaning to continue his life; therefore Edgar cures him from insanity. The difference between Edgar and Cornelia is that Edgar helps his father in disguise. He doesn’t want his father to know it is him. “Never-?O father! -?reveal myself unto him” (24,189).

Even when his father says, “Might I but live to see thee in my touch/led say I had eyes again” (15, 119-22), he doesn’t reveal his identity. This is somewhat similar to how Cornelia and Lear were uncomfortable seeing each other due to not knowing how the other one would react. Edgar and Cornelia show their unconditional love by saving their fathers from insanity. Cornelia and Edgar are the cause of their fathers’ deaths. The familial love between father and child is so strong at the end of the play that Cornelia and Edgar re the reason for their fathers’ death.

When Edgar reveals his identity to his father, the Joy of meeting his son, his wish coming true, ultimately kills him: but his flawed heart-? Alack, too weak the conflict to support-? ‘Twixt two extremes of passion, Joy and grief, Burst smilingly. (24, 193-196) This is really ironic because Gloucester lives when he doesn’t know Edgar if is still alive. He was in grief, when he was blinded and because he betrayed his son. But as soon as he finds out and meets his son, Edgar, he dies of Joyfulness. In contrast to Lear who experiences extreme sadness, and also passes away.

Lear grief is caused by the death of his beloved daughter Cornelia: And my poor fool is hanged. No, no life. Why should a dog, a horse, a rat have life, And thou no breath at all? O, thou wilt come no more. Never, never, never. -?Pray you, undo This button. Thank you, star. O, O, O, O. (24, 300-304) Lear keeps questioning the death of his daughter and also shows sign of insanity again. He prays to God asking for her life back. He is struck by misery, more than ever before, and he dies. Gloucester not only experienced Joy but also grief. Gloucester grief is caused by not being able to see Edgar and because of regret.

Ultimately, Lear and Gloucester die because of losing the one they love and also due to regretting the wrong they have done in the past. The characterization of Cornelia and Edgar shows how loyal children will unconditionally love their parents even if they are wronged by their parents. Cornelia is disowned by her father while Edgar is forced to disown himself. Edgar and Cornelia never stop loving their father and show forgiveness. They also go about curing their fathers from insanity. While Lear and Gloucester have true children that are willing to forgive any sin, their unfaithful children cause them to suffer.

A nursing assessment of a family is the basis of nursing interventions. Stanhope And Lancaster (2008) state, “By using a systemic process, family problem areas are identified and family strengths are emphasized as the building blocks for interventions, and to facilitate family resiliency. This assessment will describe a family that finds themselves alone, after the death of their wife and mother, six months ago. For ML his wife, for CL his mother.

This small family of two graciously agreed to be a part of my assessment, they were interviewed together and separately, multiple times. “Family refers to two or more individuals who depend on one another for emotional, physical, and/or financial support. ”This family is a small family of two. ML is the father, and CL is the son. They live in a three bedroom home, owned by ML IN Valrico, Florida. ML is a 46-year-old male, and CL is a 16-year-old male. ML and CL lost their wife and mother six months ago to breast cancer.

They have both struggled ever since. ML is a welder and has worked for the same company for the past 20 years. After the death of his wife, he sold their home of twelve years and moved to Valrico, to “start over”. ML works from 7am to 7pm Monday through Friday. ML works hard and provides nicely for his son. He is gone most of the day, and into the evening. ML works as much over-time as possible. He stated “as long as I am working, I do not have to be home alone with my son, not because I do not love him, but because we both know what is missing”.

ML drinks beer on the weekends, he admits it is getting heavier since his wife has passed away. Most evenings he does not cook at home, instead he brings home fast food or they eat frozen foods for dinner. Three months ago ML was diagnosed with Hypertension, Non-Insulin-Diabetes-Mellitus, Hyperlipidemia, Anxiety and Depression. He has started treatment just recently for Hypertension, Diabetes and Hyperlipidemia all with Po meds and diet. He stated, “I do not need medications for the depression, my wife just died, who wouldn’t be depressed nd anxious”. CL is a 15-year-old boy, an only child, and lives with his father. CL has had a difficult time since his mother has died. ML and CL have no other family that lives close to them. Both of his grandparents live in New York, and are much older. CL states “Dad is doing the best he can, I worry about him, and he just does not know what to do. He is sad all of the time, and I just try and stay away from him” CL is home alone a lot of the time, before and after school. His grades have suffered, he feels sad and depressed most of the time.

He has few friends since moving to this new home, and he isolates in front of the television or his Xbox. His diet is less than optimal, living on frozen and fast foods daily, other than the meals he gets at school, breakfast and lunch. CL has stated that “he is scared and lonely” he has stated “Dad and I do not talk, we both are too sad”. I believe that both ML and CL are afraid of their feelings, afraid of what will happen if they start to talk, and they may not know how to communicate with each other, especially about their feelings regarding the death of their wife and mother.

Both ML and CL have agreed to be my family for this assessment, they both admitted they needed help and that they are aware they need the help. Better than that, they both want the help. Developmental Stage According to Stanhope and Lancaster Duvall’s Developmental stages of the families “are based on the age of the eldest child” . This family would fit into stage five. “Families with teenagers, oldest child 13-20 years old. Teenagers balance freedom with responsibility, establishing parent interests and careers.

Adolescents Parents focus on midlife marital and career issues, shift toward concern for older generation. Environmental Data This family lives in a three bedroom home, owned by ML, with 2 bathrooms, a family room and dining room. The house is clean, all appliances in good working order, I see no safety hazards, waste and garbage disposal is adequate. They have a nice back yard with a built in pool and patio, but it looks as though it has not been used. The family has just moved into this home, has lived there now for 3 months.

It looks like a house, not a home. They live in a modest neighborhood, nice area of Valrico, with good schools, and a strong community. The family does not know any neighbors nor have they tried to get to know their neighbors. They have no idea of community resources; basically, they go to work and school, and stay home the rest of the time. Complete social isolation. Family Structure There is a strong need for these two family members to communicate with each other about their feelings of grief; they need to support each other and to stop isolating.

They do not spend any time together, and when they are both home, they are in separate rooms. ML is very emotional when speaking about his wife and son, he feels he has failed his son, but does not know how to talk to him. CL is completely lost, not only is he dealing with the death of his mother, but he feels he has lost his father as well, along with the normal feelings of being a teenage boy. According to Stanhope and Lancaster (2008) “The two primary functions of families in the twenty first century are relationships and health care functions”.

This family is having difficulty with communicating, and sharing. They have lost a great deal and are not coping effectively Family Stress and Coping Currently the largest family stressor is anticipatory grieving on both family members. This leads to multiple stressors and ineffective coping mechanisms. The strength and glue that held this family together is gone. ML has turned to alcohol to deal with his stress, and CL has isolated deeper. This beautiful family is in a downward spiral. Coping mechanisms need to be addressed, along with interventions to help this family.

Family Function

ML believes all he can do right now is to provide for CL in monetary actions, house him, feed him, clothe him, and make sure he goes to school. He wants to be and do more, he is just unsure how at this time, he feels by providing financial survival, that is all he can do right now. This family is not functioning, there will be more dysfunction if this family cannot get the help that is needed, their issues are not chronic nor are they terminal. They need time and loving intervention, by friends, resources in their community, and by each other.

Priority Family Nursing Diagnosis

The first nursing diagnosis for this family is; Ineffective, Individual Coping related to inadequate opportunity and time to prepare for the stressors of losing a loved one, and situational crisis as evidenced by using ineffective coping strategies, having physical symptoms of stress, and manifestations of negative behaviors to decrease stress. Family interventions will be, to use effective coping strategies, use behaviors toward self and others, report decrease in physical symptoms of stress, report increase in psychological and spiritual comfort, seek help from a health care professional as appropriate.

Within four months after seeking professional help. The second nursing diagnoses for this family is; Anticipatory Grieving related to the death of a significant family member as evidenced by lack of communicating and discussing their feelings, ineffective feelings of expression with feelings of guilt, fear, anger, and sadness, anxiety, changes in appetite, decrease energy and isolation, for both family members.

Family interventions will be to *Express appropriate feelings of guilt, fear, anger and sadness, with each other and self*Identify somatic distress associated with grief (anxiety, changes in appetite, insomnia, nightmares, decreased energy, and altered activity levels. Within four months of seeking professional treatment for both .

The third nursing diagnosis for this family is; Altered Parenting related to deficient knowledge about parenting skills, poor communication skills, depression, and sadness, and changes in family unit as evidenced by inappropriate measures to maintain a safe, nurturing environment for the child, lack of attentive, supportive parenting behavior, and lack of child supervision. Interventions for this family would be teach appropriate measures to develop a better, safer and nurturing home environment acquire and display attentive, supportive parenting skills with positive adult behavior and positive and loving adult supervision.

Conclusion This paper was developed to provide a family assessment and prioritized nursing diagnosis. With the three main nursing diagnoses, nursing and family interventions were put in place. By using the Friedman Family Assessment, family challenges are recognized and the family strengths are highlighted as the ground work for interventions and foster family resilience. The assessment explored the family’s developmental stage, structure, composition and stressors. With this data, a nurse is able to prioritize family nursing diagnosis and analyze appropriate nursing interventions to assist with the progression of each diagnosis. According to Stanhope and Lancaster (2008) “ Healthy and vital families are essential to the world’s future because all family members are affected by what their families have invested in them or failed to provide for their growth and well being.

References

1. Stanhope, M. , & Lancaster, J. (2012). Public health nursing: Population-centered health care in the community (8th ed. ). Maryland Heights, MO: Elsevier Mosby. . Turnitin Originality Report Processed on 17-Apr-2012 1:12 AM CDT ID: 242763557

The central theme to Bharati Mukherjee’s fictional story “The Management of Grief”, based on real-life events, is that of being both a part of something tangible and in an ethereal and cultural sense apart from it. There are several binary focus points of this piece and all put the work into the context of opposing sides. There is life versus death, new versus the old world, Hindu versus Sikh. There is, also, a broader theme of bringing multiculturalism to the forefront of the complications of grief. In this way, it cannot be said that there are stages of grief, as the social worker suggests, but various moving parts that cannot be connected to any group of people, those similar in culture or otherwise.

Essentially, grief is unique in its individual personification and can be seen affected by culture, but understood by all, if only in different ways. But, in this, it can be said that there is a culture of grief and that everyone becomes a member of this community, regardless of iconic culture. So instead of stages of grief and binary opposites in its aftermath, there is a tone in this piece of the necessity of shared sadness, but, also, the secret, solitary acceptance of it.

This piece is interesting in transmitting the confusing and impossible undertaking of conveying individual grief.  The detachment displayed by the main character points to this detachment from others in both an ethereal and real sense. Denial is a stage of grief, but this piece points to a larger component and that is the detachment from the grief of others in a shared tragic event. Though the value of friendship is notable in this work, the eventual letting goes of a friendship, as it formerly was into a new dimension, is introduced.  At the beginning of the stage of accepting the reality of the tragedy of the destroyed planet, the friends and neighbors of the protagonist, Shaila, are depicted with humor and detachment. Shaila uses the metaphor of the connection she attempts to keep with her lost family, “I hear their voices all around me.  I hear my boys and Vikram cry,

‘Mommy!, Shaila!’ and their voices insulate me, like headphones” (1505).

A concerned doctor’s wife, also, adds to the writer’s usage of the binary opposites of the life and death central to the theme.  She is visibly pregnant and accompanied by her living children, as she tries to help Shaila.

A visit to the site of the plane crash, which also remained a mystery for some time and later revealed to be a bombing by Sikh fundamentalists, adds imagery and impact to the suffering and shared sadness of others. Over a bay in Ireland, the protagonist and friend look over the endless water, imagining an island there. Shaila has not had her family’s remains identified and holds on to the hope that they are out in this vast body of water on an island. This is a useful metaphor for her own position of aloneness, an island unto herself. The flowers were given to the mourners by the Irish point to the attempt to share in this grief, but it is not flowers that Shaila wishes to place there in her family’s memory. “But I have other things to float; Vinod’s pocket calculator; a half-painted model B-52 for my Mitchum. They’d want them on their island.  And for my husband? For him, I’d let fall into the calm, glassy waters a poem I wrote in the hospital yesterday. Finally, he’ll know my feelings for him” (1510). Related Article:  “a solitary child, neglected by his friends, is left here still”

When Shaila arrives in India, she is struck by the pull of old versus new world ideas. Her parents shun the idea of Vedic rituals and she becomes as she says “I am trapped between two modes of knowledge…like my husband’s spirit, I flutter between two worlds” (1511). Shaila does find her refuge in the old world ideas that her parents disapprove of and believes that she sees her husband in an abandoned temple and he urges her to return home, to the life they began together. When she returns to Canada, she has dreams of her family. Many of the other families have moved away and what is left is explained as, “We’ve melted down and been recast as a new tribe” (1513). This idea of being “melted down” can be viewed as a multicultural metaphor, a group that has assimilated into their new country, but not assimilated fully into their acceptance of grief.

The character tries to help others with their grief and a climactic moment occurs when she attempts to help a Sikh family with their financial crisis. She realizes that there are barriers to culture and the expectations of the outcomes the social worker has for all of the relatives of the lost. Putting grief in a simple package for all is impossible. This formulates the profound ending with an allusion to this package of grief that is only held by the individual experiencing it.

 “Then as I stood on the path looking north to Queen’s Park and went to the university, I heard the voices of my family one last time your time has come, they said. Go be brave. I do not know where this voyage I have begun will end. I do not know what direction I will take. I dropped the package on the park bench and starting walking” (1516). This use of symbolism of this package sums up the complexities of individual grief and the mystery of what is inside the package, as it is never stated. But, leaving the package behind and walking on reveals to the reader that the protagonist has reached their individual acceptance.

Bharati Mukherjee. “The Management of Grief” in The Middleman and Other Stories. (1988).