Lindsay Watson, MA, Registered Marriage and Family Therapist, AAMFT Approved Supervisor, Toronto, ON;
Scott Allan, MD, CCFP, Lecturer, Department of Family & Community Medicine, University of Toronto, Toronto, ON;
Ian Waters, MSW, RSW, Social Worker, Professional Practice Leader and Lecturer, Department of Family & Community Medicine, University of Toronto, Toronto Western Hospital at the University Health Network, Toronto, ON;
Lori Robertson, MTS, CASC Specialist-Chaplain, St. Michael's Hospital, Toronto ON;
Hannah Kaufman, BA, MSS, MHSc, University Health Network and University of Toronto Joint Centre for Bioethics, University of Toronto and Working With Families Institute, Department of Family & Community Medicine, University of Toronto
Posted: April 10, 2014 Format: PDF
Grief and Loss: An Approach for Family Physicians
Grief and loss are commonly encountered in family practice. Patients grieve the loss of loved ones, jobs, marriages, pets and even physical or psychological functioning. Patients may mourn the loss of their good health and seek comfort, understanding, respect, and especially hope. The "work of grief" is a progression through stages of shock, anger, painful dejection, loss of interest in the outside world, inhibition of activity and the temporary interruption of the capacity to love. 1 In addition to a profound sense of sadness, there may be feelings of anxiety, anger, fear, depression, and guilt. Patients, their families, and physicians may underestimate the impact of loss on health, which may cause physical symptoms such as pain, headache, dizziness, fatigue, and disturbances of sleep and digestion, as well as psychological symptoms. Family physicians (FPs) are in a unique position to influence prevention, early detection, and morbidity of these disorders. Psychotherapy can relieve the self-destructive anger and guilt, advance the recovery phase, and stimulate psychological strength and personality growth.
How can we identify those individuals who are at risk for grief reactions in our practice? What techniques can FPs utilize to help patients go through the stages of grieving? What supports can the physician provide to families who are experiencing difficulty adapting to loss? How can FPs be aware of their own feelings around loss and how they impact on patient care?
This is one educational module in a series produced by the Working With Families Institute to provide a learning resource for physicians dealing with common medical and psychosocial issues that have an impact on families. The modules seek to bridge the gap between current and best practice, and provide opportunities for physicians to enhance or change their approach to a particular clinical problem. They use a problem-based style and real case scenarios that pose questions to the reader. The cases are followed by an information section based on the latest evidence, case commentaries, references and resources. The modules are designed for either individual learning or small group discussion.