HIV--Death and Dying

1. HIV--Death and Dying Jason Tokumoto, MD National HIV/AIDS Clinicians’ Consultation Center

2. Grief • You can avoid the pain of your grief and still resolve it successfully. • It takes 2 months to get over your grief. • Grief declines over time in a steady fashion. • Once grief is resolved, it never comes up again.

3. Grief • It is best to put painful things out of your mind. • If a bereaved individual expresses his/her feelings, the grief will be resolved. • Grief will only affect you from an emotional/psychological standpoint.

4. Death and Dying • Bereavement • Mourning • Grief

5. Bereavement • Objective response—state of having suffered a loss or death.

6. Mourning • Overt, social response to a death. • Influenced by one’s culture.

7. Grief • Normal and appropriate response to death. • Manifested in many way: • Physical(eg headache, insomnia). • Psychological(eg guilt, crying). • Cognitive(eg decreased concentration). • Behavioral(eg avoiding reminders of the deceased). • Spiritual(eg searching meaning in life).

8. Grief • Each person’s grief is unique: • Relationship between the bereaved and deceased. • Circumstances surrounding the death. • Coping styles of the bereaved. • Age and maturity of the bereaved. • Social variables. • Other concomitant events.

9. Grieving Process • Different models exist • Parkes: • Phase 1: Shock and Numbness • Phase 2: Yearning and Searching • Phase 3: Disorganization and Despair • Phase 4: Reorganization

10. HIV/AIDS • “Bereavement Overload” • Multiple losses with little time for separate grieving time. • Four ways to cope with multiple losses: • Functional engagement • Dysfunctional engagement • Functional detachment • Dysfunctional detachment

11. BalancingEngagement & Detachment • Engagement Detachment dysfunctional dysfunctional FUNCTIONAL BALANCE

12. Functional/Dysfunctional Engagement/Detachment