Moving out of home, loss of independence, cancelled events, the death of someone close to you – maybe you have experienced one or more of these situations?
Grief is a response to loss. Specifically, loss of someone or something to which a bond of affection was formed.
As your parents move through life, particularly in the later stages, they are likely to experience changes and situations that spark a grief response. It is essential to acknowledge these changes and do your best to provide support at this time.
Support is made easier by knowing what is expected in these situations. Grief is a normal response to loss and requires understanding and care. In this article we outline one of the most frequently taught frameworks for understanding grief, developed by Dr Elisabeth Kubler-Ross.
The process of grieving is very personal and individual. The model is purposely personal and subjective and is not designed to give an exact roadmap. It provides a practical guide to recognise common patterns of emotional behaviour, which could cause confusion, hurt or frustration if not understood.
Recognising these patterns can help you, your family, friends and health providers to provide empathy and understanding – and to appropriately assess the behaviour and mindset of those you are supporting.
The Kubler-Ross five stages of grief
The five stages are outlined below – note these can happen in any order.
1. Denial
“Denial is a common defence mechanism used to protect oneself from the hardship of considering an upsetting reality.” (Tyrrell, Harberger & Siddiqui, 2021)
Often this involves denying the reality of a change, a situation or a diagnosis. Or it may be blaming the people or tests involved, or simply avoiding the topic.
While persistent denial may cause concern, it is normal to experience a period of denial, and it can be necessary for processing the difficult information received.
In some instances, it may be hard to distinguish denial from understanding. Therefore, you should share upsetting news clearly and simply. If you believe the information has been understood, you do not need to repeat it at this point. The individual may simply require time and an opportunity to reconcile the information without interference.
2. Anger
This emotion is commonly experienced as the understanding of a loss begins to settle in. The emotion may be directed at medical providers, family members or higher powers, or may manifest as generalised and undirected angry outbursts.
Recognising this stage can help you understand and provide empathy in a situation that may otherwise feel confusing and hurtful. Maintain appropriate boundaries throughout this phase and be mindful not to dismiss legitimate criticism as an ‘angry outburst’.
3. Bargaining
This is typically an attempt to regain perceived control over a situation or illness.
“The negotiation could be verbalised or internal and could be medical, social, or religious.” (Tyrrell, Harberger & Siddiqui, 2021) For example, “If I follow this diet exactly, I know my cancer will go away”, or “I will devote my life to others if I can stay in my own home”.
Listen to your loved one, but be careful not to affirm false beliefs or propositions as this can be a hindrance to accepting the situation clearly later.
4. Depression
When a loved one is experiencing depression, it is perhaps the most emotional and physically intense stage of grief. Make a conscious effort to be compassionate (this can be difficult after experiencing the hardships of other stages). Depression is the phase where your loved one needs you to show the most empathy and care.
5. Acceptance
Acceptance is considered the final stage of grief and is seen as an individual accepting the reality of a situation and no longer protesting it. It is a time to reflect on the person or thing that was lost and appreciate its memory. This is also an opportunity to plan for what to do next.
Every person experiences grief in their own way and across the course of their life.
In this article, we looked at the Kubler-Ross stages of grief, intending to support an informed, caring and an empathetic approach to helping someone in the grieving process – in whatever context that may be.
If you believe a loved one may be struggling with grief, many resources are available for additional support. Beyond Blue and the Australian Centre for Grief and Bereavement are excellent places to start.
If you have any questions about this article, please contact the TPC team and we will happily answer any questions.
Article written by Emily Johnson, TPC physiotherapist
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