Grief, Bereavement, and Caregiver Support
Normal grief
Grief is individualized and not a linear sequence of stages. Yearning, sadness, waves of emotion, and temporary disbelief are normal. Anticipatory grief occurs before death. Disenfranchised grief occurs when a loss is not openly acknowledged, such as the death of a partner in a hidden relationship. Culture shapes mourning rituals and expressions. Children grieve in developmentally specific ways, often revisiting the loss as they mature. A common trap is pathologizing normal grief or expecting closure.
Prolonged grief and depression
Prolonged grief disorder involves persistent yearning or preoccupation with the deceased plus symptoms such as identity disruption, avoidance, emotional numbness, meaninglessness, or intense loneliness that impair functioning. In adults, symptoms generally persist for at least 12 months; in children, at least 6 months. Major depression is characterized by depressed mood or anhedonia plus neurovegetative symptoms and low self-worth. Grief and depression can coexist. Medication is not first-line for uncomplicated grief; psychotherapy is first-line for prolonged grief.
Caregiver support
Screen caregivers for burden, depression, anxiety, and financial strain. Provide practical help, respite, education, and bereavement follow-up. Hospice teams provide bereavement support after death. Team members also experience grief and compassion fatigue; debriefing and self-care matter.
Traps
Do not tell people to move on or find closure. Do not assume a fixed timeline. Do not miss depression masked as grief, and do not overdiagnose grief as depression.
Rule of thumb
Ask what the loss has changed and what support is wanted; normalize grief while screening for functional impairment and persistent yearning.