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Difficulty: HardGrief and Loss

A 58-year-old client, whose spouse died unexpectedly 11 months ago, is at a healthcare provider's office for a routine physical examination. The licensed practical nurse (LPN) is gathering psychosocial data. Which of the following client statements indicate a potential progression to prolonged grief disorder? Select all that apply.

  1. I have not been able to enter our shared bedroom, so I sleep on the living room sofa.Answer
  2. I feel a deep sense of emptiness and believe my life has no meaning without them.Answer
  3. C
    Sometimes I wake up in the morning and briefly forget that they are gone.
  4. D
    I continue to feel waves of intense sadness whenever our wedding anniversary approaches.
  5. I refuse to let anyone move their personal belongings; everything must stay exactly as they left it.Answer
  6. F
    I recently decided to volunteer at the hospital because they received such good care there.

Answer

The statements indicating prolonged grief disorder are the inability to enter the shared bedroom, feeling life has no meaning, and refusing to let anyone move the deceased's belongings.
The correct statements highlight severe behavioral avoidance (sleeping on the sofa to avoid the bedroom), profound identity disruption (believing life has no meaning), and an inability to integrate the reality of the loss (keeping all belongings untouched). When these manifestations persist 11 months after a death, they indicate prolonged grief disorder because they significantly impair the client's psychosocial adaptation and daily functioning.

Step-by-Step Solution

1
Identify the time elapsed since the client's loss.
The client's spouse died 11 months ago.
Prolonged grief disorder is typically considered when intense, disabling grief persists beyond 6 months and impairs daily functioning.
2
Differentiate between normal manifestations of grief and maladaptive behaviors.
Normal behaviors include anniversary reactions, finding new purpose, and brief morning confusion. Maladaptive behaviors include extreme avoidance, severe identity disruption, and environmental freezing.
Normalizing expected grief reactions prevents inappropriate escalation, while identifying maladaptive signs ensures timely reporting to the registered nurse (RN) or provider.
3
Select the statements that demonstrate severe functional impairment and inability to integrate the loss.
The statements about sleeping on the sofa, feeling life is meaningless, and keeping belongings frozen in time are selected.
These statements reflect the clinical criteria for prolonged grief disorder.

Key Concept

Prolonged grief disorder is characterized by intense, disabling grief symptoms—such as severe avoidance, identity disruption, and refusal to accept reality—that persist well beyond the normative timeframe (typically 6-12 months) and cause significant impairment in functioning.
Estimated Time:1m 30s
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Topics

Grief and Loss

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