Loss in a family has numerous related definitions that relate to grief, loss, bereavement, and complicated grief, ambiguous loss, and chronic sorrow (Holtslander & McMillan, 2011; Walsh, 2007; Boss, 2006; Boss, Doherty,LaRossa, Schumm, & Steinmetz, 1993; Burke, & Hainsworth, 1998; Isaakson & Ahlstrom, 2008 ). Walsh (2006) suggests health care professionals mobilize the capacity for healing and resilience in families and communities experiencing a loss (Walsh, 2003, 2006).
· Variables in the loss situation that require careful assessment and attention (Walsh, 2007, p 209):
· Time of Death-Untimely losses such as parents’ loss of young children requires reorganization of the family system.
· Sudden death-Sudden losses shatter a sense of normalcy and predictability. Shock, intense emotions, disorganization, and confusion are common and family members may have regrets.
· Prolonged suffering with Loss-Prolonged physical or emotional suffering before death increases family agony.
· Ambiguous loss-Physical or psychological absence of a family member. Either a body or the psychological presence of an family member. Unclarity about the fate of a missing loved one can immobilize families who may be torn apart, hoping for the best yet fearing the worst (Boss, 1999). Mourning may be blocked until remains or personal effects are recovered.
· Stigmatized losses-Mourning is complicated when losses or their causes are disenfranchised (Doka, 2002), hidden because of social stigma and secrecy.
· Pile-up effects. Families can be overwhelmed by the emotional, relational, and functional impact of multiple deaths, prolonged or recurrent trauma, and other losses (homes, jobs, communities) and disruptive transitions (separations, migration).
· Past traumatic experience-Past trauma or losses, reactivated in life-threatening or loss situations, intensify the impact and complicate recovery.
· Assist family as they attempt to find meaning in loss (Boss, 2006).
· Guide families in reconstructing meaning in way that enables them to function (Neimeyer, 2001; Eggenberger, Meiers, Krumwiede, Bliesmer, & Earle 2011).
· Help families find spiritual connections, memories, deeds, and stories that are passed on across the generations (Walsh & McGoldrick, 2004)
· Guide individual family members in exploring the past, present and future functioning
· Assist family members as they identify individual and family past strengths and develop sources of support.
· Help individual and family express understandings about the meanings of loss and identify specific ways to manage uncertainties over time.
· Discuss with family a chronic sorrow experience of Recurring and pervasive loss with no predictable end (Eakes, Burke, & Hainsworth,1998)
· Arrange and guide family discussions of perceptions, experiences and beliefs related to the loss.
· Encourage families to Share acknowledgment of reality of losses and experiences of loss and living
· Clarify facts
· Plan tributes and rituals within their belief system (Walsh , 2007)
· Assist family to Construct new hopes, dreams and realities and find new purposes (Walsh, 2007; Eggenberger, Meiers, Krumwiede, Bliesmer, & Earle 2011