In Hospice grief is a term we use often. While in the Hospice world, grief is primarily centered around loss of a loved one there are other causes of grief. When it occurs we experience the loss differently. We may be able to cope and move on in a matter of minutes or it could take days, weeks, months or years, depending on the circumstances and individual.

While the duration of a grieving period can vary significantly, there are standard stages of hospice grief that many experts agree on: denial, anger, bargaining, depression and acceptance. These stages may also be referred to as the Kübler-Ross model or DABDA.  The stages may not be experienced in the order noted, and some may be skipped entirely. Grief is individual and doesn’t follow a set process.

The Kübler-Ross model established by Elisabeth Kübler-Ross and David Kessler, expands on the hospice grief process using personal and professional experiences. Elisabeth, often noted as a pioneer in hospice, published her final work in 2005, “On Grief and Grieving.”

George A. Bonanno, Columbia University Professor, has joined the field with his own research.  Bonanno’s research was completed on individuals who experienced a variety of traumatic events.  His findings resulted in identifying resilience as the trait that was most commonly displayed in all individuals.  His model encourages individuals to focus on positive emotions after a loss or tragedy.  This has evoked some controversy as some find it hard to believe that people who have suffered a tragic loss may not need counseling and that the expressions often encouraged by counselors, family and friends, such as crying or talking may actually cause more harm than good.

I conducted an informal poll of the question “How do you describe grief?” Two responses received were:

  • An undefinable time of longing over a loss of a loved one.
  • Invisible pain that no doctor can treat and only time can heal.

Regardless of how you define grief, we vary in our response to it. The Kübler-Ross model as well as the research and findings of Bonanno are intriguing and valid.   I would propose that neither model is the “right” model. The approach to be taken is more about the individual and less about a process, or bucket, to put them in.

If you’d like more information on either the Kübler-Ross model or George Bonanno’s research please visit the links provided below.