1.2 Describe how theories of loss and grief inform practice

This guide will help you answer 1.2 Describe how theories of loss and grief inform practice.

Supporting people through loss is a central part of health and social care. When someone experiences brain injury, both the person and their family can feel a deep sense of grief and loss. Understanding different theories helps workers respond with sensitivity. This guide covers well-known theories of loss and grief and shows how they shape good care practice.

Defining Loss and Grief

Loss means losing something important—such as health, ability, independence or identity. It can also mean changes in family roles or daily life. Grief is the emotional response to this loss. People often describe feeling sadness, anger, shock or helplessness.

After a brain injury, loss and grief are common not just for the person injured, but for everyone close to them.

Theories of Loss and Grief

Kübler-Ross Five Stages of Grief

Elisabeth Kübler-Ross identified five stages people may move through when grieving:

• Denial: Refusing to believe the loss has happened
• Anger: Feelings of frustration or unfairness
• Bargaining: Trying to find ways to change the situation (“If only…”)
• Depression: Deep sadness or hopelessness
• Acceptance: Coming to terms with the loss

Not everyone goes through these stages in order. Some experience certain stages more than others, and people may revisit stages over time.

Worden’s Four Tasks of Mourning

J. William Worden said grieving involves four tasks:

1. Accept the reality of the loss
2. Work through the pain of grief
3. Adjust to life without the lost person, ability, or role
4. Find an enduring connection with what has been lost while moving forward with life

Worden’s model encourages active processing of loss, not just passive acceptance.

Bowlby and Parkes’ Attachment Theory

John Bowlby and Colin Murray Parkes focused on how our early relationships shape our reactions to loss later in life. They suggested that strong emotional bonds lead to strong grief responses. Their model highlights that people react differently depending on their personal attachment style.

Continuing Bonds

This idea comes from more recent research. It suggests that people do not “let go” completely, but continue to find new ways to connect with lost abilities, people or roles. For example, a family may remember how things used to be, while building a new life.

How These Theories Inform Practice

Theories help workers understand that everyone’s reaction to brain injury, loss or change is unique. Good practice is based on the ideas within these theories.

Practical Ways Theories Shape Care

• Recognise that grief can include a wide range of feelings—not just sadness, but anger or relief
• Expect strong emotions at different times; people do not “move on” in a set order
• Give time and space—do not rush someone to “get over it”
• Encourage open conversation about loss, change and feelings
• Support people through painful emotions, not avoid them
• Help families and individuals adjust their routines, roles and relationships gradually
• Understand that wanting to talk about the past is a healthy way of coping
• Offer ways for people to keep a sense of connection with what has been lost (such as memory books, or celebrating abilities that remain)
• Respect different ways of grieving linked to culture, background or personality
• Recognise signs of complicated grief, such as persistent low mood or withdrawal, and offer extra support

Supporting Families of People with Brain Injury

When using these theories, workers can:

• Accept that each family member may be at a different stage of grief at any one time
• Talk about how family roles have changed and help people adjust
• Encourage families to express feelings without judgement
• Recognise anniversaries or moments that trigger new feelings of loss (such as birthdays or anniversaries)
• Be aware that practical tasks such as paperwork or care duties may be harder when someone is grieving
• Avoid saying things like “at least…” or “you should be grateful”—these do not help someone process their feelings

Adapting Support to the Individual

Workers can use what they know about the person’s previous life, personality, and way of coping to tailor support. For example, a person who has always been independent may need extra help adjusting to dependence.

Being mindful of different cultural approaches to loss is also important. Some families find strength in rituals, faith, or community support.

Recognising Signs of Unresolved Grief

Sometimes, grief becomes “stuck.” This can show as:

• Long periods of intense sadness
• Refusal to talk about the loss
• Increased anger or withdrawal
• Changes in health, sleep or relationships

Theories help workers spot when someone needs further support, maybe from a counsellor or mental health specialist.

The Importance of Teamwork

Caring for someone with a brain injury will often involve many professionals. Sharing different perspectives on loss and grief helps ensure support is consistent and sensitive across the team.

• Social workers, nurses, and therapists should communicate about the family’s needs and responses
• Documentation of how loss and grief are affecting the family can support good planning
• Bereavement support can be built into care plans as needed

Final Thoughts

Understanding theories of loss and grief gives workers a strong base for supporting families. These ideas remind us that grieving is a process, not a problem to be fixed. Emotions will vary, and ups and downs are normal.

Honest, gentle support helps families and those with brain injury find a way through their loss. By recognising where someone might be in the process of grieving, you can respond in a caring, understanding and respectful way. Theory helps guide practical care—and caring practice helps families move forward at their own pace.