Grief, Loss and Bereavement. Understanding Concepts, Clinical Manifestations and Cultural Considerations at End of Life.

The weight of grief is heavy on both patients with terminal illness, and their loved ones. We are now aware that grief is not limited to the time of death-grief reactions begin to occur at the time of diagnosis of terminal illness and evolve over time, impacting the patient and family unit in a variety of ways. Loss of what life "could have been" with better health, decline in physical functioning due to illness, and loss of identity and role within the family or community all play a part in the grieving process.