The Existential Dimension of Loss and Grief.

This chapter discusses integrating grief support and spiritual care in palliative care. It explores the existential dimension of grieving and focuses on the process of loss both patients and families are going through. First, the state of the art of grief research is sketched, and some reasons are given why until now the existential dimension of loss and grief has not had sufficient attention. From there, we will develop a multi-dimensional understanding of loss and grief, connected with the four ultimate concerns identified by Irvin Yalom in his existential therapy. Following the total pain approach in palliative care, we will develop an understanding of loss and grief that brings together the physical, emotional, cognitive, social, and spiritual dimension of the phenomena. We will conclude the chapter by introducing a case of a palliative care patient and his wife, illustrating how an integrative understanding of loss and grief in palliative care may lead to a deeper and more comprehensive approach to loss as a universal human experience.