The impact of loss on adolescents: developing appropriate support.

Much of the literature examining loss and bereavement addresses the adult or child experience and overlooks the unique impact that bereavement has on adolescents during an emotionally, physically and psychologically turbulent phase of life. This literature review explores current knowledge regarding the impact of loss on adolescents and the manner in which effective support mechanisms can be fostered within the hospice setting. Adaptive and maladaptive grief reactions are described and related to the unique developmental stages of adolescence. Studies have revealed that adolescents who had a close social network of family and peer group members in which open and supportive communication existed had a healthier bereavement outcome. An important part of the nurse's role is to encourage and facilitate this process pre- and post-bereavement. Some adolescents may be reluctant to accept such individually focused intervention and professionally organized support groups may provide a more acceptable and relaxed type of formal support. Recommendations for practice are outlined to highlight ways in which support may be improved and also to raise awareness of the needs of grieving adolescents.