To get through life's problematic challenges, it helps to have the tools to cope. The 3-A Approach is such a tool. There are assumptions related to applying the components of the 3-A Approach:Acknowledge, Assess, Assist® in addressing adversity and loss. The first assumption is that wherever there is adversity, there is loss. The second is that grief is a reaction to a significant loss. The third is that there are potential benefits of strengthened resiliency & personal growth resulting from addressing loss and processing the grief.
Situational Loss is loss of a person, thing or quality resulting from an alteration of a life situation involving changes related to , in addition to death, illness, change in body image and environment
This definition from the Mosby’s Medical Dictionary, 8th ed., 2009 most precisely defines the losses people experience during challenging circumstances such as those caring for a family member with any progressive neurological or chronic mental illness.
Betsy Peterson acknowledged the situational loss and the grief that accompanies it. She wrote in her 2006 article “One Caregiver’s Search for Help” about her experience as a family caregiver for her spouse, Pete, who lived over 10 years with Alzheimer's disease. In her writings, she expressed that it took her years to recognize that while caregiving, she was grieving the loss of her husband in similar ways that individuals grieve a death. She stated there was no guidance for family members in dealing with the grief. Consequently, she felt there was something wrong with her, but continued to believe that what she was experiencing was not unusual or unhealthy. She questioned why the grief had not been addressed.
Her own experience inspired the writing of her book “Voices of Alzheimer’s: Courage, Hope and Love in the Face of Dementia”. She wrote:
Some family members recognize on their own the grief which accompanies dementia…...a substantial number of caregivers only recognize they are grieving after they are told this is what is happening to them.
Often people will not acknowledge on their own they are experiencing situational loss and grief. They need to be told so they can process their reaction to the situational losses. Strengthened resiliency and personal growth are the benefits from grief processing.
Although “Acknowledge” is the first in sequence for the 3-A Acknowledge, Assess, Assist Approach, it is not to be considered the first step/phase or stage of the 3-A Approach. Rather, the components each feed into one another as they can be applied simultaneously. A healthcare provider is Assisting by Assessing if the family member is Acknowledging the situational loss and how the reaction to the situational loss is manifesting. For self care, family caregivers can Assist themselves through Acknowledging their loss and Assessing for themselves how the reaction to loss is manifesting.
For difficult circumstances of situational loss, keep Acknowledge, Assess, Assist in the coping toolbox.