Grief is not only shaped by the loss itself, but also by how society responds to that loss. In some situations, people are not fully supported or recognised in their grief, which can make the experience even more painful. This is known as disenfranchised grief, a concept developed by bereavement scholar Kenneth Doka.
Disenfranchised grief occurs when a person’s loss is not openly acknowledged, socially validated, or supported. For patients and families, this can be particularly difficult when the circumstances of a death are complex, sensitive, or stigmatised.
Deaths that may lead to disenfranchised grief
Certain types of death are more likely to result in disenfranchised grief because they may not receive the same level of social recognition or support as other losses.
1. Suicide
Deaths by suicide are often surrounded by stigma, misunderstanding, and silence. Families and friends may feel unable to talk openly about their loss, leading to isolation and unresolved grief.
2. Substance-related deaths
When a death is linked to alcohol or drug use, grieving individuals may experience judgement or blame from others, which can prevent open mourning and support.
3. Miscarriage and stillbirth
Pregnancy loss is a deeply significant bereavement, but it is not always publicly acknowledged in the same way as other deaths. This can leave parents feeling that their grief is minimised or invisible.
4. Death of a baby or young child
While this type of loss is often recognised as tragic, some parents may still experience discomfort from others or feel pressure to “move on” quickly, limiting their ability to grieve openly.
5. Losses that are socially unrecognised
Disenfranchised grief can also occur when the relationship to the deceased is not acknowledged, such as:
- Ex-partners
- Secret or non-traditional relationships
- Step-relationships or informal caregiving roles
- Pet loss (in some social contexts)
Why disenfranchised grief matters in healthcare
In healthcare settings, recognising disenfranchised grief is important because patients and families may be grieving without adequate emotional support. When grief is not acknowledged, it can increase feelings of isolation, guilt, or distress.
By understanding the different types of death that can lead to disenfranchised grief, healthcare professionals can offer more compassionate, inclusive, and person-centred care.
Supporting patients experiencing disenfranchised grief
Support can include:
- Validating the person’s loss without judgement
- Allowing space to talk about the deceased and the relationship
- Avoiding assumptions about how someone “should” grieve
- Signposting to bereavement support services
Recognising that all grief is valid—regardless of circumstance – is a key step in improving care and emotional support for bereaved individuals.
