Ambiguous loss and the complexities of grief in dementia

The concept of ‘ambiguous loss,’ developed by American professor Pauline Boss in the 1970s, describes a form of grief that lacks the clarity of a physical death. This occurs when a person is physically present but psychologically, cognitively, or emotionally unreachable, such as in cases of dementia, severe mental illness, or brain injury.

Another form of ambiguous loss involves people who are physically absent but psychologically present, such as individuals who are missing, kidnapped, or separated by migration and incarceration. For families dealing with dementia, the experience can mirror traditional grief through symptoms like sadness, guilt, and physical distress, yet the inability to reach a definitive sense of closure makes the process uniquely challenging.