Caring for the Bereaved

Bereavement care is crucial in helping individuals cope with loss, depression, and suicidal thoughts. The report highlights the significance of bereavement education and training for healthcare professionals to ensure quality care for those who are bereaved. Additionally, better coordination in bereavement care can provide holistic support to the bereaved individuals. By providing adequate training and education, staff will be empowered to ensure quality care for those who are bereaved.

Supporting People
Facing loss

TABLE OF CONTENTS
INTRODUCTION AND IDENTIFICATION OF THE ISSUE TO BE DISCUSSED..................3
EVALUATION OF MAIN THEORIES OF LOSS, GRIEF AND BEREAVEMENT..................3
ANALYSIS AND EVALUATION OF NORMAL AND COMPLICATED GRIEF
REACTIONS...................................................................................................................................5
Critically analyse the implications that recognized risk factors have on grief responses ...........5
APPRAISE THE IMPACT OF GRIEF RESPONSES WITHIN SPECIFIC GROUPS OF THE
POPULATION................................................................................................................................6
EVALUATING THE ROLE OF THE CARING PROFESSIONAL AND COUNSELLOR
PROVIDING BEREAVEMENT CARE.........................................................................................8
CONCLUSION AND RECOMMENDATIONS ...........................................................................9
Recommendations .......................................................................................................................9
REFERENCES .............................................................................................................................10
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INTRODUCTION AND IDENTIFICATION OF THE ISSUE TO BE
DISCUSSED
Loss can be regarded as an inevitable part of life and grief is a natural process of healing.
There is a presence of many losses that occur during the lifespan of a person (Grief and Loss,
2015). One such is serious illness of a loved one and thereby suffering from the fear of their loss.
It can be regarded as a very difficult part in life of a person. Hence the current report has made
an attempt to focus on analyzing the normal and complicated grief reactions. An evaluation will
further be done on role of helper with respect to serious illness of a loved one. The report will
end with concluding with the overall crux followed by recommendations.
In this regard, a case has been taken which is of John who has recently undergone a loss
due to death of her a 76 year old mother. The lady named Anne has been diagnosed with cancer
which was in the last stage. The revelation has affected John a lot and he needs a support system.
EVALUATION OF MAIN THEORIES OF LOSS, GRIEF AND
BEREAVEMENT
Freud's model of bereavement
Freud's theory focuses on the personal attachment. According to this theory, grieving
individuals search for an attachment which has been lost. As per the views of Freud, mourning is
defined as a state of melancholia which is seen as presentation of depression and involves
complete loss of pleasure in almost everything (O'Connor, and et.al., 2009). Freud's theory views
mourning as a task for rebuilding one's inner world. This is done by experiencing intense pain of
loss. This reawakens the loving effect of the lost loved one. Grieving and bereaving is regarded
as letting go of multiple attachments which were essential in the formation of relationship. As
per the theory it can be analysed that in the case given, John is in grief of losing his mother. He
may exhibit depression and may lose pleasure in doing anything. However, after he accepts the
loss, he may search for new attachments.
Elizabeth Kubler Ross Grief Cycle model
The process of loss and grief related to serious illness of a loved one can further be
understood by understanding the five stages of grief model. These include denial, anger,
bargaining, depression and acceptance.
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 Denial – This is the first reaction that is likely to be faced by person. He may not accept
the death of her mother. John may have a belief that the death is mistaken and may start
to cling towards a false yet a preferable reality (Stacey and et.al., 2011). Anger – When the person feels that he cannot deny death of his mother then a feeling of
frustration may start to arise. This is likely to take place on his near and dear ones who
tell him to accept the reality. The person may then start giving psychological responses in
form of why me. It is not fair. How can this happen to me among others. Bargaining – The third stage is of bargaining where there is an involvement of hope
where the person feels that he can avoid the cause of grief. Usually, it has been found that
if a person faces less traumatic situation then the need is to seek compromise (Légaré and
et.al., 2006). Depression – In stage four then the individual may start getting saddened on account of
death (Kennedy and et.al., 2008). In this state, the person may get silent just by thinking
about the death of his cancer stricken mother. He may start refusing visitor and tend to
spend more time in a mournful and sullen stage.
 Acceptance – The acceptance stage is the one when the person starts feeling that things
are going to be fine (Irby‐Shasanmi and Redmond, 2014). He may develop a feeling that
nothing is impossible and then may start preparing for the coming situation. This is the
very last stage when the person may start to embrace mortality or inevitable future with
respect to death of her mother.
Hence the above mentioned stages are likely to be faced by John. However, the durability of the
stages may depend on whether the grief reactions are normal or complicated ones.
Lindmann's Grief work
According to the theory given by Lindmann, grief is considered to be a part of the healing
process and is termed as “Grief work” (Theories of Loss and Grief, 2015). As per Lindmann,
there are three tasks in grief work: Emancipation of the bondage of the deceased- In this task, attachments of the bereaved
are given up so that a new status can be developed. Here, John will focus on investing in
an attachment with a living person who is capable of returning the investment.
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 Readjustment to the environment in which the deceased lived- This task consists of
identification of roles and identity of bereaved (Kaplow and et.al., 2014.). In this stage,
John would require physical, emotional, social and emotional adjustments.
 Formation of new relationships- This is the last task in the grief work and comprises of
establishments of new and different attachments. John will establish new relationships
with other persons.
ANALYSIS AND EVALUATION OF NORMAL AND COMPLICATED
GRIEF REACTIONS
Normal reactions to grief in case of serious illness of a loved one involves for movement
towards integrated grief over a period of time. There are some periods of acute grief during this
span (King and Hicks, 2009). The individual still mourns for the loss and at times the loss can
be intense and painful. But with time, the person who is grieving over serious illness of a loved
one starts to participate in the activities of his life on a regular basis.
On the other hand, complicated grief reactions entail for creation of a disabling condition
by which the sufferer gets limited towards functioning in everyday life. The presence of
complicated grief is judged by mental health professionals by making use of certain tools. This is
because it is not easy to diagnose the complicated grief reactions.
CRITICALLY ANALYSE THE IMPLICATIONS THAT RECOGNIZED
RISK FACTORS HAVE ON GRIEF RESPONSES
The implications that recognized risk factors have on grief responses can be critically
analysed. The following are the risk factors and their implications on grief: Situational risk factor: Expected or unexpected death- Unexpected loss is considered to
be a risk factor as it leads to more difficult grief. The implications of unexpected loss is
that it is moderated by self esteem and perceived control (Landau and et.al., 2011). In the
given case, John's mother was in the last stage of cancer ad was expected to expire.
Hence, the loss of John's mother was expected and hence, it implies that he would have
controlled the grief response. However, it can be critically analysed that bereaved person
who have low self esteem are at more risk of suffering from depression.
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 Personal risk factors: Personality characteristics- As per attachment theory, grief
responses are predicted by the nature of earliest attachments of a person. The implication
of this will be that bereaved persons who have secure attachments would not experience
complicated grief (Grief, Bereavement, and Coping With Loss, 2015). However, it can be
critically analysed that John was bereaved of the death of his mother. This implies that
personal risk factors will have negative implications on grief responses. As he had
earliest attachment with his mother, he may experience extended depression. Personal risk factors: Gender- Gender acts as a risk factor for grief responses. This is
because generally, men experience more negative consequences. They also tend to suffer
from greater degrees of depression and negative health consequences as compared to
females (Lin, Dean and Ensel, 2013). The implications off this can be that John's
responses to grief could become more severe. He may suffer from agitation,
concentration problems and emotional numbness. However, it can be critically analysed
that the implications of gender as a risk factor on the grief response can be more severe
due to the lack of social support which is provided to bereaved men.
 Interpersonal context: Social support- Social support is considered to be a bereavement
specific risk factor (Luhmann and et.al., 2012). It leads to negative implications after
loss. Perceived availability of social networks, supportive climate and support seeking
help in controlling the grief. However, lack of social support is a risk factor and may
have negative implications on responses to grief. It may aggravate the grief and lead to
physical and emotional problems.
APPRAISE THE IMPACT OF GRIEF RESPONSES WITHIN SPECIFIC
GROUPS OF THE POPULATION
The impact of grief responses within specific groups of population can be appraised in the
following manner:
Individuals with intellectual disability
Bereavement and loss significantly impact the life of people who suffer with intellectual
disability. Even if this group of people do not have a cognitive understanding of death, they
notice the absence of a loved one (Mary, 2011). They also react emotionally to that loss. For
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example, a person who is deficit in memory skills and delays in oral language development
suffers from the loss of brother. For him, his brother may have acted as a friend as well as
support system. Although, th person may not understand death but he will be impacted by grief
responses. The impact of grief responses in this group of individuals is seen in the form of
emotional disturbances. These are inclusive of anxiety, anger and sadness (Brown, 2012). Grief
responses also impact through behavioral disturbances such as irritability, hyperactivity or
lethargy. Individuals with intellectual disability also suffer from feelings of loneliness.
Children
There are various grief responses of children. Normally, grief responses impact children
in the form of changes in emotional responses, physical sensations and behavioral responses. For
example, a child of 4 years of age who loses his father would be impacted by grief responses in
the following manner. Grief may impact children through sadness which is observed in a variety
of ways such as crying and deep sighing. Anger is common among the people who have lost
some loved one (Lyles, 2010). The impact of this is that the child may be angry at the one who
died. As a result of this, the children may become irritable. As children are egocentric, grief
responses of guilt and self – reproach may impact them by making them fee that they are the
cause of loss. This impacts their adulthood contributing to difficulties in later life. Grief also
impacts children as they feel unfamiliar and unsafe (Morgan and et.al., 2012).
Old age people
The grief responses of old age people may impact them in a negative manner. It may lead
to onset of many chronic diseases such as hypertension and cancer. Physical grief responses such
as crying, sighing, loss of appetite, difficulty in sleeping, feeling of heaviness etc. have adverse
impact on the health of old people (Young, 2013). For those old people who are suffering from a
chronic illness, grief responses can exacerbate the condition. However, it can be appraised that
old people have passed through various stages of life and therefore seen a number of losses in the
form of job, health, family member etc. But, grief responses can produce prolonged and serious
impacts on older people which include depression, suicidal thoughts and physical illness.
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EVALUATING THE ROLE OF THE CARING PROFESSIONAL AND
COUNSELLOR PROVIDING BEREAVEMENT CARE
The role of caring professional and counselor in providing bereavement care can be
evaluated. Caring professionals and counselors play an important role in providing bereavement
care in the following ways: Offer understanding of the mourning process- They offer an understanding of the
mourning process and its various stages (Bereavement, 2015). In this way, John would
obtain information about the stages that he may go through in the mourning process on
the death of his mother. Explore trouble areas- Caring professionals and counselors play a vital role in exploring
those areas which could potentially prevent John from moving on. Resolving areas of conflict- Counselors help the bereaved persons in resolving areas of
conflict that still remain after the death of the loved one (Scheunemann, Arnold and
White, 2012). John would get the required help and support in obtaining solutions to the
conflict areas that may be troubling him. Adjusting to new sense of self- Loss of a loved one brings a change in the identity of the
bereaved person. He needs to take up the roles and responsibilities of the deceased
person (Melin-Johansson and et.al., 2012). In the case, John has suffered the loss of his
mother who died due to cancer. Hence, john is likely to experience a change in his
identity whereby he would be taking up the roles and responsibilities of his mother and
take care of other family members. However, he may face problems in adjusting to a
new sense of self. In this, caring professionals and counselors play a significant role.
They offer help in adjusting to the new sense of self.
 Address possible issues of suicidal thoughts and depression- The impact of grief
responses are such that bereaved individual, such as John, may have issues of suicidal
thoughts and depression. Caring professionals and counselors have an important role in
providing bereavement care by helping a person to tackle possible issues of depression
and suicidal thoughts (Stacey and et.al., 2011).
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CONCLUSION AND RECOMMENDATIONS
From the report it can be concluded that coping with loss significantly impacts the
individual as well as the families, society and health care system as the whole. There are various
theories of loss grief and bereavement. They include Frued's model of bereavement, Kubler-Ross
Grief Cycle and Lindmann's Grief Work. There are various risk factors which have several
implications on grief responses. These include situational, personal and interpersonal factors.
Grief responses impact specific groups differently such as people with intellectual disability,
children and older people. Caring professionals and counselors play a vital role in providing
bereavement care.
Recommendations
The following recommendations can be given in the area of bereavement care: Bereavement education and training- Health care organizations in UK can focus on
bereavement education and training of staff (Irby‐Shasanmi and Redmond, 2014). With
provision of adequate training and quality education, the staff will be empowered. This
will enable them to ensure quality care to those who are bereaved. In this regard, all the
health care professionals should be given access to education and training in
bereavement.
 Better coordination in bereavement care- In order to provide holistic care to the
bereaved individuals, a coordinated approach should be adopted in the area of
bereavement care (Kaplow and et.al., 2014).
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REFERENCES
Journals and books
Brown, E., 2012. Loss, change and grief: An educational perspective. Routledge.
Irby‐Shasanmi, A. and Redmond, D. L., 2014. Stressful Life Events. The Wiley Blackwell
Encyclopedia of Health, Illness, Behavior, and Society.
Kaplow, J. B. and et.al., 2014. Emotional suppression mediates the relation between adverse life
events and adolescent suicide: Implications for prevention. Prevention science. 15(2). pp.
177-185.
Kennedy, C. and et.al., 2008. Supporting children and families facing death of a parent: part 1.
International journal of palliative nursing. 14(4). pp.162-168.
King, L. A. and Hicks, J. A., 2009. Detecting and constructing meaning in life events. The
Journal of Positive Psychology. 4(5). pp.317-330.
Landau, D. and et.al., 2011. Stressful life events and material deprivation in hoardingdisorder.
Journal of Anxiety Disorders. 25(2). pp.192-202.
Légaré, F. and et.al., 2006. Supporting patients facing difficult health care decisions: use of the
Ottawa Decision Support Framework. Canadian Family Physician. 52(4). pp.476-477.
Lin, N., Dean, A. and Ensel, W. M., 2013. Social support, life events, and depression. Academic
Press.
Luhmann, M. and et.al., 2012. Subjective well-being and adaptation to life events: a meta-
analysis. Journal of personality and social psychology. 102(3). pp.592.
Mary, L., 2011. Social Aspects Of Health, Illness And Healthcare. McGraw-Hill International.
Melin-Johansson, C. and et.al., 2012. Living in the presence of death: An integrative literature
review of relatives’ important existential concerns when caring for a severely ill family
member. The open nursing journal. 6. p.1.
Morgan, V. A. and et.al., 2012. People living with psychotic illness in 2010: The second
Australian national survey of psychosis. Australian and New Zealand Journal of
Psychiatry. 46(8). pp.735-752.
O'Connor, A. M., and et.al., 2009. Decision aids for people facing health treatment or screening
decisions. The Cochrane Library.
Scheunemann, L. P., Arnold, R. M. and White, D. B., 2012. The facilitated values history:
helping surrogates make authentic decisions for incapacitated patients with advanced
illness. American journal of respiratory and critical care medicine. 186(6). pp.480-486.
Stacey, D. and et.al., 2011. Decision aids for people facing health treatment or screening
decisions. Cochrane Database Syst Rev. 10(10).
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Young, C., 2013. Community management that works: how to build and sustain a thriving online
health community. Journal of medical Internet research. 15(6).
Online
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<http://www.webmd.com/cancer/tc/grief-bereavement-and-coping-with-loss-pdq-
supportive-care---health-professional-information-nci-definitions-of-terms>. [Accessed
on 21 December 2015].
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<http://childgrief.org/howtohelp.htm>. [Accessed on 21 December 2015].
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<http://www.cetuesday.com/theories-of-loss-and-grief/>. [Accessed on 21 December
2015].
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