Bereavement Workshop Flashcards
1
Q
What can grief be caused by
A
- Loss of a job
- Loss of a relationship
- Loss of a person
2
Q
what is the definition of grief
A
- Grief: Intense sorrow, especially caused by someone’s death
3
Q
What do rituals provide
A
- Ceremony
- Meaning to their lives
- Support those left behind
- Permission to express emotion and to feel emotion
- Visual and /or physical contact with the body
- Procession and public display
- Milestones in the process
- Disposal of the body
4
Q
Name the model of bereavement
A
- Phases of Grief – Parkes
- Tasks of mourning – Worden
- Dual process model – Stoebe and Schut
- Dimensions of Loss – Le Poidevin
- Tonkin fried egg model
5
Q
Describe the phases of Grief (Parkes)
A
- Shock, numbness, denial
- Separation and pain, emptiness, searching, anger, guilt
- Despair, depression,
- Acceptance
- Resolution and reorganisation
- Grieved emotions do not necessarily go in these courses of action, anything could bring back the feelings of grief
- Suggests grief is more of a passive process
6
Q
describe Wordern’s task of mourning
A
- Says that grieving is not passive but the person must engage in 4 tasks
- Task 1: Accept the reality of the loss
- Task 2: work through the pain of the grief
- Task 3: Adjust to an environment in which the decreased is missing
- Task 4; Find enduring connection with the decreased while embarking on a new life
7
Q
Describe the dural process model - Stoebe and Schut
A
- Stresses of grieving are loss orientated and restoration orientated and both are stressful
- Made up of oriented stresses and restoration orientated stresses
- A grieving person will bounce between them and be between them
- Restoration stresses: attending to life changes and doing new things, distraction from grief, new roles identities and relationships
- Loss orientated: grief work, intrusions of grief, letting go, denial avoidance of restoration changes
8
Q
Describe dimensions of loss - Le Poidevin
A
- Identity –How has the loss affected self-esteem?
- Emotional – Are they at ease with expressing feelings?
- Spiritual -What meaning has been ascribed to the loss?
- Practical- How are everyday practicalities managed?
- Physical - What is the impact on physical health?
- Lifestyle - Has the loss caused financial problems?
- Family/community- What support is available?
9
Q
Describe the fried egg model - Tonkin
A
- Tonkin described a mother grieving from the loss of her child
- Drew a circle with the large mass which was the grief of the child, she found that the circle did not shrink but she grew instead, thus the grief does not die but growing back around becomes easier
10
Q
What is the role of the health profession before death
A
- Care of the dying patient and their family
- Facilitate communication within the family
- Permit limits on what family members can do, some encourage family members to take a day of a week
- Listen
- Inform – who to call and when to call
11
Q
what are the 7 dimensions of death
A
- Enquire – sensitive questioning, showing empathy avoiding giving opinions
- Listen
- Permit and validate
- Listen
- Inform – practical details, sources of support, grieving process
- Listen
- Support – making yourself available for future meetings
- Avoid platitudes – avoid phrases such as they are in a better place now, I know how you feel
12
Q
why is grief complicated
A
- There is no timetable for normal grieving
- Significant dates can amplify grief
13
Q
What is a prolonged grief disorder
A
- Proposed to be longer than 6 months after the death
• Constant yearning for the deceased
• Ruminating about the death
• Unsure of own identity and place in the world
• Anhedonia – loss of pleasure
• Disabling by these thoughts
14
Q
How many people have prolonged grief disorder
A
- Thought about 20% have some prolonged grief,
15
Q
What is the most successful treatment to prolonged grief disorder
A
- Psychotherapy most successful treatment
16
Q
What are the predispositions to prolonged grief
A
- Previous mental health problems
- Sudden unexpected death
- Inappropriate death
- Emotional dependence on the deceased
- Multiple deaths in a short space of time
- Poor social support
- Child or spouse
- Violent death
17
Q
why is children bereavement often not dealt with well
A
- Often it is not done well as often the adult has there own grief to deal with, and are unaware to help children grieve, also element of self protection
18
Q
How else will children show there beravement
A
- Important to remember that children have a limited ability to put feelings into words and express them through action
- Important to explore any misconceptions such as they behave in a certain way it would allow the deceased to come back
19
Q
How should you help a parent help the child grieve
A
- Involve the child appropriately
- Truth telling
- Prepare the child for an expected death
- Understand what is happening
- Allow the child to attend the funeral (supported)
- Ask the child what they want if appropriate
- Facilitate saying goodbye
- Express their own feelings in front of the child
20
Q
How do you support someone who is grieving
A
- Remember: there is no right way to grieve
- Do not avoid them
- Similar bereavement stories can be helpful (“but not I know how you feel”)
- Don’t stop someone crying (it’s also OK if they do not cry)
- Remember grief may last a long time
- Help with practical things at the beginning (cooking?)
- Offer to accompany someone to organise the formalities (death cert etc.)
- Find out how they today
- Go to the funeral and the wake
- Avoid those platitudes ( “they are in a better place now”, “they have had a good innings”)
- Is there anything specific the bereaved person does to help them get through the day? ask
- Don’t be afraid to make them laugh.
- Don’t avoid mentioning the dead person. If that provokes tears, OK
- Save the flowers for three months after (when all the support has faded away)
- Remember landmarks, birthdays anniversaries
- Counselling does not have to take place soon after the death. It might be more appropriate later.
21
Q
Why is knowing about life expectancy trend important
A
- Purpose of medicine is to save lives and relieve suffering
- GMC treatment and care towards the end of life: good practice in decision making general medicine council
- Disconnect in undergraduate training between population measures of health and experience of patients
- Making the implicit explicit in your learning
- To know where to direct the science
- Connects the two death and dying
22
Q
What is the life expectancy for men and women now
A
women = 82.9
men = 79.3
23
Q
how has life expectancy improved for men and women
A
- Increase in life expectancy from 1987 from 78.2 in women to 82.9 and for men 72.5 to 79.3
24
Q
In comparison with other countries…
A
- In comparison with similar countries the UK has the lowest life expectancy improvement for males and females
25
Q
Name some factors for the slowing down in increase of life expectancy improvement
A
- government policy of austerity which has driven constraints on health
- rising deaths in accidental poisoning in younger adults
26
Q
what do life expectancy statistics not include
A
- binary difference
- difference in race and ethnicity
- sexual orientation
- these prevent development of targeted intervention
