Bereavement Issues Research Articles

'I see the high level of interpersonal support during the pandemic as proof that the good in people prevails': the COVID-19 pandemic as a catalyst for building a caring community?

The public health approach to end-of-life care has led to initiatives to promote caring communities, involving the community in supporting vulnerable dying people and their families. Our study aimed to explore how the COVID-19 pandemic affected the relevance of a caring community, whether the concept of a caring community took on a different meaning during and because of the pandemic, and how issues of death, dying and bereavement were perceived. Qualitative online survey of people interested in the 'Caring Community Cologne' project. Participants in the survey attended the launch event for the Caring Community in Cologne. Direct invitations were sent to professionals and experts in various fields. Information about the event was also disseminated via social media and the city of Cologne's website. Data were collected from June 2020 to August 2020 and analyzed using Braun & Clarke's thematic analysis. N=63 out of 121 people participated. The median age was 60years; 65% of the participants were female. Most of them worked in the social sector (53%). Three respondents described positive changes brought about by the pandemic: Greater sense of community and solidarity, more confrontation with one's own finiteness, strengthening of relationships, mindfulness and slowing down of the pace of life. Negative effects mentioned included a deterioration in mental health and well-being, with an increase in anxiety, social isolation but also forced togetherness, which can lead to conflict, and a lack of emotional closeness due to restricted contact. Our study was conducted at the beginning of the pandemic and shows that the pandemic has raised awareness of the importance and potential benefits of community-based networks and the importance of adopting a public health palliative care approach to advocate for those most in need. The findings also highlight the role of community social capital in promoting engagement, resilience and well-being.

Bereavement issues and prolonged grief disorder: A global perspective.

The death of a loved one - bereavement - is a universal experience that marks the human mental health condition. Grief - the cognitive, emotional, and behavioral responses to bereavement - is thus experienced by virtually everyone at some point in life, while mourning is a process through which grievers come to terms with the loss envisioning life without the deceased. Although distress subsides over time among most bereaved individuals, a minority will develop a condition recently identified as prolonged grief disorder (PGD). The present review provides a global perspective on bereavement, grief reactions, and PGD. Although the loss of a loved one and grief reactions are in general experienced consistently across different cultures, differences and variations in their expression may exist across cultures. Especially within specific populations that may be more at risk for PGD, possibly due to risk factors associated with the mechanisms of loss (e.g., refugees, migrants, and conflict survivors). The diagnostic criteria for PGD are mostly based on Western grieving populations, and cultural adaptations of PGD treatments are limited. Therefore, cross-cultural development and validation of PGD screening/assessment is critical to support future research on grief reactions and PGD, especially in non-Western contexts, and concerning the potential future global changes and challenges that appear to have a major impact on PGD. More transcultural research on PGD is needed to contextualize and will lead to culture-bound symptom identification of PGD, and the adaptation of current treatment protocols, which may ultimately improve health at the individual level, and health-care systems.

Clinical Crisis: When Your Therapist Needs Therapy!

Social workers are struggling within their professional and personal lives. Many clinical social workers who work in the mental health and medical field are struggling with poor health behaviors, secondary traumatic stress (STS), depression, anxiety, and burnout due to staff shortages, rapid turnover, compassion fatigue, and poor staff recruitment (Toh et al., 2018). Untreated trauma related to bereavement issues can result in PTSD and complicated grief symptoms in clinical populations when left untreated by a trained mental health clinician (Glad et al., 2022). Social work clinicians can expect therapeutic encounters to include discussions of deaths, loss, and reduced security contributing to negative mental health occurrences as a result of the COVID-19 pandemic. Social workers who work with families and individuals who are experiencing trauma are often adversely affected by these interactions, resulting in negative outcomes for the social worker (Caringi et al., 2017). A recent study of the COVID-19 pandemic and related mental health issues found an increase in anxiety and mental health issues related to stress, grief, fear, and depression (Estes & Thompson, 2020). Many social work clinicians may require mental health treatment of their own COVID-19 experiences, while simultaneously developing vicarious trauma (VT) and countertransference issues as a result of working with a clinical population in the treatment setting.

Psychiatric Resident Perceptions of Competency in the Management of Social Isolation and Grief in Geriatric Patients

Psychiatric Resident Perceptions of Competency in the Management of Social Isolation and Grief in Geriatric Patients

The relationship between guilt, depression, prolonged grief, and posttraumatic stress symptoms after suicide bereavement.

A profound feeling of guilt and its role in complicating psychological reactions are accepted as central issues in suicide bereavement. However, research examining the relationship of guilt with mental disorders commonly following suicide bereavement is still lacking. This study aimed to examine the association between guilt and symptoms of depression, prolonged grief disorder, and posttraumatic stress disorder (PTSD) after suicide bereavement, as well as its moderating role in the association between the time which elapsed since bereavement and psychopathological symptoms. 154 self-selected adult German participants bereaved by suicide completed online questionnaires assessing sociodemographics, characteristics related to the loss, guilt, depression, prolonged grief, and PTSD. Significant positive correlations were found between guilt and all assessed psychopathological symptoms. Further, guilt was a significant correlate with symptoms of depression, prolonged grief, PTSD over and above sociodemographic factors, and time that elapsed since the loss. Guilt furthermore moderated the link between the time which elapsed since bereavement and depressive symptoms, while this effect was not observed for prolonged grief and posttraumatic stress symptoms. Our findings replicate theoretical frameworks linking feelings of guilt with mental disorders after suicide bereavement. Accordingly, they highlight the necessity to adapt psychotherapeutic interventions according to the specific needs of this population to maximize treatment effectiveness.

The Intentional Compassion Framework for school communities

Objective: This article offers a framework to guide schools in developing a compassionate culture. Using a social constructionist/critical perspective, five spheres of work are identified to help schools achieve this goal. Framing death, dying and bereavement from a health promoting perspective, they involve challenging current cultural perceptions, creating a culture of support, creating a grief-informed culture, establishing a culture of reflection and reflexivity, and developing a whole school plan. Setting: Eight rural primary school communities in central Victoria, Australia. Method: Constructivist grounded theory with interviews and analysis occurring concurrently, allowing categories to develop alongside new questions to explore participants’ thinking and priorities. Results: Participants’ insights, knowledge and priorities fostered understanding and led to the five strategies for change that underpin this framework. Conclusion: Study participants’ desire for a societal, cultural shift in how to understand death, dying and bereavement issues in school communities serves as an important foundation for change.

The potential impact of bereavement grief on workers, work, careers, and the workplace

ABSTRACT Bereavement grief is typically very painful and often highly consequential. People who are working could be significantly impacted by the death of someone they care about. A qualitative study sought an understanding of the lived experience of bereavement on the mourner’s ability to work and their work-related experiences following the death of a loved one. Three themes emerged: (a) grief is universal but individually impactful, (b) accommodation is needed to assist the return to work and to regain work abilities, and (c) there are many impediments to working again. These themes highlight the potential for bereavement grief to substantially effect mourners and thus their work, careers, and the workplace. Older workers could be particularly disadvantaged because of workplace ageism. Societal and other changes appear to be needed for the health and wellbeing of mourning workers, and to address related work and bereavement issues. Bereavement grief is highly relevant to the social work profession, given its involvement in providing information, developing supportive services, and making referrals.

Why GPs Refer to Chaplaincy: A Qualitative Study

Background: Chaplaincy intervention in primary care is an emerging provision; little is known about what causes a General Practitioner (GP) to refer a patient. Aim: To discover why GPs refer to chaplaincy in primary care contexts, to understand referral processes, investigate alternative referral routes, and explore how cues relate to previously reported socio-economic health issues. Design and Setting: A qualitative descriptive study in one urban Scottish general practice. Methods: Semi-structured interviews were conducted with a convenience sample of GPs. Data were analysed, to the point of saturation, using thematic content analysis. Findings: Nine GPs participated. Appreciation of whole-person spiritual care and good access predisposed GPs to refer to chaplaincy. Referral followed a series of steps precipitated by identification of issues: mental health issues, bereavement, spiritual and relationship issues, and isolation. Doctors gauged the need for referrals subjectively. Sharing management with patients was routine, suggesting active participation. Female patients were referred more frequently than male patients. Conclusion: Referrals were made on a person-centred basis. An apparent barrier of male gender and subjectivity in assessment before referring merit further investigation. We suggest that a model representing the referral process demonstrates good practice and may stimulate discussion about GP referral to chaplaincy.

BeSAD … “it was truly an awful experience”: an exploration of pre-service teachers’ experiences and training needs to support pupils experiencing issues of bereavement, separation and divorce

ABSTRACTResearch exploring the well-being and pastoral care of pupils attending primary and post-primary schools has become an issue of increased discourse and growing national and international concern in recent years. Society often expects that teachers can support or facilitate pupils experiencing such issues; however, there is little research that explores whether pre-service teachers encounter these issues on school placement and how they approach such concerns if they do. This paper reports on a study of pre-service teachers (N = 354) from the Republic of Ireland (RoI) and Northern Ireland (NI) and the frequency with which they encountered issues relating to bereavement, separation and divorce (BeSAD). To address the training needs, six semi-structured interviews with experts in the area of BeSAD and Initial Teacher Education (ITE) are also included. The quantitative component of the research indicated that nearly half of the pre-service teachers had encountered pupils who had experienced some form of BeSAD whilst on school placement. Respondents lacked confidence when supporting pupils experiencing BeSAD, particularly in relation to separation and divorce. The interviews conducted with experts from NI and the RoI (N = 6) identified the core role that teachers play as advocates for pupils who have experienced BeSAD.

Midwestern Farm Widows: Adaptation Following Spousal Loss.

The purpose of this descriptive study was to co-create oral histories of Midwestern farm widows. Rural widows constitute a vulnerable population due to issues of bereavement and depression compounded by emotional and geographical isolation. A farm widow is often forced to maintain viability of the farm for the family's livelihood. Oral history interviews with nine Midwest farm widows were conducted and analyzed. Three overarching themes emerged: competence, industriousness, and inner strength. Women shared stories of overcoming insurmountable obstacles. This study contributes to the literature on grief and expanding inner strength among rural widows. Further research could inform theory related to inner strength following a challenging life event.

The experiences of staff who support people with intellectual disability on issues about death, dying and bereavement: A metasynthesis.

Historically, people with intellectual disabilities have tended to be excluded from knowing about death, dying and bereavement. Staff in intellectual disability services can play a valuable role in improving understanding of these issues in those they support. This qualitative metasynthesis aimed to understand the experiences of staff supporting adults with intellectual disabilities with issues of death, dying and bereavement. Thirteen papers were identified following a systematic review of six databases. Three themes were developed following a lines-of-argument synthesis: (i)talking about death is hard: negotiating the uncertainty in death, dying and bereavement; (ii) the commitment to promoting a "good death"; and (iii) the grief behind the professional mask. "A cautious silence: The taboo of death" was an overarching theme. A more open culture around issues of death, dying and bereavement in intellectual disability settings is essential and could be promoted through staff training and support.

Taxation Issues in Late-Life Divorce and Bereavement

Taxation Issues in Late-Life Divorce and Bereavement

Creative Supervision for Counselors Working in a Hospice Setting

ABSTRACTThe number of individuals receiving hospice care in the United States is on the rise. Many individuals who suffer from debilitating health issues use the care of helping professionals in a hospice environment. Supervision approaches for counselors who encounter grief, loss, death, and bereavement issues in hospice settings are needed. The authors introduce three creative interventions for use with supervisees in one of the four stages of the integrative developmental model of supervision. One intervention, the “Rock Talk,” is more thoroughly explained and then demonstrated in a case illustration of a supervisee using the intervention to say goodbye to a hospice client.

Śmierć dziecka i żałoba rodziców jako zagadnienie duszpasterskie

Artykuł koncentruje się wokół zagadnień związanych ze śmiercią dziecka i okresem żałoby rodziców. Oprócz literatury dotyczącej tego tematu autor wykorzystuje własne doświadczenie zdobyte podczas spotkań z osieroconymi rodzicami w Sanktuarium Bożego Miłosierdzia w Krakowie­‑Łagiewnikach. Artykuł składa się z trzech części. W pierwszej omówiono zagadnienie straty bliskiej osoby i jej wpływu na życie osobiste i rodzinne, w następnej zagadnienie żałoby, a ostatnia część związana jest z pomocą osobom doświadczonym śmiercią dziecka.

Making death, compassion and partnership ‘part of life’ in school communities

Death can be considered a social taboo, a common source of fear and public avoidance. School communities are not immune to this, as the topic of death is constantly avoided. It is vital to understand how we can socially and culturally cultivate a positive regard for death, dying and bereavement in our school communities. Community members need to discuss these difficult issues and use strategies to enhance compassion, connectedness and support. In this literature review we reason that death is specifically not ‘part of life’ in school communities. Due to the dearth of school community-based literature on this issue and the progressive literature residing in palliative care, we aim to coalesce palliative care and school-based research, evaluate it and highlight compassion and partnership as a way forward for school communities. Essentially, our societal attitudes about death and dying have been profoundly altered and our community ownership of these normal life events has largely disappeared. This is demonstrated for example, by palliative care moving from the social grass roots ‘modern hospice movement’ formed in the 1960s and being reintegrated into the mainstream health care system by the end of the 1990s, resulting in an overall medicalised morphing of death, dying and bereavement issues. Therefore, we recommend that further research be conducted in how to develop compassionate schools to inform us how death may be continually made ‘part of life’ in school communities, for the benefit of students, teachers and families alike.

The Birdhouse Project as Experiential Learning Tool for College Students and Beyond

This study details the use of a project-based experiential exercise in a 4-year university Sociology of Death and Dying classroom setting in a large public institution in the United States. The Birdhouse Project was implemented with 436 student participants from 15 senior-level Death and Dying classes across six regular semesters over a 3-year span. Findings clearly indicate the efficacy of the project in both educational and clinical settings for encouraging growth in knowledge building, insight or compassion building, and skills building. Additionally, through implementation of the project, participants experienced improved articulation of bereavement issues around both death and nondeath losses.

Rodzina wobec śmierci dziecka. Żałoba, kryzys, wsparcie społeczne

The paper aims at presenting a child’s death as a critical incident both for a family viewed as a system and for its members, and examines the potential challenges and dangers faced when a social support is given in such circumstances. The author addresses the issue of bereavement after a child’s death as a particular type of mourning, describing the dynamics of the process and factors conditioning its proper course. A child’s death is seen as a cause of crisis. The author presents individual and family resources, which enable parents to cope with this particular experience and emphasises the need of the multidimensional social support that is necessary for parents to survive such an ordeal. At the same time the potential obstacles are defined when such as support is given, which mainly refers to its inadequacy. Participation in an external support group is presented by the author as an effective alternative to support given by the relatives of those affected by a child’s death.

Management and treatment of men affected by metastatic prostate cancer: evidence‐based recommendations for practice

ABSTRACTCurrently, 250 000 men are affected by prostate cancer in the UK. Clinical guidance is crucial for nurses involved in the care delivery for men with advanced prostate cancer and for their families to maximize their quality and quantity of life. It is essential that nurses understand how prostate cancer is diagnosed, can recognize signs of disease progression, are familiar with disease management, and can educate patients and manage any symptoms appropriately and effectively. Therefore, the aim of this paper is to review current evidence‐based guidelines in relation to care delivery for men with metastatic prostate cancer in order to optimize best supportive care. A literature review was conducted in a range of electronic databases (DARE, Cochrane, MEDLINE, BNI, PsychINFO, EMBASE and CIHAHL) to identify studies employing qualitative and/or quantitative methods. National (UK) and European clinical guidelines were also reviewed. Methodological evaluation was conducted and the evidence‐based recommendations were integrated in a narrative synthesis. Supportive care is a person‐centred approach to the provision of the necessary services for those living with or affected by cancer to meet their informational, spiritual, emotional, social or physical needs during diagnosis, treatment or follow‐up phases including issues of health promotion, survivorship, palliation and bereavement. A multidisciplinary and proactive approach to the management of men with metastatic prostate cancer ensures safe and effective supportive care delivery. Nurses involved in the care delivery for this patient group need to be aware of the complex physical and psychological supportive care needs, and evidence‐based management care plans to ensure a personalized and tailored support to optimize quality of life.

The Impact of Death Education on Fear of Death and Death Anxiety Among Human Services Students.

Human services professionals will undoubtedly work with the dying and bereaved populations at one time or other. Yet, they are poorly prepared to do so since death education, that is, lessons about the human and emotional aspects of death, its implications, and subsequent bereavement issues, is often not part of their curriculum. This nonequivalent comparison group study (N = 86) examined death fear and death anxiety among human services students before and after receiving death education using the Multidimensional Fear of Death Scale. The results showed a statistically significant decrease in death anxiety among the group of students who participated in death education compared to those who did not.

Excluding parental grief: A critical discourse analysis of bereavement accommodation in Canadian labour standards.

Grief following child loss is profoundly destabilizing with serious long-term repercussions for bereaved parents. Employed parents may need time away from work to deal with this loss. The purpose of this study was to reflect upon the ways labour policies and practices respond to parental bereavement. Critical discourse analysis was used to examine labour policies and practices related to employment leave for bereaved parents in Canada. Results were compared to international labour standards. Universally, employment policies provide only for the practical issues of bereavement. Commonly, leave is three days, unpaid, and meant to enable ceremonial obligations. Policies do not acknowledge the long-term suffering caused by grief or the variable intensity of different kinds of loss. Managerial, moral, normative and neoliberal values embedded in these policies efface the intensely personal experience of grief, thereby leaving employees at risk for serious health and workplace safety issues. Bereavement leave currently understands grief as a generic, time-limited state with instrumental tasks and ceremonial obligations. In contrast, research characterizes responses to child loss as intense, highly personal experiences for which healing and recovery can take years. This disconnect is especially problematic when viewed through the lens of employee wellbeing, reintegration and workplace productivity.