we help you develop yourself bereavement and loss adults deborah boys learning and development west...

We help you develop yourself

Bereavement and Loss Adults

Deborah BoysLearning and DevelopmentWest Sussex County Council

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Aims

The aim of this course is to help inform your practice when working with adults who have experienced bereavement and loss.

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Learning & Development OutcomesBy the end of this course you will be able to:Discuss bereavement and loss and what these terms meanDescribe the grieving process Make links to theory and experiencesReflect on how bereavement affects different peopleUse and signpost to resources to support people who are bereaved

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A Grief Observed by C.S. Lewis“There is something new to be chronicled every day. Grief is like a long valley, a winding valley where any bend may reveal a totally new landscape. As I’ve already noted, not every bend does. Sometimes the surprise is the opposite one; you are presented with exactly the same sort of country you thought you had left behind miles ago. That is when you wonder whether the valley isn’t a circular trench. But it isn’t. There are partial recurrences, but the sequence doesn’t repeat”

(Lewis, 1961:47)

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Terminology Bereavement

Refers to the state of having lost someone, or indeed something, significant

GriefUsually means the emotional experience that accompanies a significant loss

MourningApplies to the activities associated with bereavement

Loss applies to the feelings associated with all of the above which may be significant or less so…

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Bereavement and Loss

Describe the different types of loss that you have experienced

Identify which types of loss were significant to you and why

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Significant Loss?


Different types of loss…

What are the different types of loss that a person might experience?

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Friend(s)A

parent

As a result of divorce or separation

A pet

Workplace

Transition/milestonesHomeSibling

GrandparentLoss of…


The grief process Bereavement can occur when there is a

significant loss to that person

The significance of the loss is individual to each person

The ways in which people deal with their feelings surrounding loss will also be different

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Factors that can influence bereavement and loss The timing of the loss The occurrence of several losses or of loss

with other major lifecycle changes A history of traumatic loss and unresolved

mourning The nature of the death The significance and function of the

person

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Current theories of grief and bereavement The following theories about bereavement

highlight the way that each person’s experience is unique.

There is no fixed theory that fits exactly but they do serve to help our understanding about the process.

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Freud, S.

The notion that a satisfactory outcomein loss or bereavement depends uponemotional expression of grief

Sigmund Freud

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Worden (2003)

The process of adjustment to losscommonly known as ‘grief work’ usinggrief counselling and grief therapy

(Worden, 2003)

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The four tasks of grieving To accept the reality of the loss To work through the pain of grief To adjust to the environment without

the deceased To emotionally relocate the deceased

and move on with lifeWorden, 1991

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Theories of counselling intervention through creation of a safe base in which to explore feelings and concerns.

Attachment theory which promotes security (Holmes, 1993); Person centred approach (Rogers, 1961, 1980), (Ainsworth, 1978)

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Attachment Theory

Anxious/Ambivalent attachment

Secure attachment

Avoidant attachment

Overwhelmed loss response and anxious

Balanced/resilient loss response

Controlled loss response

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Grief theories cont.

The characteristics of grief, particularly as they relate to bereavement are founded in the work of Bowlby (1980); Kubler Ross (1970) and Parkes (1996) collectively known as stage and phase models of grief

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Stage and phase models

Anger Denial Despair Guilt Hopelessness Bargaining Acceptance Mourning

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Sugarman (2001)

Dealing with death and bereavement often obscures the reality that multiple losses are experienced across the life cycle e.g. those that come with developmental change

Some of these ‘little losses’ are rehearsals for more profound encounters with loss and provide a strengthening of emotional and cognitive capacities

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Sugarman (2001) cont./…

Coping demands are fully tested when relationships or health are damaged or disintegrate and where deeply held aspirations are thwarted or unexpected or traumatic death occurs

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Stroebe and Schut (1999)Grief as a two dimensional process: Loss orientation – dealing with the

distress of grief Restoration orientation – focus on

diversion from grief and attention to ongoing life demands

Successful movement between these two grief modes is necessary to adapt to loss

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Lazarus and Folkman (1984) Where internal resources and external

sources of support are inadequate for the meeting of loss, vulnerability will result

Recognising loss and the vulnerability it may produce is central to the process of helping a person overcome bereavement and loss

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Reflection: How might an adult’s experience differ from a child’s experience?

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Make links to the people you are supporting


Children and their grief experienceFactors to considerThe age of the childTheir experience of lossThe child’s coping strategiesThe presence and support of family, friends, carersThe child’s mental health and well-beingThe child’s understanding about what has occurred

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The experience of bereavementBereavement causes a great intensity and variety of emotions which may be felt for many months, if not years, after the death or loss of connection with someone close. In children sometimes these feelings do not manifest until later adulthood.

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Helping relatives and clients Acknowlede the feelings and wishes of

the client and relatives Acknowledge your own feelings Observe religious and spiritual

practice of client who has died Deal with possessions sensitively Anticipate that reactions to news of a

death will vary from person to person


Helping relatives

Practical help and support What to do when there is a death The death certificate The funeral/memorial service Remembrance Further support and advice


Helping staff cope with lossPractical help and supportAcknowledgement of caring role and grief Opportunity to attend funeral if appropriate Make a remembrance book/garden/space Remembrance/memorial service in setting Policy and information guidance Further help and advice


Don’t forget…

Other residents who may have formed friendships with deceased person

That residents may be feeling anxious about their own death

To create opportunities for listening and open communication


Remembering

It is important that people are able to talk about and remember the person after they have died Opportunities to remember can assist in maintaining a person’s sense of identity

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Activities to promote remembering…

Talk about the person you are missing with someone who knows them or who is willing to listen

Write a letter Take some flowers or a card to the memorial or

special place Have an album of favourite photos Plant a tree or shrub, bulbs, flowers Listen to favourite music you shared Visit places that evoke happy memories Keep a memento that reminds you of them

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Who supports you?

Someone to talk to? Professional advice and guidance Further training and development Developing Policies with staff and

professionals


Resources West Sussex County Council End of Life Pathway page

http://www.westsussexcpd.co.uk

Information and guidance– http://www.endoflifecareforadults.nhs.uk

/– http://www.bereavementadvice.org/inde

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we help you develop yourself bereavement and loss adults deborah boys learning and development west...

Documents

bereavement loss

different types of loss

significant loss mourning

history of traumatic

grief process bereavement

experienced bereavement

terminology bereavement

loss adults deborah