Bereavement Care

Editorial

Alison Penny — Tue, 01 Sep 2020 00:00:00 -0700

Loss in the family – A reflection on how schools can support their students

Atle Dyregrov, Kari Dyregrov, Martin Lytje — Tue, 01 Sep 2020 00:00:00 -0700

Abstract

Each year, thousands of British schoolchildren experience the loss of a loved one. In this trying time, it is vital that school staff have a good understanding of how to offer support. Sadly, many school staff struggle with how to provide support and in what form. Based on experiences from Scandinavia, in this article we provide guidelines and practical advice for the forms of support which we consider beneficial. In cases of anticipated losses, the school can do its utmost to collaborate with the home and student in order to ensure efficient communication and good student care. Following a loss, the school should work to provide a caring climate that makes it easier to return to class. We recommend making most decisions in collaboration with the bereaved children in order to ensure they receive support they themselves find beneficial.

Funeral practices and grief

Tue, 01 Sep 2020 00:00:00 -0700

Abstract

Does restricting the ceremonial/ritual arrangements around a cremation to a minimum have a negative association with grief over time? This question has increasingly concerned professionals in the funeral industry as well as those in healthcare capacities working with bereaved persons. We examined the relationship between cremation arrangements and levels of grief. Bereaved people in the UK completed questionnaires 2 to 5 months post-loss and a year later (N=233 with complete data). Complexity of the cremation service was not significantly related to grief; neither was satisfaction with arrangements (which was typically high). Results suggested that it makes no difference to grief whether a more minimalistic or elaborate funeral ceremony is chosen under conditions where the bereaved feel free to make choices that best suit their situation. We concluded that the funeral industry seems to be offering bereaved people an appropriate range of cremation arrangement choices to meet their needs. Important limits to generalizability are discussed. That funeral services serve multiple functions for bereaved persons is emphasized.

‘It was a blanket of love’: How American and Italian parents represent their experience of perinatal hospice through the use of metaphors

Margherita Dahò — Tue, 01 Sep 2020 00:00:00 -0700

Abstract

The loss of a child is one of the most profoundly stressful events an adult can experience, but perinatal hospice may be an important resource for the family’s wellbeing. The aim of this study was to understand how a group of American and Italian parents of infants affected by life-limiting or terminal conditions and treated with personalised comfort measures represents, with a metaphorical statement, the experience of perinatal hospice care. Thirty five questionnaires were collected and included 13 parents from Italy and 22 from the US. Parents represent their experience as positive and rich with lovely family moments and, although it is also a hard path, they consider it as an important gift. Other metaphors elected were related to spirituality and transcendence, underlying the need of parents to express and share their spiritual values and beliefs. Finally, parents also perceived an overall support from care providers and felt as if they were part of the same family.

The use of Winnicott’s concept of transitional objects in bereavement practice

Clare Wakenshaw — Tue, 01 Sep 2020 00:00:00 -0700

Abstract

Working with young children, Donald Winnicott (1951) identified transitional objects as items which were both created and discovered by an infant for comfort, and to support the developmental necessity of separating from their primary caregiver. In adulthood, the keeping and holding of a physical object, for example a piece of jewellery owned by a loved one who has died, is frequently seen as supportive for bereaved people but is rarely named or conceptualised as a transitional object. Taking an object relations perspective, the aim of this review will be to consider research and literature within bereavement theory and practice in order to suggest how transitional objects can be conceptualised in grief work across all life stages. Examples from research and the authors own therapeutic practice will be shared in order to suggest ways in which the use of transitional objects can support therapeutic practice with bereaved people.

Stillbirth, still life: A qualitative patient-led study on parents’ unsilenced stories of stillbirth

Tue, 01 Sep 2020 00:00:00 -0700

Abstract

Our objective was to explore parents’ experiences of stillbirth using a patient-led qualitative approach, in the Canadian context. Parents who had experienced stillbirth in the previous five years were recruited through posters and snowball sampling. We conducted a co-design focus group to set the direction of our research, narrative interviews, and a reflect focus group to engage parents in finalizing the analysis and findings. Data was analysed iteratively using a participatory approach with grounded theory principles. Our findings highlight that stillbirth is a story of death, but it is also a story of life. Parents (n=11) require the space to experience both the birth and death elements of the story; yet, one or both elements are often silenced. Stillbirth, still life was the core concept that emerged from parents’ stories of their stillborn babies. Parents’ narratives are driven by the need to honour their babies’ lives. They are learning to be unsilenced.

Exploration of clinicians’ perspectives of using a bereavement risk screening tool in a palliative care setting: a qualitative study

Lois Lawler, Christy Noble, Emily Plunkett, Rachel Wenke, Lise Johns — Tue, 01 Sep 2020 00:00:00 -0700

Abstract

To minimise the adverse outcomes of prolonged complex bereavement, health professionals need effective risk screening tools to identify those at risk. However, existing tools can be challenging to implement in the clinical setting. This qualitative study aimed to explore clinicians’ perspectives and experiences of using the Bereavement Risk Index (BRI) screening tool, including identifying barriers and enablers regarding its use and what they perceived as important domains in bereavement risk screening. Data was collected through semi-structured group and individual interviews and deductively analysed using the Theoretical Domains Framework. Eleven participants employed in one regional palliative care service were interviewed. The results revealed three key implications: 1) a risk screening tool is highly beneficial, however contextual factors can limit its implementation; 2) clinician confidence in the tool and perception of the tool’s comprehensiveness are significant factors in its use; 3) feedback is needed as to whether clinicians’ assessment of bereavement risk remains accurate and valid in the longer term.

Bereavement Care – Tribute to Colin Murray Parkes

Debbie Kerslake — Tue, 01 Sep 2020 00:00:00 -0700