University of Chicago
Type of paper: Thesis/Dissertation Chapter
Loss and grief
Almost everyone in the world experiences an event which can be considered as a loss. It is the disappearance of something or someone important to an individual, grief is the natural response to the loss, people feel a range of emotions when they suffer a loss such as shock, panic, denial, anger and guilt. Death is one of the major events associated with loss but there are many others that occur which can also have a negative effect on someone’s life by impacting in various ways.
A description of a range of losses which may trigger grief
Any significant loss in our life can cause grief, and individuals can have a mixed range of feelings with regards to their loss. These losses include Infertility where the individual will experience emotions common to the death of a loved one, this type of loss can trigger many reactions such as depression, anger towards life in general or towards others that have children, shame, they feel they are less of a person as they are unable to have children, frustration, it can also result in the avoidance of social interactions (www.infertility.about.com). Divorce where the individual feels they have lost all hope and dreams for the future, fear of now having to cope alone, resentment towards the other person, guilt, they may also struggle with a lifestyle change which may also have a negative impact on social aspects of their life due to financial changes(www.divorcesupport.about.com). The loss of a job where the individual feels anger, jealousy of others who have a job, they may feel they have lost their identity and are useless. This can also cause the individual to suffer social exclusion (www.helpguide.org). There are many more that can trigger grief such as loss of a body function, rape, loss of a friendship, homelessness, role-redefinition.
A description of two theoretical models of grief
One model of grief I looked at was Kubler-Ross (1969) who initially developed the five stage model of grief, Denial, Anger, Bargaining, Depression, and Acceptance and later added to more, Shock and Testing. The stages are set up
in the following way – Shock Stage – The first response in hearing the unpleasant news, the person may freeze and be unable to take in what is being said. Denial Stage – This is a defence mechanism it is the refusal to accept what has happened. Anger Stage – This is when the person will suffer feelings of rage and may look for someone to blame ‘Why me, It’s not fair’. Bargaining Stage – This sis the stage where a person will try to negotiate or compromise, ‘can we still be friends? ’, they may also pray try and bargain with a god they believe in. Depression Stage – Person might withdraw at this stage, they will feel sadness, regret, fear, when at this stage it shows the person is beginning to accept the situation. Testing Stage – This is where the individual looks for realistic solutions to the problem. Acceptance Stage – This is when the person begins to come to terms with the event and can finally see a way forward.
Another model that is similar to Kubler-Ross is Psychodynamic or ‘Griefwork’ model by Colin Murray Parkes. This model also breaks the grief process down into five stages:
4 Anger and Guilt
5 Gaining a new identity
Parkes idea was that when a loss occurs the individual affected will inevitable go through transitions in their lives. These transitions can be very challenging as people have a feeling of security from their own every day routines in their lives. Parkes described this as a person’s ‘assumptive world’ and this is created on how it has always been. An individual’s concept is that this is how it will always be, to think differently from this would create feelings of insecurity. A persons thoughts would have to change from what they normally take for granted in order to cope with what has changed.
Parks explains that most life changing events ‘ psychosocial transitions’ are those that:
Entail people to alter their belief about the world.
Are lasting in their implications rather than temporary.
Take place within a short time giving little opportunity for preparation.
If these three factors are present during a changing event then Parks explains that the persons ‘assumptive world’ endures major change.(Hnc Social Care Open Learning Pack)
A description of a range of agencies which can offer support to people experiencing loss and grief A range of agencies who can offer support to people experiencing loss and grief include the following:
Statutory Agencies – The local housing department, Nhs, G.P, department of social security who can help deal with any financial issues arising from the situation and the social work department who can help by providing services such as homecare, occupational therapy and community care.
There is also a large number of voluntary organisations available to support people experiencing loss or grief such as Age concern who help to come to terms with old age and improve later life for everyone, they offer advice and information regarding health and housing and opportunities for training.(Age Concern.org.uk) Cancer Link offers counselling and support programmes to help cancer patients cope with their illness and treatment(www.cancerlink.co.uk). Victim Support gives free confidential help to victims of crime. They offer emotional and practical support such as counselling, help to fill out form, getting medical treatment and rehousing(www.victimsupport.co.uk). Cruse Bereavement Care Scotland offers support after bereavement and also offers information , support and training services to those who are helping someone who has suffered a bereavmenet(www.crusebereavment.org.uk), and Ardgowan Hospice who offer support, respite care and end of life care to people suffering cancer or other life limiting illness. They offer a wide range of services from counselling, spiritual and bereavement support for patients and their family to yoga, hypnotherapy and relaxation classes.
A description of how you supported an individual experiencing loss and grief not associated with death
I have supported a person in my work place that experienced loss and grief by using effective communication including being a good listener. The service user had been the victim of a sexual assault. When the incident initially happened the service user was in denial and told no one, but it was clear from their behaviour that something was wrong with them, they were frightened of being alone and wanted constant reassurance that I would not move from outside their room door. I sat with the service user reassuring them that I was here for them and trying to encourage them to open up to me. Eventually the service user made the disclosure and we discussed how it would be dealt with i.e. contacting police and relevant agencies. Throughout this ordeal the service user has encountered a range of emotions from shame, guilt, feeling of being dirty, scared, they felt they had lost control of their lives and lost trust in people. I helped the service user work through these issues by sitting with them and listening carefully and being able to empathise with them. They were able to explore all their thoughts and feelings without feeling they were being judged. I also encouraged them to write about what they were feeling and thinking at times when they found it difficult to talk about. Through time and patients they grew stronger and were able to face what had happened to them and find a way to look to the future.
A description of the legal and other procedures to be followed in the event of a death in two care settings Procedures following death in a care home for the elderly
At the time of death the person who discovers the deceased needs to record the time of death, who was present and any relevant details of devices used or if cpr was given along with their details on the relevant paper work. The next step would be to inform the medical practitioner responsible for that person’s care, as verification needs to be completed by them or an appropriate qualified nurse before the body can be removed. The person verifying they death must be aware of local guidance regarding verifying death. Which will be in line with national guidance. Verification should take place as soon as possible. The verification details should be recorded on the appropriate paperwork. The person verifying the death is responsible for confirming identity of deceased. A name band with the deceased person’s name, D.O.B, address and nhs number should be attached to the deceased person. The death then needs to be reported to the coroner and the relatives of the deceased informed, if the death is unexpected the police must be informed and the body cannot be moved.
Procedures following death in a hospital
When death occurs within a hospital if the deceased was a patient the charge nurse will contact the deceased’s family to inform them, if the deceased was not a patient the family will be informed and asked to identify the body. If clinicians are unsure about the cause of death a post mortem must take place by legal requirements to determine the cause of death. The deceased person’s relatives must provide proof to allow them to collect the person’s personal possessions. Staff must be made aware if the deceased person was an organ donor. The hospital will then liaise with the families chosen undertaker, obtain the death certificate and make arrangements for the next of kin to collect the certificate. The following procedures for both including legal are taken from the Scottish Executive Website – www.scotland.gov.uk/library5/social/waad-pp.asp
A description of how attitudes and practices surrounding death have changed in Britain Attitudes and practices have changed considerably in Britain today. In the past death was an event that was witnessed by all who lived in the house, including children. Once the person had died they remained in the house where family members would prepare the body for burial, they body would remain there until it was taken for burial. During this time normal daily life continued for the other members of the family. However this is now no longer the case as more people are now dying in hospital, this has therefore moved to the medical professions responsibility rather that the families. Funeral directors now remove and prepare the body and arrange all aspects of the funeral arrangements for the deceased’s family. Today’s attitudes to death are very different, Britain’s attitude to death is described by Katz and Siddell (1994) as a ‘death denying society’. Due to people now living longer and epidemics no longer killing thousands because of the ever increasing progress of the public health service death is often seen as a failure of the medical profession to keep someone alive.(open learning pack)
A description of the rites and practices of two major religions Christianity – Christian belief is one of resurrection and the eternal life of the deceased person’s soul. A religious service takes place to celebrate that person’s life on earth and the new journey they have taken through death. These services usually include special readings, hymns and prayers only used for funerals. After the service the deceased is either buried or cremated, during this part of the tradition special prayers for the deceased are said. Mourners traditionally wear black clothing on this day and after the burial or cremation they gather together for food and drink.
Hinduism – Following the death of an individual the family come together to prepare the body and will perform prayers. Hindus mostly cremate their dead as they believe this releases their spirit. The flames during the cremation are an important symbol as they represent the presence of the holy god Brahma the creator. White is considered the appropriate colour to wear and traditionally they will wear Indian garments. Prayers are said at the entrance to the crematorium, there may also be offerings of flowers and sweetmeats passed around. The chief mourner usually the eldest male represents the family and they will push the button to make the coffin disappear as well as lighting the funeral pyre. After the cremation the family will gather for prayers and food then begin a 13 day mourning period.(www.ifishoulddie.co.uk)
A description of the rites and practices of one new religious movement Jehovah’s Witness – Jehovah’s witness have no special rituals for those who are dying but will usually appreciate a visit from one of the elders of the faith. There are particular beliefs surrounding blood transfusions, Jehovah Witness’s regard blood transfusion as morally wrong and are therefor prohibited. Organ transplants are generally not permitted and they are not likelt to be willing or permitted to donate or receive an organ through which blood flows. They also do not celebrate events such as birthdays and Christmas.(funeralwise)(open learning pack)
A description of two non-religious responses to death
Humanist Funeral – This type of funeral is for people who are non-religious. The British Human Association formed in 1967. Their principles are not based on religion but on the principles of reason and respect of others. Humanist ceremonies acknowledge loss and celebrate the deceased’s life without any religious rituals. This type of service centres more on the person who has passed away, where the family will choose such things as music, poetry or write a personal tribute that is read out by family or friend. This type of funeral gives more opportunity for personal input from the deceased’s loved ones. The funeral can take place at a cemetery, crematorium and woodland burial ground. Normally a printed copy of the ceremony is given to mourners on arrival at the service, which can be kept as keep sake.(www.ifishoulddie.co.uk)
New Age – This is a non religious belief which formed its foundations in Britain in the 1960’s. This was a reaction against what some people thought that Christianity had and Secular Humanism had failed in such as to provide them with guidance both spiritually and ethically. Unlike most formal religions it has no holy texts, central organisation, membership, formal clergy, dogma or creed. It is a network of believers and practitioners who share similar beliefs and practices which they can add to whichever religion they follow. New age rituals focus on healing the mind,body,spirit or earth using methods such as reiki or rolfing, they believe these techniques help to heal the body ailments and bring spiritual awareness. Influenced by Asian tradition they often hold retreats or workshops with a spiritual teacher or guru. With regards to the New Age response to death for many followers, ecological funerals, commonly known as ‘green burials’, may be their preferred choice as a more environmentally friendly form of woodland burials, nature reserve burials or burials at home. (www.patheos.com), (open learning pack)
In conclusion some people associate grief and loss with only death but as can be seen from the beginning of this essay grief and loss are not exclusive to those who have experienced a death. There are many other forms of grief and loss that are equally intense for those experiencing other types of loss such as end of a relationship,rape and infertility to name a few. Although there are some common symptoms in response to loss and grief there is no universal predictable emotional path that every individual follows and the grief process is very personal and unique to every individual.There are many theories with regards to the grief process one of which is Kubler-Ross who believes that no matter what the loss, every individual goes through a certain process in order to deal with the loss .Individuals may feel they are alone when it comes to dealing with their grief but there are a wide range of statutory abd voluntary agencies available to help with the process and any financial issues individuals might face.
When I had the opportunity to provide support to a service user who suffered a loss it gave me a closer insight in to how the individual feels and copes when supported in a positive way and the process they had to go through to overcome what happened to them.With regards to death we see that although care settings can have different procedures when dealing with a death the correct legal procedures are the same throughout and must be adhered to. We see that attitudes towards death have also changed, people are no longer accepting all the responsibility for dealing with the death of a loved one , preferring to allow undertakers to organise the arrangements and nowadays there is a mourning period . We also see that religions take different approaches when it comes to a funeral service Christianity and Hinduisim each have their own tradittions with regards to the service and attire but the service is centered around the persons religion , whereas with a Humanist Funeral focuses on the deceased person and the life that they had. The grief process no matter what the loss is not pleasant it is only by dealing with the grief through help or mourning that we can move on.
Social care open learning pack