Bereavement Reactions, Consequences, and Care (1984) / Chapter Skim
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Pages 281-296
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From page 281... ...
Cor~c~usions and Recommendations
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From page 283... ...
Individuals will vary in terms of speed of recovery and in the amount of laack-andforth movement between phases. Fourth, as has been recorded in myth and literature over the centuries, and as suggested by individual clinical experience, some bereaved persons are at increased risk for illness and even death.
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From page 284... ...
Although some researchers have reported that children do not grieve in the same way as adults, a number of grief-like reactions have been noted, such as appetite and sleep disturbances and difficulty in concentrating. Like adults, bereaved children may complain of physical symptoms, especially abdominal pain.
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From page 285... ...
Thus, at least some bereaved children are at increased risk for a number of ad .
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From page 286... ...
In fact, as discussed in Chapter 10 and in the final section of this chapter, the committee believes it is time to subject various intervention strategies to rigorous study so as to determine their benefit to particular groups of bereaved individuals. Practice Recommendations In the committee's view, the well-being of the family and others close to a dying patient is part of health professionals' responsibility in terminal illness.
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From page 287... ...
In particular, as discussed in Chapter 8, the likelihood of the distress following bereavement taking the form of physical symptoms, and the particular bodily complaints, may vary substantially by cultural group and social class. If they are unaware of this possibility, health professionals might conduct needless and costly tests or prescribe unnecessary and potentially harmful treatment.
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From page 288... ...
Furthermore, if the occurrence of an individuals symptoms is associated with family dysfunction, it is logical to include family assessment and treatment when dealing with abnormal bereavement states. In the case of bereaved children, it seems clear there is a potential for long-term, enduring consequences.
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From page 289... ...
Regular meetings at which staff are encouraged to air their concerns, adequate back-up support from mental health professionals, and clearly delineated roles on health care teams may help alleviate the sense of isolation and overwhelming burden of individual responsibility so commonly reported. Public Education Because of the fairly recent historical changes noted in this volume, including institutional care of the dying and geographic mobility of families, most people have little direct contact with death and may not be prepared for its impact on their families.
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From page 290... ...
Current hypotheses about subpopulations that are at risk for particular adverse consequences should be tested, and prospective studies should be designed to identify characteristics of new subgroups. More definitive knowledge about individual risk factors and their interplay holds the promise of identification of high-risk individ
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From page 291... ...
Most are based on responses of children receiving mental health care or, in the case of very young children, are based on observations of institutionalized children. Controlled studies of community samples of bereaved children should be conducted.
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From page 292... ...
In particular, more information is needed on the long-term effects of Toss in order to understand how physiologic responses change over the course of grieving and how responses to loss compare with other re .
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From page 293... ...
Without such studies, the interactions between risk factors will remain unclear and it will not be possible to confidently identify groups at high risk. Good cross-disciplinary longitudinal studies also will provide the foundations for intervention strategies that are appropriate to the range of needs of bereaved individuals.
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From page 294... ...
In designing such studies, attention should be paid to possible distinguishing characteristics of families who choose the hospice option; those characteristics could have particular significance following bereavement and, if not identified and controlled for, could confound the results of the efficacy of bereavement interventions. Although each of the major forms of intervention has certain distinctive features, there is a great variation within each type as well as some similarities among the different approaches.
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From page 295... ...
Research initiatives in this area should encourage cooperation between program administrators, clinicians, and researchers from several disciplines so that carefully controlled studies can be conducted. In the case of drug therapies, the lack of research is striking.
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