‘You Took me Back to the sea:' Using Narrative to Explore and Inform the Practice of Social Work with Dying People

This article centres on a qualitative interview extract, the ‘Story of the Pebble', in which a West African Hospital Social Worker Ado, working in a UK context, and identifying as a Shaman, describes successfully trusting his instincts to create a symbol for a dying patient. Despite criticisms from colleagues, Ado's capacity to understand his patients needs are justified both before and after her death.The article discusses significant themes from the interview extract, including the meaning of professionalism, practice wisdom and cultural influences in a UK social work context, as well as through Ado's heritage and identification as a Shaman. The article considers holistic patient care in a medical context and suggests this has some useful lessons for social workers, particularly those involved with dying people. Although the extract, and wider research study from which it is drawn, pre-date the Covid 19 pandemic, this is referenced throughout, linking the interview extract to ways of helping practitioners and educators to consider people holistically at end of life. AD -, Chichester, UK ;, Chichester, UK

Distance and grief: Optimising wellbeing for transnational migrants in Tasmania

End-of-life care, bereavement and grief involve significant challenges and impact our wellbeing in varied ways. For transnational migrants, geographical distance to a dying loved one, relatives, friends and meaningful locations can further complicate care, bereavement and grief. Our research aims to improve understandings of the role distance plays for transnational migrant wellbeing at these times. Using an instrumental, interpretative case study design we explored the experiences of five people with migration backgrounds with end-of-life care, bereavement and grief in Tasmania, Australia. Additional data sources included policies for end-of-life and bereavement care in Tasmania. In our study, participants tended to seek – and create – places and spaces of informal, rather than formal, support, both in their receiving society and country of origin. Online spaces played a key role: keeping people in touch with family members overseas, providing a means to care from a distance and ways to participate in grief rituals – albeit with mixed success. A lack of places to perform death and grief rituals, and inability to be physically present at a loved one's death (for some, due to COVID-19 travel restrictions) posed significant challenges to participants' wellbeing and impacted coping. We argue that if societies better understand the significances of places, spaces and distance during times of end-of-life, bereavement and grief, we can adjust policy and practice accordingly to collectively optimise wellbeing for transnational migrants. © 2023

Children's Experiences of Death Anxiety and Responses to the Covid-19 Pandemic

The aim of this study was to explore children's experience and responses to the Covid-19 pandemic through their illustrations and short narrations. During October 2020 and January 2021 data was collected from thirteen children aged 9–10 years old in a primary school in the North-West of England. Children were asked to draw their thoughts and feelings about the pandemic and to write a short narration to accompany the drawing. Thematic analysis of data revealed that during the pandemic children at this age have an understanding of death, experience death anxiety and are able to use creative expression to facilitate meaning of the impact of lockdown on their lives such as feeling isolated, lonely, sad and bored. Creative expression also facilitated adaptive coping mechanisms derived from being able to spend more time with family. The data on primary school children is part of a larger study which involved surveys and interviews with children aged 12–16 years in secondary schools. AD -, Buckinghamshire, Milton Keynes, UK ;, Buckinghamshire, Milton Keynes, UK

Black death and mourning as pandemic

Black bodies have been the site of devastation for centuries. We who inhabit and love these bodies live in a state of perpetual mourning. We mourn the disproportionate dying in our families, communities and the dying in the black diaspora. We are yet to come to terms with the death that accompanied the AIDS pandemic. Tuberculosis breeds in the conditions within which most of us live. We die from hours spent in the belly of the earth where we dig for minerals to feed the unquenchable thirst of capital. Malaria targets our neighbors with deathly accuracy. Ebola stalks west Africa where it has established itself as a rapacious black disease. It kills us. In the black diaspora, African Americans are walking targets for American police who kill and imprison them at rates that have created a prison industrial complex. Africans die in the Mediterranean ocean and join the spirits of ancestors drowned centuries ago. With South Africa as the point of departure, this paper stages a transcontinental examination of black death. It is animated by the following questions. What are the dimensions of black death, what is its scale and how is it mourned? What does the COVID-19 pandemic mean for we who are so intimately familiar with death? (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Prolonged Grief in Times of Lockdown During the COVID-19 Pandemic.

This study aimed to estimate the prevalence of prolonged grief (PG) during the COVID-19 pandemic and to analyze associated variables. 142 family members of patients who died during the lockdown at a hospital were surveyed 6 months after the death. Prolonged grief, depression and anxiety, grief rumination, and loss-related variables were captured. Logistic regression analyses were conducted to detect the associated variables of PG symptoms. Prolonged grief was present in 44.4% of the bereaved. 76.2% of the relatives reported feeling distressed due to visitor restrictions, and the majority of them were unable to bid farewell to their family member at the time of death. Pastoral or psychological care was also lacking. Low education (p < 0.001), emotional closeness (p = 0.007), loss of a spouse (p < 0.001), inability to bid farewell after death (p = 0.024), feeling of threat due to the pandemic (p < 0.001), depression (p = 0.014), and anxiety (p = 0.028) were significantly associated with prolonged grief.

Developmental Manifestations of Grief in Children and Adolescents: Caregivers as Key Grief Facilitators.

The death of a loved one represents one of the most distressing and potentially traumatic life events in childhood and adolescence. Grief reactions in youth are influenced by ongoing developmental processes and manifest differently depending on the child's age and developmental stage. These grief-related processes unfold within youths' caregiving context, as children and adolescents rely heavily on the adults in their environment to navigate and cope with the death of a loved one. Despite the field's increasing recognition of the potential for maladaptive grief reactions to impede functioning over time, few longitudinal research studies on childhood grief currently exist. In this article, we will (a) provide a brief overview of the childhood bereavement literature; (b) review the new DSM-5 and ICD-11 Prolonged Grief Disorder diagnostic criteria through a developmentally-informed lens; (c) describe how grief reactions manifest in children and adolescents of different ages through the lenses of multidimensional grief theory and relational developmental systems theory; (d) highlight key moderating factors that may influence grief in youth, and (e) discuss a primary moderating factor, the caregiving environment, and the potential mechanisms through which caregivers influence children's grief.

Estimating Prevalence of Bereavement, Its Contribution to Risk for Binge Drinking, and Other High-Risk Health States in a State Population Survey, 2019 Georgia Behavioral Risk Factor Surveillance Survey.

BACKGROUND: Binge drinking is a pattern of alcohol abuse. Its prevalence and associated risk factors are not well documented. Heavy drinking, on the other hand, has a well-documented association with bereavement. This report uses a cross-sectional, population-based survey to estimate prevalence of bingeing and its association with new bereavement. Bingeing is defined as 4 or more drinks (women) or 5 or more drinks (men) in a 2-4-h setting. For the first time in 2019, the Georgia Behavioral Risk Factor Surveillance Survey (BRFSS) included a bereavement item: 'Have you experienced the death of a family member or close friend in the years 2018 or 2019?' METHODS: Georgia BRFSS is a complex sampling survey administered annually. It is designed to represent the 8.1 million people aged 18 years and older in the U.S. state of Georgia. Alcohol consumption patterns are routinely measured in the common core. In 2019, the state added a new item probing for bereavement in the prior 24 months predating the COVID-19 pandemic. Imputation and weighting techniques were applied to yield the population prevalence rates of new bereavement, bingeing, and their co-occurrence with other high-risk health behaviors and outcomes. Multivariate models, adjusted for age, gender, and race, were used to estimate the risk for other unhealthy behaviors posed by the co-occurrence of bereavement and bingeing. RESULTS: In Georgia, bereavement (45.8%), and alcohol consumption (48.8%) are common. Bereavement and alcohol use co-occurred among 1,796,817 people (45% of all drinkers) with a subset of 608,282 persons reporting bereavement combined with bingeing. The most common types of bereavement were death of a friend/neighbor (30.7%) or three plus deaths (31.8%). CONCLUSIONS: While bingeing is a known risk to public health, its co-occurrence with recent bereavement is a new observation. Public health surveillance systems need to monitor this co-occurrence to protect both individual and societal health. In a time of global bereavement, documenting its influence on binge drinking can support the work towards Sustainable Development Goal #3-Good health and Well-Being.

Corrigendum: COVID-19 pandemic's disproportionate impact on childhood bereavement for youth of color: reflections and recommendations.

[This corrects the article DOI: 10.3389/fped.2023.1063449.].

A Psychometric Analysis of the Spanish Version of the Grief Impairment Scale: A Screening Tool of Biopsychosocial Grief-Related Functional Impairment in a Salvadoran Sample.

The objective of this study was to translate and psychometrically evaluate a Spanish version of the Grief Impairment Scale (GIS) using a sample of bereaved adults from El Salvador (N = 579). The results confirm the unidimensional structure of the GIS, and solid reliability, item characteristics, and criterion-related validity, where the GIS scale significantly and positively predicts depression. However, this instrument only showed evidence of configural and metric invariance between different sex groups. Overall, these results support the Spanish version of the GIS as a psychometrically sound screening tool for health professionals and researchers to use in their clinical work.

Clinical listening: Experience of a grieving mother in times of COVID-19

The aim of this article is to present the dynamics of a clinical situation with a mother bereaved by the death of her child victimized by COVID-19, through a theoretical-clinical study based on the phenomenological method. From the perspective and bases of the clinical phenomenological-existential, we will show a psychotherapeutic action in which grief is understood beyond the criteria positioned by the DSM-5. In phenomenological research on maternal mourning, mourning is understood as something of the order of the inescapable and the immeasurable. It is with this understanding of the affection of the bereaved that we will present the dynamics of a clinical performance of a 50-year-old woman attended by the Applied Psychology Service of a public university. We emphasize that the silence of the psychotherapist, during the care of the bereaved mother, favored that the mother felt understood in her pain. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Portuguese) O objetivo deste artigo e apresentar a dinamica de uma situacao clinica com uma mae enlutada pela morte de seu filho vitimado pelo COVID -19, por meio de um estudo teorico-clinico pautado no metodo fenomenologico. Em uma perspectiva clinica com bases fenomenologico-existenciais, mostraremos uma atuacao psicoterapeutica em que o luto e compreendido para alem dos criterios posicionados pelo DSM-5. Nas pesquisas fenomenologicas acerca do luto materno, o luto e compreendido como algo da ordem do incontornavel e do imensuravel. E com essa compreensao do afeto dos enlutados que apresentaremos a dinamica de uma atuacao clinica de uma mulher de 50 anos atendida pelo Servico de Psicologia Aplicada de uma universidade publica. Destacamos que o silencio do psicoterapeuta, durante o atendimento da mae enlutada, favoreceu que a mae se sentisse compreendida em sua dor. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Spanish) El objetivo de este articulo es presentar la dinamica de una situacion clinica con una madre afligida por la muerte de su hijo victima de COVID-19, a traves de un estudio teorico-clinico basado en el metodo fenomenologico. Desde una perspectiva clinica con bases fenomenologicas-existenciales, mostraremos una accion psicoterapeutica en la que el dolor se entiende mas alla de los criterios posicionados por el DSM-5. En la investigacion fenomenologica sobre el duelo materno, el luto se entiende como algo del orden de lo ineludible y lo inconmensurable. Es con esta comprension del afecto de los afligidos que presentaremos la dinamica de un desempeno clinico de una mujer de 50 anos a la que asistio el Servicio de Psicologia Aplicada de una universidad publica. Hacemos hincapie en que el silencio de la psicoterapeuta, durante el cuidado de la afligida madre, favorecio que la madre se sintiera comprendida en su dolor. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

‘The one thing guaranteed in life and yet they won't teach you about it': The case for mandatory grief education in UK schools

Nearly all British children are bereaved of someone close to them by the time they turn 16 and, with the Covid-19 pandemic and world humanitarian crises across the news and social media, they are being exposed to more anxiety about death than ever before. Learners need to be taught about grief and death to prepare them to manage bereavement and support others. As it stands, although teaching resources exist and some curriculum guidance documents mention loss or death, there is no statutory requirement for schools anywhere in the UK to cover grief or bereavement and many pupils have no classes about these difficult topics. This article consolidates the case for grief education in schools. We discuss six key questions to examine evidence that children benefit from talking about grief, death and loss;the current provision for grief education in UK schools;the obstacles to teaching these topics and ways to overcome them;and the potential further implications of a policy change. Following the lead of child bereavement charities, research and new national reports on UK bereavement support, we demonstrate the need for mandatory grief education in all four countries of the UK and offer evidence-based recommendations for its implementation. © 2023, Cruse Bereavement Care. All rights reserved.

Dying in isolation

Palliative care is a nursing and medical specialty focused on providing comfort to those with chronic, life-limiting illness from diagnosis to the end of life through symptom management, aligning goals of care, and providing psychosocial/spiritual support. During the COVID-19 pandemic, millions experienced new, rapid symptoms and many faced untimely deaths. As experts in end-of-life care, palliative care clinicians played a vital role in pandemic care. Yet, the delivery of palliative care required significant adjustments due to visitor restrictions and isolation precautions. These changes included, but are not limited to, communication styles, involvement of family in symptom management, and adoption of telehealth. Throughout pandemic care, palliative care clinicians were also helping patients, families, and clinicians navigate a multitude of ethical decisions, including supporting frontline healthcare workers. This chapter focuses on palliative and end-of-life issues during the COVID-19 pandemic. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

The care for oncologic patients undergoing pediatric palliative care and the griefs of a health team

Introduction: The health care offered to children and adolescents with cancer has been expanded, giving space to orthothanasia and palliative care, with a comprehensive look at the subject facing the threat to the continuity of life, as well as challenging professionals to access issues related to grief. Objective(s): In order to explore this reality, this study intended to analyze how professionals experience grieving processes in the exercise of palliative care in pediatric oncology. Method(s): A qualitative research was conducted with the participation of 23 health professionals working in palliative oncology and pediatric care, who responded to a semi-structured interview script, whose analyses were performed with the support of the IRaMuTeQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) software. Result(s): The results were organized in four classes: in class 1, the specificities of the treatment of children with cancer and other aspects related to chronic illness are portrayed;class 2 shows that health trainings do not prepare professionals to deal with death and with patients with no possibility of cure, and these professionals have (pre-) concepts about palliative care;class 3 highlights the principles of palliative care and other factors of the work in this therapy;and class 4 deals with the bonds formed by professionals and their grieving experiences. Conclusion(s): Cure must not be a requirement for the provision of care in relation to children with cancer that can benefit from the adoption of palliative care therapy and the validation of the sensitivity of professionals.Copyright © 2023, Universidad Compultense Madrid. All rights reserved.

Overcoming the social stigma of losing a pet: Considerations for counseling professionals

During the COVID-19 pandemic, individuals found themselves spending more time with their pets and relied on them to maintain normalcy and provide security during isolation. Pets play a significant role in the lives of their caregivers, taking on different attachment roles depending on the needs of the individual. Grieving the death of a pet continues to be disenfranchised in society. Perceptions of judgment can lead individuals to grieve the loss without social support. The present review builds on research in the field of pet loss and human bereavement and factors in the impact of the COVID-19 pandemic on human-animal attachment A goal of the present review is to provide counselors with perspectives to consider in their practice when working with clients who have attachments to their companion animals and to acknowledge the therapeutic benefits of working through the grief process to resolution as a way to continue the bond with a deceased pet. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

PARENTS' EXPERIENCE of BABY LOSS during the COVID-19 PANDEMIC in AOTEAROA NEW ZEALAND

Background: The COVID-19 pandemic resulted in rapid and unparalleled changes to the provision of health care globally. New Zealand (NZ) experienced a lower rate of COVID-19 deaths compared with other high-income countries, related to the swift reaction to close borders and implement strict lockdowns, known colloquially as the 'go hard, go early' response. Healthcare workers reduced non-essential contact implemented social-physical distancing and wore personal protective equipment. This influenced the delivery of maternity care and perinatal bereavement support. There is limited information of the impact of the pandemic on parents bereaved by perinatal loss, and none in the NZ context. Our aim is to explore the experiences of NZ parents bereaved by late miscarriage, stillbirth and neonatal death during the COVID-19 pandemic. Method(s): Semi-structured interviews with bereaved parents via video-call technology analysed using qualitative Framework Analysis. Result(s): We interviewed 26 bereaved parents. Their losses comprised 15 stillbirths, 4 late-miscarriages, 1 neonatal death. Four key themes were identified, (1) Distant and impersonal care, (2) Exclusion of partners, (3) Negotiating hospital rules, and (4) Hindered access to social & cultural support. Conclusion(s): This study adds important insights into perinatal bereavement care in NZ during the COVID-19 pandemic, which impacted negatively on parents' already difficult experience of baby loss. The degree of impact was related to periods of greater restriction and institutional responses to the pandemic. The unique context of NZ's model of maternity care, with a known maternity provider and culturally responsive care mitigated some of the difficulties imposed by the pandemic.

Proceedings of the 6th National Patient Reported Outcome Measures (PROMs) Annual Conference

The proceedings contain 47 papers. The topics discussed include: long COVID rehabilitation services, Cardiff and Vale and Cwm Taf Morgannwg University health boards: social return on investment;the clinical meaning of family reported outcome measure (FROM-16) scores: translational research to support holistic clinical practice;patient-centered outcome measure design: the perspectives and preferences of children and young people with life-limiting or life-threatening conditions;co-creation of a patient reported outcome measure for older people with frailty and acute care needs (PROM-OPAC);PROMs: coming of age in lymphoedema services in Wales;ForMi-person-centered planning and outcomes recording app;true colors online mood monitoring in the bipolar disorder research network (BDRN) research program: challenges, benefits and importance of personalization;patient reported outcome measures for rheumatoid arthritis disease activity: using Rasch measurement theory to achieve more meaningful measurement;developing a roadmap towards national collection of electronic patient-reported outcomes for people with chronic kidney disease in the UK;and measuring bereavement support needs in people bereaved during Covid-19;the adaptation and development of a bereavement support needs scale.

A Catholic Christian understanding of autism spectrum disorder and grief within the funeral setting

Attending the funeral of a loved one offers bereaved individuals the opportunity to say goodbye to the deceased, providing closure to the grieving loved one and concretizing the deceased's death. Within the Catholic-Christian tradition, the funeral rite is seen as an act of worship, a part of the more powerful story of salvation. Within this belief system, the funeral rite represents the deceased loved one's soul returning to God in the afterlife. It is a way to thank God for the endless mercy He has shown His children on Earth. Under the helpful guidance and expertise of funeral directors, funeral proceedings allow family and friends to grieve the loss of their loved one, surrounded by a community of prayer and support, which can provide a step toward healing. However, certain groups of individuals are commonly deprived of the opportunity to participate in or attend the funeral of a loved one. People in the autism community can fall into this category, as their grief is often disenfranchised. Their experience of disenfranchised grief can be problematic, as excluding these individuals from the funeral service may impact their grief and mourning process. Because grief reactions within people with autism are understudied, little is known as how to adequately address the needs of these individuals at the funeral of a loved one. Also, many funeral directors do not receive formal training on how to work with people with autism. Thus, they may not be aware of the extra support that individuals with autism may need when attending a funeral service.Therefore, through the lens of Catholic-Christian integration, this dissertation seeks to examine how grief manifests within people with autism more fully. Specifically, this dissertation examines the role that funeral attendance may play in their grief processes. Moreover, using archival data from a pilot study, a training program for funeral directors will be examined for its effectiveness. Furthermore, interview data from professionals in the field of autism and grief will be analyzed and discussed. Combining a thorough literature review of the topic with data from professionals in the field, this dissertation aims to better understand how grief manifests within this population, specifically as it relates to funeral attendance. Throughout the dissertation, the need for grief studies and interventions within the autism community will be highlighted, especially during this time of increased death and subsequent grief and mourning due to the COVID-19 pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Investigation into Grief Experiences of the Bereaved During the Covid-19 Pandemic.

The objective of the current study was to investigate the grief experiences of people affected by COVID-19. The study adopted a qualitative design of descriptive phenomenology. Fifteen adults who had lost a family member during the COVID-19 pandemic were selected as the sample through the purposive sampling method until theoretical saturation was achieved. Data was collected using semi-structured interviews and the Colaizzi analysis method. Six main themes (i.e., unexpressed grief, psychosomatic reactions, negative emotions, family problems, and social and occupational problems) were extracted. Data analysis showed that complex disenfranchised grief is the pervasive consequence of the COVID-19 experience. According to the findings, participants experienced disenfranchised grief during the loss of their loved ones due to the COVID-19 disease, which was a complex, painful experience accompanied by negative emotions and family, work, and social tensions. This grief is accompanied by more severe and prolonged symptoms, making it difficult for the bereaved to return to normal life. In unexpressed grieving, there are intense feelings of grief, pain, separation, despair, emptiness, low self-esteem, bitterness, or longing for the presence of the deceased. This grief originated from the conditions of quarantine and physical distance on the one hand, which required the control of the outbreak of the COVID-19 disease, and on the other hand, the cultural-religious context of the Iranian people.

The Integration of the Resolved Through Sharing Perinatal Bereavement Follow-up Model with Latinx Cultural Values: A Case Illustration.

The Resolved Through Sharing (RTS) Perinatal bereavement model is an approach used for working with birthing people and their families who have experienced a perinatal loss. RTS is designed to help families cope with their grief and integrate the loss in their lives, meet the needs of the families during the initial crisis, and offer comprehensive care to each member of the family affected by the loss. This paper utilizes a case illustration to describe a year-long bereavement follow-up of an undocumented underinsured Latina woman who suffered a stillbirth during the beginning of the COVID-19 pandemic and the hostile anti-immigrant policy during the Trump presidency. The case illustration is based on a composite case of several Latina women who had pregnancy losses with similar outcomes, demonstrating how a perinatal palliative care (PPC) social worker provided ongoing bereavement support to a patient who experienced a stillbirth. The case illustrates how the PPC social worker utilized the RTS model, incorporated the patient’s cultural values, and acknowledged systemic challenges which resulted in the patient receiving comprehensive, holistic support that aided her emotional and spiritual recovery from her stillbirth. The author ends with a call to action for providers in the field of perinatal palliative care to incorporate practices that allow for greater access and equity for all birthing people.

"The communication I had with him back then is still stuck in my mind." Bereaved families of cancer patients' experiences for end-of-life communication.

PURPOSE: Communication with family members is important to end-of-life care for patients with cancer. It is an interactive engagement between terminally-ill cancer patients and their families through which they expand their mutual understanding to cope with losses and find meaning in death. This study aimed to describe the experiences of end-of-life communication between patients with cancer and their family members in South Korea. METHODS: This is a qualitative descriptive study using in-depth semi-structured interviews. Ten bereaved family members with end-of-life communication experience with terminal cancer patients were recruited through purposive sampling. Data were analyzed using qualitative content analysis. RESULTS: A total of 29 constructed meanings, 11 sub-categories, and the following 3 categories were derived: "Offering a space for patients to reminisce and reflect," "Building a bond," and "Reflections on what we need." End-of-life communication primarily centered on the patients, with families struggling to share their stories with them. Although the families coped well, they also regretted the lack of meaningful communication with the patients, indicating a need for support to facilitate effective end-of-life communication. CONCLUSION: The study highlighted concrete communication for finding meaning at the end-of-life for cancer patients and their families. We found that the families have the potential to communicate appropriately to cope with the patients' end-of-life. Nevertheless, end-of-life presents a unique challenge in which families require adequate support. Given the increasing number of patients and families dealing with end-of-life care in hospitals, healthcare providers should be mindful of their needs and help them cope effectively.