Grief and Bereavement

2014 ◽  
pp. 149-160
Author(s):  
William S. Breitbart
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Complicated Grief ◽  
Anticipatory Grief ◽  
Comprehensive Overview ◽  
Traumatic Grief ◽  
Grief And Bereavement ◽  
Bereavement Care ◽  
Routine Assessment

Bereavement care is an integral dimension of palliative care. Identifying risk factors for complicated grief and routine assessment of the bereaved allow the psycho-oncologist to proactively intervene and reduce unnecessary morbidity. This chapter provides a comprehensive overview of definitions regarding grief and bereavement, the features of normal grief, anticipatory grief, inhibited or delayed grief, chronic grief, traumatic grief, and complicated grief, as well as a review of interventions used to support the bereaved.

Bereavement

2021 ◽  
pp. 773-784
Author(s):  
David W. Kissane
Keyword(s):  
Palliative Care ◽  
Complicated Grief ◽  
Anticipatory Grief ◽  
Desirable Outcome ◽  
Bereaved Children ◽  
Cognitive Behavioural ◽  
Pathological Grief ◽  
Post Traumatic ◽  
Traumatic Distress ◽  
Special Circumstances

The phenomena and trajectory of mourning as a normal adaptive process are differentiated from clinical depression, avoidant and complicated grief, post-traumatic distress disorder, and other forms of pathological grief. Anticipatory grief can be a particular challenge during palliative care. The family is recognized as the major source of social support and the environment in which grief is shared with others. Key risk factors for pathological bereavement outcomes can be identified on admission to palliative care, permitting preventive models of psychological care to be used through palliative care into bereavement. Models of therapy include supportive-expressive, interpersonal, cognitive behavioural, family focused, and specific therapy for complicated grief. Pharmacotherapy can judiciously accompany psychotherapy. Life-cycle issues include bereaved children, siblings, parents, and grief for the very elderly. Grief can be stigmatized and ambiguous in special circumstances, yet positive growth is a desirable outcome from any loss.

scholarly journals Risk Factors for Anticipatory Grief in Family Members of Terminally Ill Veterans Receiving Palliative Care Services

2015 ◽  
Vol 11 (3-4) ◽  
pp. 244-266 ◽  
Author(s):  
Laurie A. Burke ◽  
Karen A. Clark ◽  
Khatidja S. Ali ◽  
Benjamin W. Gibson ◽  
Melissa A. Smigelsky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Family Members ◽  
Terminally Ill ◽  
Anticipatory Grief ◽  
Care Services ◽  
Palliative Care Services

Bereavement

2015 ◽  
Author(s):  
David W. Kissane ◽  
Talia I. Zaider
Keyword(s):  
Palliative Care ◽  
Complicated Grief ◽  
Anticipatory Grief ◽  
Desirable Outcome ◽  
Bereaved Children ◽  
Cognitive Behavioural ◽  
Pathological Grief ◽  
Post Traumatic ◽  
Traumatic Distress ◽  
Special Circumstances

The phenomena and trajectory of mourning as a normal adaptive process are differentiated from clinical depression, avoidant and complicated grief, post-traumatic distress disorder, and other forms of pathological grief. Anticipatory grief can be a particular challenge during palliative care. The family is recognized as the major source of social support and the environment in which grief is shared with others. Key risk factors for pathological bereavement outcomes can be identified on admission to palliative care, permitting preventive models of psychological care to be used through palliative care into bereavement. Models of therapy include supportive-expressive, interpersonal, cognitive behavioural, family focused, and specific therapy for complicated grief. Pharmacotherapy can judiciously accompany psychotherapy. Life-cycle issues include bereaved children, siblings, parents, and grief for the very elderly. Grief can be stigmatized and ambiguous in special circumstances, yet positive growth is a desirable outcome from any loss.

The Virulence of Grief in the Pandemic: Bereavement Overload During COVID

2021 ◽  
pp. 104990912110570
Author(s):  
Antonio Gabriel De Leon Corona ◽  
Jessica Chin ◽  
Paul No ◽  
Jennifer Tom
Keyword(s):  
Palliative Care ◽  
Risk Factor ◽  
Health System ◽  
Crucial Role ◽  
Complicated Grief ◽  
Palliative Care Team ◽  
Unresolved Grief ◽  
Grieving Process ◽  
High Death ◽  
Bereavement Care

The COVID-19 pandemic brought about bereavement overload as a risk factor for complicated grief. Bereavement overload (BO) describes individuals’ reactions to losses transpiring in a quick succession, without the time and opportunity for coping [9]. It can occur during catastrophic events and impact everyone experiencing the loss. With the high death toll from COVID-19, many people have lost multiple loved ones followed by an abbreviated grieving process due to the nature of the pandemic. This can have psychosocial impact on survivors for years. One of the evolving roles of Palliative Care within and after the pandemic should be to recognize those suffering from BO. Obtaining loss histories may identify those at risk of pathologic grief to provide preventive bereavement care. We present three cases encountered in our health system during the COVID-19 pandemic amongst a family member, a patient, and a healthcare provider. In each case the Palliative Care Team worked closely with these individuals to identify COVID-associated BO and helped them reconcile their unresolved grief to be able to move forward. These cases reflect only a fraction of those who experienced loss during the pandemic, but they illustrate how grief can be complicated by the pandemic for everyone involved. Palliative Care will have a crucial role moving forward, in treating the pandemic of complicated grief within the pandemic to adapt to the needs of all survivors, as we realize the effects of COVID will last long after its virulence has waned.

scholarly journals Current Grief Support in Pediatric Palliative Care

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 278
Author(s):  
Taryn Schuelke ◽  
Claire Crawford ◽  
Rachel Kentor ◽  
Heather Eppelheimer ◽  
Cristina Chipriano ◽  
...  
Keyword(s):  
Palliative Care ◽  
Chronic Illness ◽  
Meaningful Work ◽  
Pediatric Palliative Care ◽  
Time Of Death ◽  
Anticipatory Grief ◽  
Comprehensive Overview ◽  
Grief Support ◽  
The Future ◽  
Innovative Approaches

Grief support changes as more is learned from current grief theory and research. The authors provide a comprehensive overview of current grief support as it relates to Pediatric Palliative Care (PPC). The following aspects of grief are addressed: (1) anticipatory grief: the nondeath losses that occur with a complex and chronic illness, as well as the time leading up to death; (2) grief around the time of death: the intense and sacred experience of companioning with a dying child; (3) grief after death: supporting bereavement and mourning through programing and other methods; (4) innovative approaches: the future of grief support. The contents of this article are meant to support and educate programs currently providing grief services and those aiming to begin the meaningful work of grief support.

scholarly journals Opioid-Induced Respiratory Depression in Pediatric Palliative Care Patients with Severe Neurological Impairment—A Scoping Literature Review and Case Reports

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 312
Author(s):  
Maximilian David Mauritz ◽  
Carola Hasan ◽  
Larissa Alice Dreier ◽  
Pia Schmidt ◽  
Boris Zernikow
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Young Adults ◽  
Scoping Review ◽  
Pediatric Patients ◽  
Case Reports ◽  
Neurological Impairment ◽  
Opioid Therapy ◽  
Pediatric Palliative Care ◽  
Severe Neurological Impairment

Pediatric Palliative Care (PPC) addresses children, adolescents, and young adults with a broad spectrum of underlying diseases. A substantial proportion of these patients have irreversible conditions accompanied by Severe Neurological Impairment (SNI). For the treatment of pain and dyspnea, strong opioids are widely used in PPC. Nonetheless, there is considerable uncertainty regarding the opioid-related side effects in pediatric patients with SNI, particularly concerning Opioid-Induced Respiratory Depression (OIRD). Research on pain and OIRD in pediatric patients with SNI is limited. Using scoping review methodology, we performed a systematic literature search for OIRD in pediatric patients with SNI. Out of n = 521 identified articles, n = 6 studies were included in the review. Most studies examined the effects of short-term intravenous opioid therapy. The incidence of OIRD varied between 0.13% and 4.6%; besides SNI, comorbidities, and polypharmacy were the most relevant risk factors. Additionally, three clinical cases of OIRD in PPC patients receiving oral or transdermal opioids are presented and discussed. The case reports indicate that the risk factors identified in the scoping review also apply to adolescents and young adults with SNI receiving low-dose oral or transdermal opioid therapy. However, the risk of OIRD should never be a barrier to adequate symptom relief. We recommend careful consideration and systematic observation of opioid therapy in this population of patients.

scholarly journals Long-term prevalence and predictors of prolonged grief disorder amongst bereaved cancer caregivers: A cohort study

2019 ◽  
Vol 17 (5) ◽  
pp. 507-514 ◽  
Author(s):  
Rachel D. Zordan ◽  
Melanie L. Bell ◽  
Melanie Price ◽  
Cheryl Remedios ◽  
Elizabeth Lobb ◽  
...  
Keyword(s):  
Mental Health ◽  
Palliative Care ◽  
Psychological Health ◽  
Linear Regression Analysis ◽  
Population Based ◽  
Anticipatory Grief ◽  
Prolonged Grief Disorder ◽  
Prolonged Grief ◽  
Cancer Caregivers

AbstractContextThe short-term impact of prolonged grief disorder (PGD) following bereavement is well documented. The longer term sequelae of PGD however are poorly understood, possibly unrecognized, and may be incorrectly attributed to other mental health disorders and hence undertreated.ObjectivesThe aims of this study were to prospectively evaluate the prevalence of PGD three years post bereavement and to examine the predictors of long-term PGD in a population-based cohort of bereaved cancer caregivers.MethodsA cohort of primary family caregivers of patients admitted to one of three palliative care services in Melbourne, Australia, participated in the study (n= 301). Sociodemographic, mental health, and bereavement-related data were collected from the caregiver upon the patient's admission to palliative care (T1). Further data addressing circumstances around the death and psychological health were collected at six (T2,n= 167), 13 (T3,n= 143), and 37 months (T4,n= 85) after bereavement.ResultsAt T4, 5% and 14% of bereaved caregivers met criteria for PGD and subthreshold PGD, respectively. Applying the total PGD score at T4, linear regression analysis found preloss anticipatory grief measured at T1 and self-reported coping measured at T2 were highly statistically significant predictors (bothp< 0.0001) of PGD in the longer term.ConclusionFor almost 20% of caregivers, the symptoms of PGD appear to persist at least three years post bereavement. These findings support the importance of screening caregivers upon the patient's admission to palliative care and at six months after bereavement to ascertain their current mental health. Ideally, caregivers at risk of developing PGD can be identified and treated before PGD becomes entrenched.

Risk Factors and Wound Management for Palliative Care Patients

2007 ◽  
Vol 9 (4) ◽  
pp. 179-181 ◽  
Author(s):  
Angela Richards ◽  
Teresa J. Kelechi ◽  
Winnie Hennessy
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Wound Management

scholarly journals Audit of the management of patients at high risk of carbapenemase-producing enterobacteriaceae (CPE): Are we ready?

2017 ◽  
Vol 18 (6) ◽  
pp. 296-300 ◽  
Author(s):  
Lasantha Ratnayake ◽  
Amy Harris ◽  
Doreen Ko ◽  
Linda Hawtin
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
High Risk ◽  
Individual Risk ◽  
Risk Status ◽  
Healthcare Settings ◽  
The Uk ◽  
Individual Risk Factors ◽  
Routine Assessment ◽  
Relevant Section

Background: Incidence of carbapenemase-producing enterobacteriaceae (CPE) in the UK is increasing. In 2013, Public Health England (PHE) published a toolkit to control spread of CPE within healthcare settings. Aim: To assess compliance to hospital CPE policy (adapted from PHE) in the identification, isolation and screening of suspected CPE patients. Methods: Admission booklets of 150 patients were evaluated to see whether the relevant section had been completed to identify high-risk CPE patients. Where necessary, patients were interviewed or their GPs were contacted to assess their CPE risk. Additionally, 28 patients screened for CPE were audited to assess compliance to screening and isolation. Findings: Only 23 patients out of 147 (15.6%) were risk assessed on admission. Risk status of 27 (18.4%) patients could not be assessed due to lack of data. Fifteen patients out of 28 (54%) screened for CPE were identified and isolated on admission. Ten out of 19 patients (53%) had three screens 48 h apart. Discussion: This audit highlights difficulties in screening based on individual risk factors as the majority of patients were not screened on admission and documentation on isolation and screening was poor. More needs to be done to raise awareness of the requirements for routine assessment, isolation and screening.

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