Bereavement

Client Adaptation and Hospice Services

Donna Infeld, Nadine R Penner

• Publisher: Routledge
• Year: 2014
• Print ISBN: 9780789003072
• eBook ISBN: 9781317721093
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Helping a mother transcend the death of her only child, helping a young child understand and cope with the death of a loved one, and helping survivors of the AIDS epidemic cope with the loss of numerous loved ones and the loss of community are among the greatest challenges facing today's bereavement counselors. Bereavement explores these sensitive issues and ways bereavement counselors can help these individuals construct new identities and new worldviews that are self-affirming. Using this book as a guide, you can improve your understanding of the various resources and options that can be employed to achieve the healthy resolution of grief with individuals, families, and communities. Recognizing that the experience of grieving is unique for all individuals, Bereavement addresses a wide range of issues facing bereavement professionals. Its authors offer a multitude of effective therapeutic interventions and techniques. You will learn to encourage grievers to incorporate important aspects of their lost relationship(s) into their present lives to gain greater personal integration and wholeness; see how to use music, dance, art, and play therapy with clients to help them explore their grief and move through the various stages of grieving; acquire helpful hints and practical advice for offering extended bereavement care to both hospice and non-hospice families; and see how a highly successful interdisciplinary bereavement team approach has been employed in one of the largest bereavement programs in the U.S. You will also learn about other crucial topics and issues faced by bereavement counselors, including:

• uniting survivors of different types of death in a support group
• teaching your community about death/dying
• developing rural hospice bereavement services
• emotional, behavioral, physical, social, and cognitive symptoms of grief
• healthy coping mechanisms
• pre-death bereavement interventions
• Post-Traumatic Stress Disorder
• multiple trauma
• survivor guilt
• bereavement counseling as a supplement to normal support networksBereavement will help you enhance your knowledge and skills in the delivery of effective bereavement services. Whether you are a beginner or a counselor with several years of experience, you will find this book an invaluable guide as it walks you through the different stages of mourning, through different human reactions to death and dying, and through different therapeutic approaches.

Transcending a Devastating Loss:
The Life Attitude of Mothers Who Have Experienced the Death of Their Only Child

Kay Talbot

SUMMARY. This study measured 80 mothers' attitudes about life five or more years after the death of their only child (mean = nine years). Participants completed the Life Attitude Profile-Revised. The five highest and five lowest scoring mothers were interviewed in depth. Discriminant analysis of participant questionnaires revealed that 86% of participants were correctly classified by seven variables as survivors (reinvestors in life) or as remaining in a state of perpetual bereavement. Four of these variables accounted for 39% of the variance in participants' life attitude scores. Interview and questionnaire findings suggest motherhood becomes an integral part of the self and in order to survive after the death of an only child it is necessary not to relinquish this construct. A positive life attitude was found to be an important indicator of adaptation to this unique form of bereavement. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: [email protected]]

INTRODUCTION

Bereavement researchers have concluded that the phenomenon of parental bereavement is the most difficult form of bereavement (Cleiren, 1993; Knapp, 1986; Osterweis, Solomon, and Green, 1984; Rando, 1986; Sanders, 1979–80, 1989). This is because the loss is multifaceted. Parents lose not only their unique relationship with a valued and loved child, they lose the part of themselves that child represents. They lose the future they and the child would otherwise have created together. They lose the immortality of being survived by the child and the child's descendants. And they lose their false illusions about the degree of control they have over life (Edelstein, 1984).

The emotional, cognitive, physical, social, and spiritual changes which result from the loss of a child work together to confront bereaved parents with a heightened responsibility for a new existence. The additional loss of the role of parent which accompanies the death of an only child adds to this existential crisis. Virtually every aspect of their lives is irrevocably altered. In studying the process of role exit, Ebaugh (1988) found that role residual was common to all who exited a role, voluntarily or not. Role residual is “the identification that an individual maintains with a prior role such that the individual experiences certain aspects of the role after he or she has in fact exited from it” (Ebaugh, 1988, p. 173). Further, “the more personal involvement and commitment an individual had in a former role, that is, the more self-identity was equated with role definitions, the more role residual tended to manifest itself after the exit” (p. 178). While bereaved mothers were not included in Ebaugh's study, I postulated that for many bereaved mothers the role of motherhood is highly correlated with self-identity and for these mothers, the loss of their role as a mother intensifies the identity conflict that is already made extant by the loss of the part of themselves that the child signified. I hypothesized that mothers who have survived the death of their only child to reinvest in life again-a life that has goals, hope, trust, and meaning-will have found ways to successfully incorporate “mothering” into their new lives.

METHOD

To measure life attitude, I used the Life Attitude Profile-Revised (LAP-R) (Reker & Peacock, 1981). The LAP-R contains six scales which measure (1) life purpose; (2) life coherence; (3) life control; (4) death acceptance; (5) existential vacuum; and (6) goal seeking. Scores from the six LAP-R scales were used to calculate a Life Attitude Balance Index (LABI) which takes into account both the degree to which meaning and purpose in life have been discovered and the motivation to find meaning and purpose (Reker, 1992). I reasoned that the range of possible LABI scores provided by the LAP-R instrument could represent a bereavement continuum, with those scoring low representing a state of perpetual bereavement and those scoring high representing survival. In order to understand the experience of survival, I also found it necessary to understand the experience of not surviving, of remaining perpetually bereaved after the death of an only child.

I recruited participants through the mailing list of Alive Alone, Inc. (Bevington, 1993) which provides a newsletter and networking opportunities for bereaved parents with no surviving children. Eighty mothers who met the study criteria completed the LAP-R, the Perceived Well-Being Index (PWB-R) (Reker & Wong, 1984), and a lengthy questionnaire containing demographic information and variables related to grief resolution. I performed the following statistical analysis of responses to the questionnaire: correlation, discriminant, multiple regression, and chi square analysis.

LABI scores for the 80 participants ranged from −8 (lowest) to 162 (highest), which compares to a total possible range of −80 (lowest) to 208 (highest). The distribution of participant scores approximated a normal curve, with a mean of 84.6 and standard deviation of 38.62. As expected, participants' LABI scores were somewhat negatively skewed from those of the normative sample which consisted of 491 women (mean = 94.1, standard deviation = 29.98; p < .01...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• About the Editors
• Preface
• Saying Hello Again: A New Approach to Bereavement Counseling
• The Interdisciplinary Bereavement Team: Defining and Directing Appropriate Bereavement Care
• Bereavement Services Development in a Rural Setting
• Meeting the Bereavement Needs of Kids in Patient/Families—Not Just Playing Around
• Transcending a Devastating Loss: The Life Attitude of Mothers Who Have Experienced the Death of Their Only Child
• Grief and AIDS: Surviving Catastrophic Multiple Loss
• Index