Making Sense of Death

Spiritual,Pastoral and Personal Aspects of Death,Dying and Bereavement

Gerry Cox, Robert Bendiksen, Robert Stevenson, Gerry R Cox, Robert A Bendiksen, Robert G Stevenson

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781351843096
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The editors of "Making Sense of Death: Spiritual, Pastoral, and Personal Aspects of Death, Dying and Bereavement" provide stimulating discussions as they ponder the meaning of life and death.This anthology explores the process of meaning-making in the face of death and the roles of religion and spirituality at times of loss; the profound and devastating experience of loss in the death of a spouse or a child; a psychological model of spirituality; the dimensions of spirituality; humor in client-caregiver relationships; the worldview of modernity in contrast to postmodern assumptions; the Buddhist perspective of death, dying, and pastoral care; meaning-making in the virtual reality of cyberspace; individualism and death; and the historical context of Native Americans, the concept of disenfranchised grief, and its detailed application to the Native American experience.It also explores: a qualitative survey on the impact of the shooting deaths of students in Colorado; a team approach with physicians, nursing, social services, and pastoral care; a study of health care professionals, comparing clergy with other health professionals; marginality in spiritual and pastoral care for the dying; a qualitative research study of registered nurses in the northeast United States; and loss and growth in the seasons of life.

SECTION IV

Professional Caregivers and Spirituality

CHAPTER 12

When a Patient Dies: Meeting Spiritual Needs of the Bereaved in a Health Care Setting

Fran Rybarik and Diane Midland

Over half of all deaths in the United States occur in acute care hospitals (Kaufman, 1998). Approximately 780,000 individuals die annually in short-stay hospitals in the United States (National Center for Health Statistics, 1999). When one considers the number of family members and friends touched by these deaths, the figures become unimaginable. All too frequently, loved ones feel abandoned by health care providers when the status of the patient’s care changes from full, aggressive treatment to comfort care, or when the patient dies. Health care has traditionally been focused on “curing” and, as such, has not done well in the area of supporting dying patients and grieving friends and family. Spiritual care is a key component of that support.

In general, spirituality refers to one’s beliefs, values, sense of purpose, direction, and one’s relationship to a larger whole. The spiritual dimension allows humans to attach meaning to the life experiences they encounter. Attaching meaning is a way to understand and cope with the losses one experiences through the death of another. Recent studies support the hypothesis that intrinsic spirituality aids bereavement— that individuals who apply their belief system to experiences like bereavement seem to cope more adaptively (Easterling, Gamino, Sewell, & Stirman, 2000).

In the early 1980s, Gundersen Lutheran Medical Center in La Crosse, Wisconsin, developed a program to support and facilitate the grief of parents whose baby died during pregnancy, at birth, or shortly after birth. As the RTS (formerly known as Resolve through Sharing) program was established on the units were perinatal and newborn death occurred, it became evident that these same premises of sensitive, compassionate care could—and should—be practiced throughout the entire health care environment.

An interdisciplinary committee comprised of physicians, nursing, social service, and pastoral care was organized to define what a comprehensive bereavement program might look like within a health care organization. The ultimate result of this committee was the establishment of Bereavement: Guidelines for Care (Midland, 2002) that would provide consistent care no matter where a patient died in the medical center. The guidelines are divided into three main categories: anticipatory grief support; care at the time of death; and follow-up with a bereaved family member. The guidelines are based not only on the experiences and mission of Gundersen Lutheran Medical Center, but also on international, national, and regional research and standards (Corr, Morgan, & Wass, 1994; Discher & Haggerty, 1994; Joint Commission on Accreditation of Healthcare Organizations, 2000; Roberg, 1993; Witter, Tolle, & Moseley, 1990). Excerpts from the guidelines are in Table 1.

ESTABLISHING A TEAM APPROACH

Throughout the Bereavement: Guidelines for Care (Midland, 2002), it becomes evident that care of the dying patient and his/her significant others is best accomplished through a team approach. Although there may be a natural tendency to think that no one can perform a task as proficiently as I can (or perhaps another person from my discipline), the reality of health care and bereavement care is that collaboration and consultation are imperative. No one individual or discipline can do it alone. It truly takes a “team” effort to provide the best service and avoid staff “burnout” or “compassion fatigue.” Each discipline has their unique area of expertise that will enhance the total outcome of the care provided.

TEAM DEVELOPMENT

Keep in mind that teams do not develop overnight. They require nurturing and restructuring as changes occur within the setting. Feedback is necessary between team members so that there are opportunities to learn—to evaluate what works, what doesn’t work. A team is defined as “a group of people who are committed to the attainment of a common objective, who work well together and enjoy doing so, and who produce high quality results” (Team Building: Measuring Success, 1998). To be a team, there must be shared goals, interdependence, commitment, and accountability for the outcome. There must also be room for conflict, challenge, failure, and mutual respect.

Working together as a team requires going through various stages of development, sometimes described as the life cycle of a team. One model defines five stages of a team life cycle: Forming, Storming, Norming, Performing, and Adjourning (Team Building: Measuring Success, 1998). Some common experiences of team members at each stage of team development are listed in Table 2.

Teams may find that they move between the various stages at any given time. As the composition of the team changes—a member leaves and a new person comes onboard—the team returns to a forming stage and repeats some of the behaviors of each stage during the process of redesign. Teams that provide bereavement support at the bedside within the health care environment seldom reach the adjourning stage. Each time a patient is near death or dies, an interdisciplinary team is in...

Table of contents

• Cover
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Acknowledgments
• Preface
• Introduction
• Section I Facing the Death of a Loved One
• Section II Meaning-Making in the Face of Death
• Section III Extraordinary Death and Loss
• Section IV Professional Caregivers and Spirituality
• Section V Conclusion
• Contributors
• Index