Download caring for bereaved people The Activities on these Portfolio Pages

CARING FOR BEREAVED PEOPLE
The Activities on these Portfolio Pages correspond with the learning objectives
of the Guided Learning unit published in Nursing Times 103: 51 (18 December,
2007) and 104; 1 (8 January 2008). The full reference list for this unit follows
Activity 4.
Before starting to work through these Activities, save this document onto your
computer, then print the completed work for your professional portfolio.
Alternatively, simply print the pages if you prefer to work on paper, using extra
sheets as necessary.
Recording your continuing professional education
To make your work count as part of your five days’ CPD for each registration
period, make a note in the box below of the date and the total number of hours
you spent on reading the unit and any other relevant material, and working
through the Activities.
Hours:
Date:
ACTIVITY 1
Learning objective: Describe the
emotional, physical, behavioural and
psychological responses to bereavement.
Activity: James Black* is 53 years old.
His wife has just been diagnosed with
advanced ovarian cancer. What
emotional, physical, behavioural and
psychological response might he
experience or express:



Before the death;
At the time of his wife’s death;
Three months after her death?
RESPONSE
Begin your response here.
Nursing Times Portfolio Pages: Caring for Bereaved People
11
1
CARING FOR BEREAVED PEOPLE
ACTIVITY 2
article help to explain James’ (Activity 1)
reactions at each stage?
Learning objective: Understand three
perspectives of bereavement theory.
RESPONSE
Activity: Consider your answers to the
above activities. How do the
bereavement models discussed in the
Nursing Times Portfolio Pages: Caring for Bereaved People
Begin your response here.
22
2
CARING FOR BEREAVED PEOPLE
ACTIVITY 3
Learning objective: Explain nurses’ role
in helping bereaved people.
Activity: Think about the care the
following bereaved relatives may need
from nurses:
 A 55-year-old woman whose husband
has just died of an acute myocardial
infarction;
Nursing Times Portfolio Pages: Caring for Bereaved People


A 78-year-old widower whose wife
has died after a long chronic illness;
The parents of an 18-year-old
schoolgirl killed in a road traffic
accident.
RESPONSE
Begin your response here.
3
3
CARING FOR BEREAVED PEOPLE
ACTIVITY 4
Learning objective: Identify the skills
required to help bereaved people.
Activity: Lily Jackson’s* husband died
three weeks ago from lung cancer. Her
children have returned to their homes
some miles away and Lily is very much
by herself. She has become very
withdrawn and tells you that she spends
most of her time crying. She is angry with
Nursing Times Portfolio Pages: Caring for Bereaved People
her husband for dying and wants to get
rid of all his things as quickly as possible.
What skills do you need to help Lily at
this time?
(*Names have been changed.)
RESPONSE
Begin your response here.
4
4
CARING FOR BEREAVED PEOPLE
FULL REFERENCE LIST: Part 1
teaching loss, grief and bereavement.
Nurse Educator; 28: 2, 71-76.
Anstey, S., Lewis, M. (2001)
Bereavement, grief and mourning in:
Kinghorn, S., Gamlin, R. (eds) Palliative
Nursing Bringing Comfort and Hope.
London: Bailliere Tindall.
National Statistics Office (2007) Death
Registrations. Available at:
www.statistics.gov.uk/cci/nugget.asp?id=95
2
Bowlby, J. (1980) Attachment and Loss
Vol 3: Loss. London: The Hogarth Press.
Bowlby, J. (1969) Attachment and Loss
Vol 1: Attachment. London: The Hogarth
Press.
Cobb, M. (2004) The care and support of
bereaved people in: Payne, S. et al (eds)
Palliative Care Nursing Principles and
Evidence for Practice. Maidenhead: Open
University Press.
Ellershaw, J., Ward, C. (2003) Caring for
the dying patient: the last hours or days of
life. British Medical Journal; 326: 30-34.
Field, D., Payne, S. (2003) Social aspects
of bereavement. Cancer Nursing Practice;
2: 8, 21-25.
General Register Office for Scotland
(2007) The Registrar General’s Review of
Scotland’s Population. www.groscotland.gov.uk/statistics/publications-anddata/annual-report-publications/index.html
Husband, L., Henry, C.L. (2002) Palliative
care and care of the dying in: Kenworthy,
N. et al (eds) Common Foundation Studies
in Nursing (3rd ed). Edinburgh: Churchill
Livingstone.
Klass, D. et al (1997) Continuing Bonds.
Philadelphia PA: Taylor & Francis.
Kubler Ross, E. (1969) On Death and
Dying. New York: Macmillan.
Matzo, M.L. et al (2003) Strategies for
Nursing Times Portfolio Pages: Caring for Bereaved People
Northern Ireland Statistics and Research
Agency (2007) Mortality Statistics for
Northern Ireland (2006)
www.nisra.gov.uk/archive/demography/publ
ications/births_deaths/deaths_2006.pdf
Parkes, C.M. (2000) Bereavement as a
psychological transition: processes of
adaptation to change in: Dickenson, D. et
al (eds) Death, Dying and Bereavement.
London: Sage Publications/Open
University.
Parkes, C.M. (1998) Traditional models
and theories of grief. Bereavement Care;
17: 2, 21-23.
Payne, S. (2004) Overview in: Payne, S. et
al (eds) Palliative Care Nursing Principles
and Evidence for Practice. Maidenhead:
Open University Press.
Payne, S. et al (1999) Loss and
Bereavement. Buckingham: Open
University Press.
Prior, L. (2000) The social distribution of
sentiments in: Death, Dying and
Bereavement, Dickenson, D. et al (eds)
London: Sage Publications/Open
University.
Read, S. (2002) Loss and bereavement: a
nursing response. Nursing Standard; 16: 3,
47-53.
Russell, P. (2007) Dying, Death and
Spirituality in: Hogston, R., Marjoram,
B.A. (eds) Foundations of Nursing Practice
Leading the Way (3rd edition) Basingstoke:
Palgrave Macmillan.
5
5
CARING FOR BEREAVED PEOPLE
Stroebe, M.S. et al (2002) Handbook of
Bereavement Research: Consequences,
Coping and Care. Washington DC:
American Psychological Association.
Stroebe, M.S., Schut, H. (1999) The dual
process model of coping with bereavement:
rationale and description. Death Studies;
23: 197-224.
Walter, T. (1996) A new model of grief:
bereavement and biography. Mortality; 1: 1,
1-29.
Nursing Times Portfolio Pages: Caring for Bereaved People
Worden, W. (2001) Grief Counselling and
Grief Therapy: A Handbook for the Mental
Health Practitioner (3rd ed). London:
Tavistock/Routledge.
Worden, W. (1991) Grief Counselling and
Grief Therapy: A Handbook for the Mental
Health Practitioner (2nd ed). London:
Tavistock/Routledge.
Worden, J.W. (1982) Grief Counselling
and Grief Therapy: A Handbook for the
Mental Health Practitioner. New York:
Springer.
6
6
CARING FOR BEREAVED PEOPLE
FULL REFERENCE LIST: Part 2
Anstey, S., Lewis, M. (2001)
Bereavement, grief and mourning in:
Kinghorn, S., Gamlin, R. (eds) Palliative
Nursing - Bringing Comfort and Hope.
London: Bailliere Tindall.
Egan, K.A., Arnold, R.L. (2003) Grief and
bereavement care. American Journal of
Nursing; 103: 9, 42-52.
Ellershaw, J. E., Wilkinson, S. (2003)
Care of the dying: A Pathway to
Excellence. Oxford: Oxford
University Press.
Field, D. Payne, S. (2003) Social aspects
of bereavement. Cancer Nursing Practice;
2: 8, 21-25.
Kinghorn, S., Duncan, F. (2005) Living
with loss in: Lugton. J., McIntyre, R. (eds)
Palliative Care The Nursing Role (2nd ed).
Edinburgh: Elsevier Churchill Livingstone.
Russell, P. (2007) Dying, death and
spirituality in: Hogston, R., Marjoram, B.A.
(eds) Foundations of Nursing Practice
Leading the Way (3rd ed). Basingstoke:
Palgrave Macmillan.
Nursing Times Portfolio Pages: Caring for Bereaved People
7
7
CARING FOR BEREAVED PEOPLE
Table 1. Grief response
Emotional
 Sadness;
 Anger;
 Guilt;
 Self-reproach;
 Anxiety;
 Loneliness;
 Fatigue;
 Helplessness;
 Shock;
 Yearning;
 Relief;
 Numbness.
 Physical
 Hollowness in the
stomach;
 Tightness in the chest;
 Tightness in the
throat;
 Over-sensitivity to
noise;
 Sense of
depersonalisation;
 Breathlessness;














Muscle weakness;
Lack of energy;
Dry mouth.
Behavioural
Sleep disturbance;
Appetite disturbance;
Absentmindedness;
Social withdrawal;
Dreaming;
Searching;
Crying;
Sighing;
Restless;
Visiting old haunts.
Psychological
 Disbelief;
 Confusion;
 Preoccupation;
 Sense of presence;
 Hallucinations
Source: based on Worden
(1991)
Nursing Times Portfolio Pages: Caring for Bereaved People
8
8
CARING FOR BEREAVED PEOPLE
Fig 1. The Dual Process
Dual process model (Stroebe & Schut 1999)
Grief work
Distraction from
grief
Intrusion of grief
Attending to life
changes
Loss-oriented
Restoration-oriented
Doing new things
Denial/avoidance
of restoration
changes
Denial/avoidance of
grief
Breaking bonds
New roles/ identities
relationships
Nursing Times Portfolio Pages: Caring for Bereaved People
9
9