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Bereavement Care: Early Intervention and Long-Term Strategies

Bereavement Care: Early Intervention and Long-Term Strategies. Terry L. Glusko and Matthew Israel MJHS Hospice and Palliative Care Bereavement Department and Art & Soul ™ Programs. Goals for This Module.

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Bereavement Care: Early Intervention and Long-Term Strategies

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  1. Bereavement Care:Early Intervention and Long-Term Strategies Terry L. Glusko and Matthew Israel MJHS Hospice and Palliative Care Bereavement Department and Art & Soul™Programs

  2. Goals for This Module • Present a generalized view of grief & loss needs both before and after a patient’s death. • Examine a case study to actualize these concepts. • Put theory into practice by super-imposing the hospice model of bereavement support across palliative care and other medical settings.

  3. Grief & Loss Needs of Families Facing a Terminal Illness Anticipatory Grieving and Multiple Losses • Research findings and limitations of understanding • Defining the terms • De-mystifying anticipatory grief • The views of temporality and multidimensionality

  4. Grief & Loss Needs of Families Facing a Terminal Illness The “Uncomplicated” Outline of Anticipatory Grief • Dual-perspective • Patient • Family, friends and others • Dimensions of time • Past • Present • Future • Dynamic factors • Psychological • Social • Physiological

  5. “My Mommy’s an angel in heaven now”

  6. Case Goals • Creative arts therapy and children’s support implemented within 48-hours. • How were the patients children were adjusting to their mother not being in the home? • How were the children were coping with their mother’s diagnosis and terminal and prognosis? • How can we as a team prepare the patient’s children to transition from living in Brooklyn with their mother to living with their father in Manhattan?

  7. The Home Assessment • Provide the patients children with a creative outlet to express their feelings about their relationship their understanding and thoughts on patient’s prognosis. • Provide a safe forum for each child to express their feelings independently and as a family. • Establish a follow up plan of family support.

  8. Immediate Follow up Bereavement Support

  9. Grief & Loss Needs of Families After a Death • Natural Responses - Feelings - Physical sensations • Cognitions • Behaviors • Dimensions Commonly Affected • Spiritual, religious or philosophical • Interpersonal • Process Through Phases or Counseling • Acknowledging the reality of the loss (storytelling as the goal) • Mourning the loss (feeling the feelings) • Remembering what was and re-framing what is (memories, rituals and new relationship to deceased) • Re-defining identity and re-integrating (social roles and living) • Finding meaning (in the loss and/or new reality) • Seeking on-going support (caring for oneself)

  10. Short Term Bereavement Support • Provide a safe environment for the family to come in together to express their feelings related to the patients death. • Continue building support and coping mechanisms for the children and their family. • Assess the children’s feelings towards changing their home environment.

  11. Transition to a Children’s Bereavement Group • The family transitioned to a children’s bereavement group centered around building strong peer supports and the ability to open up and share feelings about grieving the death of a loved one.

  12. Work Towards Termination • The children and their father attend the entire 11 session children’s bereavement group and built strong bonds with their peers and the ability to express themselves about their mother’s death through their artwork.

  13. Models for Bereavement Support • Hospice Programs - Pre-loss goals & interventions addressed by interdisciplinary team • Routine outreach and education for 1-year following a death • Availability of individual/family counseling • Ongoing support groups specific to loss-type • Memorial services • Special programming (camps, workshops, etc.) • Suggestions for Palliative Care & Other Medical Settings • Pre-loss goals & interventions addressed by interdisciplinary team • Condolence cards • Grief & loss educational pamphlet or letter • Memorial services • Referrals to community resources • Philanthropic opportunities

  14. Conclusion • Questions and Discussion • Resources and References • Gilbert, K. (2009) Grief in a family context. Indiana University • Rando, T. (1986) Loss and anticipatory grief. Lexington Books: Lexington, MA • Wolfelt, A. (2004) Understanding Your Grief: Companion Press: Fort Collins, CO. • Contact Presenters • Terry Glusko: 212-649-5531 or tglusko@mjhs.org • Matthew Israel: 718-759-4522 or misrael@mjhs.org

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