Compared with clear-cut loss by death, ambiguous loss is defined as a loss that is not definite because the person is missing or mentally absent but physically present (e.g., through Alzheimer's disease). We expected the ambiguity of loss to show in psychologically more compromised loss memories and self-defining memories, but not in autobiographical memories in general. Thirty Chinese adults who had lost a parent through death, thirty whose parent had gone missing, and thirty who cared for a demented parent narrated their loss experiences and memories of sad and turning-point events as well as self-defining memories. Individuals with ambiguous loss narrated the loss and a self-defining memory with more contamination and fewer redemption sequences, and only the loss memory with fewer themes of agency and communion than individuals with definite loss, but not in memories of sad and turning point events. Effects of ambiguity of loss were independent of prolonged grief, which in turn independently predicted some of these effects. Thus the ambiguous quality of loss predicts effects on loss memories and self-defining memories independently of psychiatric symptoms.
The death of a partner may be stressful for unmarried intimate partners as they lack legal status vis-à-vis the partner, and, thus, lack sufficient cultural support. This qualitative study examined the meaning attributed to the loss by 12 Israeli bereaved intimate partners of fallen soldiers. Through applying a constructivist-narrative methodology, we derived three clusters from interviews with the intimate partners: (a) The relationships never ended – “an unfinished business,” (b) The need to conceal the relationships – “a hidden wound,” and (c) The relationship guides their lives – “a compass.” Practical implications were discussed.
D'un style élégant et maîtrisé, Jean-Pierre Gautheur met en mots le deuil, le manque et l'amour, immense et blessé, qui remplissent le coeur de ceux qui ont perdu un être cher.
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BACKGROUND: People can live for many months without knowing why their body is failing prematurely before being diagnosed with motor neurone disease (MND); a terminal neurodegenerative disease which can be experienced as 'devastating' for the person and their family.
AIM: This study aimed to explore the meaning of supporting a loved one with MND to die.
METHODS: This study uses reflection and autobiographical story to connect with broader cultural, political and social meaning and understandings of dying.
FINDINGS: Four themes were identified relating to the end-of-life trajectory of MND. Loss of person (lived body experienced in silence); loss of relationships (lived relations are challenged); loss of home and loss of time (lived space and lived time take on new meaning); loss of future (dying-facing it alone).
CONCLUSION: Dying with MND is a complex phenomenon. When a person can no longer move and communicate, relationships between those involved in end-of-life care are challenging. A person with MND needs the support from those acting as power of attorney to make their end of life their own, and they themselves need support to find meaning in their suffering. This autoethnographic reflection provides vicarious experiences for nurses and other healthcare professionals working with people with MND and similar conditions.
Expérience unique de rencontre intime avec soi, la grossesse engage la future mère vers des remaniements psychiques importants : de la transparence psychique à la préoccupation maternelle primaire, dans un continuum entre l’ante et le postnatal, la relation d’objet virtuelle développant l’interface entre le devenir parents et le naître humain. La mort périnatale représente un insupportable télescopage entre vie et mort, survenant dans ce contexte de fragilité psychique et bousculant l’ordre des générations. Les couples sont ainsi contraints, au-delà de la douleur indicible, d’entreprendre un voyage psychique effrayant. D’ailleurs, qu’ont-ils perdu ? Comment peut s’engager le travail de deuil d’un objet pas encore véritablement objectalisé dans ce temps des remaniements psychiques liés à la grossesse ? Et au delà, quels sont les enjeux psychiques du deuil périnatal ? Le moment de l’annonce est un véritable traumatisme. Ce trauma entraîne un sentiment d’anéantissement de soi et l’effondrement des ressources de mentalisation et de symbolisation habituelles avec un tel effet de désorganisation sur le fonctionnement psychique que le sujet ne peut plus élaborer ce à quoi il est confronté. Les spécificités du deuil périnatal sont multiples et sous-tendent les remaniements psychiques liés à la perte. La représentation même de l’objet de la perte, du fait de l’absence de traces, de souvenirs, est particulière, demandant d’interroger la métapsychologie freudienne en réfléchissant sur le devenir objectal du bébé mort. La nature de l’investissement fœtal, entre narcissique et objectal, influence-t-elle l’élaboration du deuil ?
Plusieurs destins psychiques du fœtus ont été décrits, qui influencent l’évolution du deuil, eux-mêmes en lien avec l’histoire infantile de la femme. L’ensemble de ces facteurs semble déterminer une évolution favorable ou non à un deuil périnatal. C’est ce que nous proposons de questionner à partir de la rencontre avec Mme L.
This work presents a historical analysis of death announcements (N = 1,443) posted in the New York Times between 1912 and 2002. Announcements were coded according to two main categories: the genre of the announcement and the presence of emotion words. Four distinct main genres emerged: death notices, memorials, recognition postings by organizations, and recognition postings by nonorganizational parties (friends and family). The proportion of death notices declined steadily from 1912 to 2002, while the proportion of announcements paying tribute to the deceased increased. The announcements were also analyzed in terms of emotion words used, and it is argued that the increasing frequency of emotion words used in the death announcements reflects a progressive emotionalization and psychologization of grief and loss.
This study examines the impact of a death and dying course on 39 undergraduate students’ attitudes and anxieties about death. Authors outline key aspects of the curriculum used in the course and discuss how the approach lends itself to a transformative learning experience related to death and loss, preparing students who will face clients with a variety of needs in these areas across practice settings. The majority of students (n = 34) experienced a decrease in death avoidance, fear of death, and overall death anxiety. Students with a history of multiple violent, traumatic, or unexpected deaths (n = 5) did not experience any significant changes but demonstrated increased scores of death anxiety suggesting that they may be in need of greater support while engaging in death education.
Several reports have indicated that grief and mental health outcomes of people bereaved by suicide vary by their relationship to the deceased. Parents who have lost offspring experience higher levels of distress than those with other relationships to the deceased. However, there are limited studies investigating the experience of parental bereavement by suicide, and further research is needed. The present study aimed to clarify the differences in grief reactions between bereaved parents and those with other relationships to the deceased in Japan and explore a statistical model of adaptation to the loss. In total, 105 bereaved participants completed a questionnaire covering grief reaction, meaning reconstruction, mental health, social context, and demographic variables. Parents scored higher on several grief reaction items and lower in sense-making than those with other relationships. In addition, path analysis showed that sense-making acted as a moderator in the experience of loss of offspring and grief reaction.
Veterinary professionals are recognized as an important source of support for many veterinary clients, particularly during companion animal euthanasia and end-of-life care. While many veterinary professionals recognize the importance of their role, many also report feeling unsure about what methods of support are most effective. Furthermore, few evidence-based guidelines currently exist to inform veterinary professionals on the support of grieving clients. To begin bridging this gap, this study qualitatively explored how veterinary professionals currently report supporting grieving clients before, during, and after companion animal euthanasia. Findings suggest that veterinary participants in this study strive to be meaningful sources of support for grieving clients and employ an array of support practice to do so. However, opportunities exist for veterinary professionals to better explore clients' needs, expectations, and feelings as they relate to companion animal euthanasia, including offering more grief-related resources and access to professional counseling services.
For patients at the end of life, the oncologist's care continues beyond the cessation of disease-directed therapy. When cure or even prolongation of life is no longer possible, oncologists have one last task remaining: to provide expert care to patients at the end of life and support for their families. Physical comfort, clear communication, emotional support, helping patients maintain a sense of purpose, clarifying wishes about attempts at resuscitation, working on legacies, addressing patient distress, and helping families as they struggle with their loss are all the work of a team of clinicians, led by the oncologist, who the patient and family continue to look to as their guide, even when no further antineoplastic therapies or immunotherapies can be offered. The team often includes the rest of the oncology team of clinicians, as well as social workers, chaplains, a palliative care clinician, and, when appropriate, a hospice team. Families with young children need specialized counseling and support. Ongoing losses (in identity or function or of roles in the family, community, or workplace) contribute to spiritual and existential distress. The palliative care and hospice teams can help with life reviews and reconnection with sources of spiritual support, including religious rituals, to help reaffirm identity and roles. The oncologist's final responsibility is ongoing communication with the survivors after the patient's death. Survivors appreciate ongoing communication, cards, and phone calls to answer any remaining questions and quell any lingering doubts. These communications also bring closure to the oncologist and oncology team, allowing them to reflect on and grieve their loss and to remember the work they did with the patient and his or her family.
Grief following a death loss is a common experience that all individuals face at some point in life. There, however, are only a few in-depth studies regarding grief in cultures around the world and specific roles that rituals and beliefs related to death may have in the grieving process. Results of interview data from eight grieving Turkish women revealed three themes: (a) metaphors of loss, (b) funeral rituals, and (c) rituals in relation to control and personal factors. Overall, participants' sense of control appeared to influence their grief experiences and perceptions of rituals.
A significant proportion of secondary school pupils in the UK have experienced the death of someone close. Bereavement in childhood can have a significant and long lasting impact. The aim of this study was to explore how pupils aged between 12 and 18 understand major loss, death and dying, whom they talk to and the support they access at these times, and their awareness of the range of support available to them. A total of 31 pupils, 108 parents and 37 staff from a large Scottish secondary school took part and data was collected using online questionnaires. A high proportion of pupils had experience of major loss or bereavement and showed significant awareness of their feelings and responses to these. It appears that young people primarily seek support from family and friends, but the role of peers is less well recognised by parents and teachers. The school was recognised as a source of support mainly by teachers.
Le narrateur vient de perdre sa mère. Il cherche à conjurer la mort. Beur, enfant de la République, il part à la rencontre de deux figures du passé : le Ghassanide, poète contrarié devenu chef des armées du calife Abd el-Malek, et Maysara, fils d'un porteur d'eau berbère, qui, rebelle dans l'âme, a levé une armée et s'est autoproclamé calife. Quand le roman se referme, le deuil est surmonté. Le narrateur a réussi à réconcilier les trois cultures dont il est issu.
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PURPOSE: To conduct a systematic review and meta-analysis examining the association of the prevalence of depression and time since spousal loss in widowed people.
METHODS: The databases MEDLINE, Embase and PsycInfo were searched (May 2017) for papers reporting on time since spousal loss in widowed people and the prevalence of common mental disorders. A systematic review was conducted according to MOOSE guidelines. Random effects meta-analyses of the prevalence of depression were conducted by intervals of time since spousal loss.
RESULTS: The literature search identified 12,982 studies of which 22 were eligible for inclusion in the systematic review. Of these, 14 were furthermore eligible for inclusion in the meta-analysis. The summary estimates found in the meta-analysis for the prevalence of depression in the intervals of time since spousal loss were: = 1 month: 38.2% (21.9–55.8%); > 1 month to 3 months: 25.0% (17.3–33.5%); > 3 months to 6 months: 23.1% (18.0–28.7%); > 6 months to 12 months: 19.4% (15.2–24.0%); > 12 months to 18 months: 11.1% (5.3–18.7%); > 18 months to 24 months: 15.2% (12.3–18.2%); > 24 months to 60 months: 10.5% (4.3–18.5%).
CONCLUSION: Widowhood is associated with a high prevalence of depression and the study identifies a population group needing special attention in daily clinical practice. The prevalence is highest in the first month of widowhood, however, continues to be high at least 5 years into widowhood.
Fifty years ago, Elisabeth Kübler-Ross' On Death and Dying provided a model of dying as stages of coping with impending loss of one's life. She sought to give dying hospital patients a voice; the result gave a new model for speaking about dying and grieving. This paper examines the model and religious appropriations and crticism of her theme of death as loss.
BACKGROUND AND OBJECTIVES: According to the Dual Process Model (DPM), shifting between loss-oriented (LO) and restoration-oriented (RO) coping is essential for adjustment following bereavement. Knowledge about how LO and RO coping change over time and how such changes are related to adjustment is missing. With a prospective design this study investigated (1) relations between levels of LO/RO coping and selected outcomes and (2) changes in LO/RO coping across time and their relations to adjustment.
METHODS: A sample of 145 spousal bereaved individuals completed questionnaires measuring LO and RO coping, grief symptoms, positive affect, and attachment orientation approximately 2-3 months (baseline) and 7 months (follow-up) post-loss.
RESULTS: High usage of LO coping was associated with poorer outcomes and high usage of RO coping was associated with better outcomes at both baseline and follow-up. Individuals generally shifted towards more RO coping across time and those who exhibited this shift showed lower levels of grief at follow-up compared to individuals who changed towards more LO coping across time.
CONCLUSIONS: Individuals showing more RO coping reported better adjustment both early and later in the bereavement process. Changes in coping orientation over time might be useful for understanding complicated grief reactions following loss.
Eprouvé par la mort de son épouse après 50 ans de vie commune, Jean Proulx offre ici une magnifique réflexion sur le deuil. Dans cette tristesse qu’il appelle sa "joie à l’envers", il cherche des percées de lumière pour transcender l’obscurité de la perte. La souffrance accueillie le guide alors vers sa vérité intérieure. Il découvre peu à peu que l’acceptation de l’inéluctable est créatrice. Il sent que son deuil porte en lui sa force de guérison. Enfin, au souvenir de la fin de vie de sa femme, il comprend que les êtres aimés disparus peuvent être nos maîtres et nous réapprendre à vivre. Sous la plume de l’auteur, le deuil, si douloureux soit-il, devient une traversée vers l’essentiel. Une méditation à lire lentement pour retrouver, au sein de la détresse, la paix du cœur.
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