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Dying and grieving in the 21st century: Exploring the challenges to professional carers

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Dying and grieving in the 21st century: Exploring the challenges to professional carers 4th November 2008 ... Context Concepts Care The Context of Grief ... – PowerPoint PPT presentation

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Title: Dying and grieving in the 21st century: Exploring the challenges to professional carers


1
Dying and grieving in the 21st century Exploring
the challenges to professional carers
  • 4th November 2008
  • Linda Machin PhD

2
What shapes our understanding of dying and
grieving?
  • Context
  • Concepts
  • Care

3
The Context of Grief - a changing landscape
  • Changing perspectives on the expression of
    emotions
  • Changing social patterns
  • New possibilities and ethical challenges around
    life and death issues

4
The emotional expression of grief
  • Two great wars and the national need to take
    pride in heroism and not grieve the dead - the
    stiff upper lip
  • The rise and influence of psychotherapeutic
    theories as acknowledgement of grief and as a
    guide to freer emotional expression

5
Changing social patterns
  • Social mobility
  • A move in emphasis from community to the
    individual
  • Ethnic and religious diversity
  • Changing values - growing secularism

6
New possibilities and ethical challenges around
life and death issues
  • Creating life - IVF, selecting embryos, cloning
    etc
  • Extending life -transplant surgery, life- support
    machines etc
  • Ending life - abortion, switching off
    life-support machines, euthanasia etc

7
Contemporary Concepts on the nature of grief
  • The concept of the Dual Process model of grief
  • The concept of Continuing Bonds
  • The concept of resilience

8
The Dual Process model of grief - a challenge
to the classic concept of grief work
Restoration orientation
Loss orientation
Grief work
Attending to life changes
oscillation
9
Continuing Bonds- a challenge to the concept of
letting go and moving on
  • Role model
  • Help with decision making
  • Value clarification
  • A place in memory

10
The concept of Resilience - a challenge to the
primary focus on risk
  • Personal resourcefulness -
    flexibility, courage, perseverance etc.
  • A positive life perspective -

    hope,
    optimism, a capacity to make sense of experience,
    motivation in setting goals etc.
  • Social embeddedness -

    availability of support and the capacity to
    access it.

11
Care - a process of giving and receiving
  • Who needs care?
  • What kind of care? -transforming risk into
    resilience
  • The cost to the carer
  • Policy and research

12
Who needs care?
  • Assessing risk
  • Appraising resilience

13
What kind of care? Transforming risk into
resilience
  • Confronting
    Appraising the negative
    the positive
  • balancing the
    competing

  • elements of grief
  • accessing support

14
The cost to the carer
  • Competence
  • sensitivity
  • availability
    burn out

  • compassion fatigue
  • renewal
  • self-knowledge
  • self-care
  • support

15
Policy and research issues - the challenge
  • Practitioners as policy and research followers
  • Practitioners as policy and research leaders

16
The challenge - to the cared for and their carers
  • To suffering must be added mourning,
    understanding, patience, love, openness and the
    willingness to remain vulnerable.
  • Anne Morrow Lindbergh

17
Conference aim
  • To explore and debate the complexities of loss,
    grief and bereavement in the 21st century

18
Conceptual challenges
  • .two contradictory perspectives recur in
    psychology and the social sciences. One
    perspective holds that humans are basically the
    same. The other holds that there are enormous
    differences among people. (Rosenblatt 1993)

19
Holding the contradictions in balance
  • Using theory as a template for our general
    understanding.
  • applying our knowledge to the variability of
    individual response to loss.

20
Conference aim
  • To reflect on our roles as professional
    caregivers when supporting people who are dying
    and grieving.

21
Care challenges
  • To recognise the cultural, social, organisational
    and personal contexts in which care operates.
  • To continually update and appraise the state of
    conceptual knowledge about death, dying and
    bereavement.
  • To acquire and maintain practice skill and
    self-care as central to effective care giving.

22
Some closing thoughts - from a dying man
  • Handle me with care,the wrappers worn
  • and held by threadbare string, almost torn
  • apart gaping edges invite you to look with
  • curious eyes. Worthless, you might think,
  • so old, carelessly parcelled up. Just think
  • before you touch, think where I have been,
  • seen, spoken,listened,touched, hurt, born, and
  • felt. Cant you feel the passion left within me?

23
  • Share it (the passion within me), undo the
  • string, slowly please, (Im so slow now).
  • Undo the hurt (I hurt now), the guilt (arent
  • you guilty too?), the hate (as I hate whats
  • happening now). Undo the love, and let it go,
  • my gift to you. John
    Smith
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