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Observations Regarding Anticipated Grief


The Symptoms of Anticipatory Grief The Various Dimensions of Life According to the Hospice Foundation of America, grief affects us in various dimensions of life: ... – PowerPoint PPT presentation

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Title: Observations Regarding Anticipated Grief

Observations Regarding Anticipated Grief
  • Tom Saunders, M. Div, Chaplain
  • Please complete general and pre-session surveys
    before the presentation http//streaming.biocom.ar

Vida! Educational Series
Educational Objectives
  • Define anticipatory grief.
  • Explain at least two different phases of grief.
  • Be able to use two methods for dealing with
    anticipatory grief.

What is Anticipatory Grief?
Anticipatory grief is grief that is experienced
prior to a significant loss. One could say that
anticipatory grief can be a grief of preparation.
Preparation for the patient who has a terminal
illness and preparation for the family and other
persons in the life of the patient.
What is Anticipatory Grief?
This means that anticipatory grief can be a
reality for the patient, the family, caregivers,
friends and even the professionals who care for
the patient. Anyone emotionally associated with
the patient can also experience this type of
(No Transcript)
Definition of Terminal Illness
  • The fundamental elements of terminal
    illnesses are 1. The presence of an advanced,
     progressive and incurable illness 2. The lack of
    a reasonable response to specific treatment 3.
    The presence of numerous problems or intense
    symptoms that are multiple, multifactorial, and

(The Spanish Society of Palliative Care)
Definition of Terminal Illness cont.
  • The fundamental elements of terminal illnesses
    are 4. Large emotional impact on the patient,
    family, and treatment team related explicitly or
    not to with the presence of death 5. Prognosis of
    six months or less.

What is Anticipatory Grief
  • Psychiatrists Dr. Carmen Rosales Herrera and
    Dr. Mary Sol Olmeda explain that anticipatory
    grief, as a phenomenon of scientific study, began
    with soldiers during the second world war. More
    recent studies have included research regarding
    the parents of children with terminal illnesses.

Other Conditions and Illnesses
  • Although the focus of this presentation is
    about anticipatory grief experienced in the
    environment of hospice and palliative care, there
    are other conditions and illnesses that can be
    the cause of anticipatory grief.

The Symptoms of Anticipatory Grief
  • The symptoms of anticipatory grief can be the
    same symptoms one experiences with regular grief.

  • The Various Dimensions of Life
  • According to the Hospice Foundation of
    America, grief affects us in various dimensions
    of life
  • Physically
  • Emotionally
  • Spiritually

  • Emotional Symptoms of Grief
  • Stress
  • Depression
  • Sadness
  • Anger
  • Crying
  • Indecision or confusion
  • Temporary changes in personality

  • Spiritual Characteristics of
  • Anticipatory Grief
  • Questioning ones faith
  • Bargaining with God
  • Searching for miracles or other special religious
    beliefs to cure the illness

Spiritual Care of Patients and Families
  • In our spiritual care of patients and
    families, we never criticize the faith they
  • We can talk about the reality of the
    situation, but faith is an expression of hope,
    and we want to encourage hope in every individual.

(No Transcript)
  • Classic Phases or Stages of Grief
  • By Dr. Elizabeth Kubler Ross
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance
  • Hope

  • As the patient can pass through these phases
    during a terminal illness, the patients
    caregivers can also.

(No Transcript)
  • Its important to know that one may not
    experience these phases.
  • There is not a fixed sequence in passing through
    these phases.
  • One might experience some of all of these phases
    at various times during the course of
    anticipatory grief or regular grief.

  • It is said that this is a less dramatic grief
    because one has more time to put his or her
    feelings in order. Also it provides time to take
    care of issues like insurance, inheritances, and
    other paperwork. At times there is a sense of
    relief after the death of ones loved one when
    anticipatory grief has been experiences.
  • José María Romera

  • Anticipatory Grief can be a motivation for
    important conversations with the patient.
  • Dr. Ira Byock In his book The Four Things
  • That Matter Most talks of what we can be
  • saying to our loved ones during the course of
  • a terminal illness. Forgive
    me -- I forgive you Thank you
    I love you Good bye

Methods for Dealing with Anticipatory Grief
  • Support groups (self care/ caregiver groups)
  • Spiritual support from clergy/ pastoral counselor
  • Support from a religious community
  • Emotional support from a psychologist, social
    worker, or other professional
  • Exercise
  • Support from family and friends
  • Appropriate rest

  • The Work of Expressing Grief
  • Dr. Alan Wolfelt talks about the work of
    expressing grief. He and other experts in the
    area of grief speak of the needs to express grief
    in various ways that work for the individual.

  • The Work of Expressing Grief
  • Recognize anticipated grief
  • Journal your grief
  • Draw/ paint your grief (other art forms)
  • Pray your grief
  • Eulogize your loved one
  • Create ceremonies for the expression of
    anticipatory grief
  • Express your anticipated grief in your
  • own way

Case Studies
  • Patients
  • Caregivers
  • Family members

Conclusions Observations from Hospice
  • Anticipatory grief is common.
  • Anticipatory grief can open up other parallel
    grief one can recognize a constellation of
  • There is support to deal with the effects of
    anticipated grief, such as for regular grief
  • Anticipatory grief is a grief of preparation and
    can help us regarding future losses.

  • About.com. (2009, March 16). Anticipatory grief -
    explanation of anticipatory grief. About
    Palliative Care - Hospice and Palliative Care.
    Retrieved July 19, 2012, from http//dying.about.c
  • Ayudando en el duelo anticipado Calcetines del
    revés. (2012, March 24). Calcetines del revés
    Así estamos ahora, como calcetines dados la
    vuelta. Somos nosotros, pero no somos los mismos.
    Esta es nuestra lucha por encontrar una nueva
    manera de vivir sin los seres amados que nos
    faltan.. Retrieved July 19, 2012, from
  • Byock, I. (2004). The four things that matter
    most a book about living. New York Free Press.
  • Clínica Alemana de Santiago S.A. - Chile. (n.d.).
    Clínica Alemana de Santiago S.A. - Chile.
    Retrieved July 3, 2012, from http//www.alemana.cl

  • Etapas descritas por la Dra. E. Kubler Ross que
    pueden aplicarse al duels. (n.d.). Renacer.
    Retrieved July 18, 2012, from www.renacerbuenosair
  • Kramer, H., Kramer, K. (1993). Conversations at
    midnight coming to terms with dying and death.
    New York W. Morrow and Co..
  • Romera, J. M. (n.d.). El duelo anticipatorio.
    hoy.es. HOY Extremadura a diario con noticias y
    última hora del periódico y la edición digital.
    Retrieved July 4, 2012, from http//www.hoy.es/200
  • Herrera, C. R., Olmeda, M. S. (2001). El duelo
    anticipatorio. psiquiatria.com. Retrieved July 4,
    2012, from www.psiquiatria.com/bibliopsiquis/bitst

  • Hospice Foundation of America. " Comprendiendo el
    Duelo - YouTube ."YouTube - Broadcast Yourself. .
    N.p., n.d. Web. 13 July 2012. lthttp//www.youtube.
  • SECPAL / Guía CP/ Definición de enfermedad
    terminal características. (n.d.). SECPAL.
    Sociedad Española de Cuidados Paliativos..
    Retrieved July 19, 2012, from http//www.secpal.co
  • Stamateas, B. (n.d.). Duelo por la muerte de un
    familiar- Por Bernardo Stamateas en Canal 26 -
    YouTube . YouTube - Broadcast Yourself. .
    Retrieved July 19, 2012, from http//www.youtube.c
  • Wolfelt, A. (2007). Living in the shadow of the
    ghosts of grief step into the light. Fort
    Collins, CO Companion Press.

(No Transcript)
Educational Series
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    post-session surveys
  • after viewing the presentation
  • go to http//streaming.biocom.arizona.edu/event/?
  • Thank you!
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