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Dying and grieving in the 21st century: Exploring the challenges to professional carers. 4th November 2008 Linda Machin PhD. What shapes our understanding of dying and grieving?. Context Concepts Care. The Context of Grief - a changing landscape.

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dying and grieving in the 21st century exploring the challenges to professional carers

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

4th November 2008

Linda Machin PhD

the context of grief a changing landscape
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
the emotional expression of grief
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
changing social patterns
Changing social patterns
  • Social mobility
  • A move in emphasis from community to the individual
  • Ethnic and religious diversity
  • Changing values - growing secularism
new possibilities and ethical challenges around life and death issues
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
contemporary concepts on the nature of grief
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’
the dual process model of grief a challenge to the classic concept of grief work
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

continuing bonds a challenge to the concept of letting go and moving on
‘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
the concept of resilience a challenge to the primary focus on risk
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.
care a process of giving and receiving
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
who needs care
Who needs care?
  • Assessing risk
  • Appraising resilience
what kind of care transforming risk into resilience
What kind of care? Transforming risk into resilience

Confronting Appraising the negative the positive

balancing the competing

elements of grief

accessing support

the cost to the carer
The cost to the carer

Competence

sensitivity

availability burn out

compassion fatigue

renewal

self-knowledge

self-care

support

policy and research issues the challenge
Policy and research issues - the challenge
  • Practitioners as policy and research followers
  • Practitioners as policy and research leaders
the challenge to the cared for and their carers
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

conference aim
Conference aim:

To explore and debate the complexities of loss, grief and bereavement in the 21st century

conceptual challenges
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)

holding the contradictions in balance
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.
conference aim20
Conference aim:

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

care challenges
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.
some closing thoughts from a dying man
Some closing thoughts - from a dying man

Handle me with care,the wrapper’s 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. Can’t you feel the passion left within me?

slide23
Share it (the passion within me), undo the

string, slowly please, (I’m so slow now).

Undo the hurt (I hurt now), the guilt (aren’t

you guilty too?), the hate (as I hate what’s

happening now). Undo the love, and let it go,

my gift to you. John Smith