Death and Dying in Families: Supporting Bereaved Family Members
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1 Death and Dying in Families: Supporting Bereaved Family Members Ian Scott, MSW, RSW Psychosocial Oncology Clinician CCMB MacCharles
2 Presenter Disclosure Speaker: Ian Scott Relationships with commercial interests: None.
3 Mitigating Potential Bias Not applicable
4 Learning Objectives: Generate ideas for supporting family members who experience the death of someone close to them Summarize the tenets of supporting bereaved family members Describe some of the unique challenges facing a bereaved family, including conflict, anticipatory grieving and support for children
5 Quiz! 1. It s essential to know the specific grief rituals of different cultural groups. True / False 2. Anticipatory grieving is an opportunity to explore the meaning of the relationship. True/False 3. It is ok to ask children what they miss and don t miss about a person. True/False
6 General Observations About Grief There is no right or wrong way to grieve Grief has no set timetable Grieving often involves extreme thoughts and rollercoaster emotions can affect our whole self Grief can be affected by a number of factors Grieving requires support, empathy and validation from others
7 Ideas for Supporting Bereaved Family Members The 101 : Opening ourselves to the presence of grief Acknowledging uniqueness of grief Accessing the feelings related to grief Affirming the decision to seek support
8 Ideas for Supporting Bereaved Family Members Some finer details to explore with families: - The final moments - Role changes - Post-death logistics (planning, finances, etc.) - Cultural traditions curiosity and respect - Anniversaries and holidays
9 Ideas for Supporting Bereaved Family Members For the Health Care Provider: Meet family members individually or as a group Ask open-ended Qs: What has this experience been like for you and your family? Validate the unknown timeline: Grieving can be different for everyone, what has it been like for you? Activities include letter writing, journaling, memorializing Language be careful with normal, loved one, clichés Can be single or multiple sessions
10 Conflict in the Family
11 Conflict in the Family Frequently encountered in psychosocial oncology Communication breakdowns Different ways of handling grief -talk, cry, rage or silence Intra-family conflict and family/friend tension Comforting in, dumping out Many people have mixed feelings ambivalence
12 Conflict in the Family Careful with the concept of forgiveness Take inventory of entire relationship Relationships are not simplistic or perfect! These discussions can feel unsanctioned or immoral our job is to make space for these discussions to occur
13 Anticipatory Grieving Becoming a single parent, role changes, etc. Family members grieve at their own pace and willingness to talk about mortality varies An opportunity to explore: - Meaning of the relationship - What someone wants to say before a death - Spiritual concerns - Advanced care planning
14 Support for Children Andrea Warnick Cause, Catch, Cure and Care (Adults often have the same concerns!) Young people are not elevators Opportunities to talk, be involved and a way to remember the person who died Opportunities for play and recreation Someone to listen to their fears, fantasies and questions In terms of conflict, ask what they miss and don t miss about the person validate mixed feelings
15 Case Study #1 Hillary Dad died from lung cancer Mom experiences anger Hillary grieves with tears Hilary describes mom s trauma from residential school legacy Hilary s partner not wanting to be around Hillary when she is crying Was absent in final moments Planning and paying for funeral planning for them to die Social media photos of ceremony
16 Case Study # 2 Ken and Thomas Anticipatory Ken Stage III NSCLC receiving RT and Chemotherapy Ken considers diagnosis to be a positive development strengthened his faith and resolve to cope with cancer Son Thomas asks Doesn t he know that cancer can be fatal? Thomas anticipating a potential loss but feels unable to address it with his dad
17 Case Study #3 Mona Husband Theo diagnosed with metastatic renal CA 2 young children ages 3 and 6 Anticipatory becoming a single parent Discussed how to talk about the illness with the children Building a bridge between dad and the kids Blurring of roles: Partner/Caregiver
18 Quiz! 1. It s essential to know the specific grief rituals of different cultural groups. True / False 2. Anticipatory grieving is an opportunity to explore the meaning of the relationship True / False 3. It is ok to ask children what they miss and don t miss about a person. True/ False
19 Take Home Message Remember the 101 : - Opening ourselves to the presence of grief - Acknowledging uniqueness of grief - Accessing the feelings related to grief - Affirming the decision to seek support Trust yourself there is no script Are we taking care of our own stuff?
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