Medical assistance in dying (MAiD) legislation was passed in Canada in 2016, yet the bereavement experience of family and friends is not well understood. Using interpretive description, we interviewed nine bereaved individuals. The time before the assisted death seems most impactful-an experience of bringing death to life shapes bereavement after death. We identified themes that inform this grieving: (1) certainty of date/time of deathintensifies a parade of lasts, initiates a countdown and affords time to say goodbye ; (2) active family engagement as planners supports sense-making; and (3) enacting MAiD as ceremony slows time to "digest" loss.

This study examined activities related to the provision of psychosocial care by counsellors in the hospice/palliative care setting. A qualitative design using written reports was used in an urban Canadian hospice/palliative care program. A convenient sample of 13 counsellors indicated the activities they typically performed in their work with patients and families. Thematic analysis of the activities directly related to patient and family care was performed and then validated by presenting these activities back to the counsellors in a group setting. Seven themes resulted: 1) companioning; 2) psychosocial assessment, planning, and evaluation; 3) counselling interventions; 4) facilitation and advocacy; 5) patient and family education; 6) consultation and reporting; and 7) team support. These thematic findings confirmed those of previous studies and also highlighted two additional findings. Team support was seen as an activity that directly affected client care, and there was a strong emphasis on the activity of companioning the dying and their families. Also discussed are implications of these results, as well as suggestions for further research. Resume I Cette etude se penche sur les taches de travail des conseillers dispensant des services dans Ie cadre d'un programme de soins palliatifs dans un nopltal urbain au Canada. Ainsi, on a fait une etude de nature qualitative en utilisant les rapports ecrits comme mode de cueillette de donnees. Treize conseillers ont ete choisis et on leur a demande de repondre par ecrit adeux questions ouvertes, I'une portant sur les taches specifiquernent liees aux soins aux malades et, a leur famille et I'autre se rapportant plutot au travail. A partir des reponses, l'equlpe de recherche a fait I'analyse thematique des taches reliees aux soins des malades et leur famille et a de nouveau reuni Ie groupe de conseillers afin de leur presenter les resultats et les faire valider. Les conseillers ont regroupe ces taches selon sept themes principaux soient : 1) la presence physique; 2) l'evaluation psychosociale et la planification des interventions; 3) Ie conseil et les interventions; 4) la mediation et la representation; 5) l'education des patients et leur famille; 6) la consultation et les rapports; 7) Ie soutien dans l'equipe de soins. Ces conclusions, quant aux themes retenus, confirment les resultats d'etudes anterieures mais tout en attirant I'attention sur deux nouvelles thernatiques. Le soutien dans l'equipe a ete retenu comme I'un des themes ayant un impact sur les soins aux malades et on accordait beaucoup d'importance a un autre theme soit la presence physique aupres des mourants et leur famille. L'article se termine par une discussion sur les consequences de ces resultats et offre des suggestions pour de futures recherches.

Complicated grief (CG) is one of the central themes in bereavement research and advanced clinical practice today. Using a mixed-methods approach, we wanted to learn (a) what tools Canadian practitioners used to identify or diagnose CG and (b) what interventions or strategies they used to address CG. Sixty-three professionals responded to our survey. There were no straightforward answers to these questions: the stateof-the art of CG in Canada is, in fact, complicated. Practitioners used a wide assortment of tools and strategies with no consensus on any one approach or tool. Building a Canadian CG community of practice was recommended.