Anticipatory mourning: processes of expected loss in palliative care

Abstract

This qualitative study explored the retrospective perceptions of the anticipatory mourning experience of caregivers who had not received hospice services. Data revealed five major processes that were consistently described by informants: realization; caretaking; presence; finding meaning; and transitioning. Characteristics of each of these processes are described. Study informants provided information about what was helpful to them. The implications for health care providers include: an awareness of changed family roles and relationship attachments that can cause strain on family systems; familiarity with the complex demands on caregivers and their need for accurate information, anticipatory guidance and support resources; professional expertise especially in regard to education about what to expect; a caring presence; and pain and symptom management.

The impact of the Bealtaine arts programme on the quality of life, wellbeing and social interaction of older people in Ireland

“…Current models fail to reflect this dynamic (13,15). Furthermore, older people have to come to terms with many kinds of loss within long-stay care, and bereavement is a constant feature of life in such settings (18,19). Therefore, it is not realistic to view the end-of-life experience as neatly confined to a defined period during which palliative care services can be mobilized and administered (9,20).…”

“…There are also situations in which older people require an increased level of support and care for reasons that are not life-threatening -for example, as changes in cognitive function lead to behavioural disturbances and a need for input from mental health specialists. In the bereavement zone, anticipated losses and feelings of grief may be experienced by an older person, family members, and staff (19), especially since the reality of his or her mortality has become more apparent in the dying and death zone. In the bereavement zone, it is also acknowledged that staff, as well as family members and peers, will be bereaved.…”

An Emerging Concept: Peaceful Letting Go

“…The meaning of self-preservation is maintaining the status quo, prolonging the inevitable while interconnecting with others to form new life meanings (Kars et al, 2011;Kruse, 2004;Wiegand, 2008). Acceptance is the turning point or a transition where the individual comes to terms with the impending loss and is ready to relinquish control of the situation (Clukey, 2008;Kruse, 2004;Tilden et al, 1999, p.432). Finally, peaceful letting go is defined as acceptance grounded in self-awareness that steadies uncertainty and promotes self-preservation.…”

“Enough Already!”: Caregiving and Disaster Preparedness—Two Faces of Anticipatory Loss

“…There is also an enormous body of literature on family caregiving across the life course (Lefley, 1997). In recent years, this body of literature has been augmented by a smaller number of studies focusing on the anticipatory losses involved in caring for family members with terminal illness (Clukey, 2003;Rolland, 1997). There is also an impressive literature on psychosocial costs and benefits in the aftermath of natural disasters (Fivush, Sales, Goldberg, Bahrick, & Parker, 2004;McMillen, Smith & Fisher, 1997;Ironson et al, 1997;Neimeyer, 2002;Pinar & Sabuncu, 2004).…”

“…Loretta Clukey (2003), in a qualitative study of caregivers who were expecting the loss of a loved one, found that the experience involves a complex mix of emotions including ''sadness, anger, feeling overwhelmed, tired, trapped, guilty, frustrated and relieved'' (p. 3467). I too have felt battered by a barrage of these emotions over the years of our caregiving.…”