Bereavement care

In developed countries, the majority of deaths now occur in those aged 65 years or older who are either in a residential, hospital or community setting, where care is primarily provided by nurses. Nurses are pivotal in the provision of palliative care to older people dying. The philosophy of palliative care acknowledges bereavement support as an equally important component of the care provided to those dying and their family (Maddocks, 2003). Therefore, when implementing palliation, nurses seek to identify those who are grieving and to manage the impact of this experience through implementation of supportive interventions both at an individual and organisational level. Through the experience of caring for older people dying, nurses witness pain, suffering and loss as part of their normal everyday practice. In this chapter, the concept of bereavement is described in the context of all those who may be bereaved: the person dying, other residents, family members, nurses and the organisation as a whole. It is the intention of this chapter to illustrate that being bereaved as a consequence of experiencing loss is a normal process, and one which should be promoted as a healthy response in all people affected by the loss of the older person resulting from death. The purpose of this chapter is to assist you to understand what this means for you, other staff, the families and other older people you will need to support. It is important that you gain a deeper understanding of bereavement so you can recognise bereavement as a healthy outcome and promote this perspective in the workplace. The chapter will initially explore the concept of bereavement and differentiate between the terms associated with death and dying - that is, loss, grief and mourning - as well as consider their relationship to bereavement. The chapter will then discuss the principles of bereavement and apply these to nurses' everyday practice. It will conclude by examining the care interventions that need to be implemented to support other staff, families, other older people and yourself to engage in healthy bereavement and to reduce the likelihood of complicated grief developing