grief & culture. our journey today defining grief consideration of culture the barrier is not...
TRANSCRIPT
Grief & Culture
Our Journey Today
Defining Grief
Consideration of Culture
The Barrier is Not Culture
Communication & Preparation
Walk Beside the Family
Cultural Assessment Questions
Defining Grief
“Grieving is a necessary passage and a difficult
transition to finally letting go of sorrow - it is
not a permanent rest stop.”
(Dodinsky)
What is Grief?
Comes from the Latin word “gravis” meaning “heavy”
The process of experiencing the psychological, behavioral, social, and physical response to the perception of loss (Rando, 2000)
Grief
Is a natural reaction to loss
Is a healthy emotional response for dealing with loss
Acknowledges, honors & expresses feelings connected to loss
Grief can occur in response to loss of anything one values or is attached to
Grief is also…
Complex and individualized phenomenon
Each individual and family grieve in their own way
Strongly influenced by culture, experiences and role models
Considerationof Culture
Culture is…
Shared values, traditions, norms, customs,
teachings, arts, history, folklore, and institutions of a group of people.
Consider culture because it…
Helps us to understand the values, attitudes and behaviors of others
Helps us to avoid stereotypes and biases that undermine our efforts
Plays critical role in development and delivery of services responsive to needs of recipient
Our Challenge
How do you as professionals work with patients and
families who are from diverse cultures and who may have perspectives different from
your own?
The Barrier Is Not Culture – It Is Us
The Personal
We have our own…Values, attitudes and behaviors
Life experiencesLevel of stressStereotypes and biases
Personal Introspection
Need for understanding culture and how it relates to our approach to service delivery
Need to possess warmth, empathy & genuineness
Need for respect and compassion for those different than one’s self
Beliefs
Develop awareness of our own beliefs
Recognize people from other cultures may not share these same beliefs
Challenge assumptions you may have of a person’s cultural beliefs and customs
Helps families express their thoughts and feelings
Facilitates exploration of alternatives
Provides information to make informed choices
Recognizes factors affecting people’s ability to choose among viable alternatives
The Professional
Plays critical role in development & delivery of services responsive to needs of families
Influences… How we listen What we hear How we process information How we make decisions How we carry them out
The Intersection…
What are some of the values, beliefs,
attitudes, behaviors, life experiences, levels of
stress, stereotypes and biases I feel and bring
to the work with families?
Ask Yourself …
Communication & Preparation
Cultural Dialoguing
Inquire
Integrate multiple perspectives
Uncover & examine assumptions
Unfold shared meaning
Ask Yourself…
When talking with someone who has a different opinion than me, I tend to:
Discuss (debate) Dialogue
Guidelines
Avoid ethnocentrism
Suspend judgments
Make no assumptions
Listen towards understanding
Listen to needs, views & concerns
Inquire out of genuine curiosity
Reflect
Walk Beside the Family
Do Not Assume
Do not assume a person who belongs to a particular cultural group follows the culture’s usual practices and beliefs. Always ask about the individual’s
beliefs,practices, and preferences.
Language
Be aware of need for interpreter
If family speaks English but it is their second language, then ask if they would like an interpreter
Use an interpreter so family member does not need to interpret Could prove embarrassing
or upsetting to translate Culture may impact
translation
ListenListen, listen, listenDo not always need to say
something Allow for silencesListen in nonjudgmental and
accepting mannerDo not offer solutions or try to
“fix” person’s feelingsAsk open-ended questionsAttend to nonverbal
communication
Communicate
If family talk about loss, do not avoid or change subject
Accept you cannot take away the family’s pain; they need to work through it & this takes time
Provide reassurance and affirm the normalcy of their grief reactions
Honor Feelings
Be open to the family’s emotions & thoughts
Do not use phrases such as “I know exactly how you feel” or “I can imagine how you are feeling; instead, “I cannot begin to imagine how you are feeling”
Honor Word Choice
Use of different phrases: pay attention and use
Cross the river
Walk on
Passing to other side
Going to the spirit world
Touch
Ask before touching (i.e., holding a hand or giving a hug) as touch may not be
appropriate in some cultures.
Eye Contact
Pay attention to and honor the type of eye contact that
the family uses.
Cultural Assessment Questions
(Adapted from Lum & Arnold, 2009)
Beginning the Discussion
“In regard to organ donation, are there any special customsor beliefs that I should know
about as we begin talking together?”
Who Should be Involved?
Would you like me to speak with you alone or you and your family?
Decision-Making
Communal or Individualistic? Do you prefer to make
medical decisions or would you prefer that others in your family or community make them for or with you?
Practices and/or Restrictions
Are there aspects of medical care that you wish to forgo or have withheld because of your cultural beliefs?
Is anything discouraged or forbidden?
Practices and/or Restrictions
Are there specific practices or restrictions that are important to honor at the time of death or afterwards?
Unique Cultural Values
What concerns do you have about organ donation?
Are there things that are important to you or your family that I should know about?
Unique Cultural Values
Is there anything that would be helpful for me to know about how you and your family view organ donation?
Are there cultural beliefs, practices, or preferences that I should be aware of?
Dedication
This work is dedicated to the terminally ill elders who sacrificed precious hours of their remaining
days to share their dying experiences and to teach me about dying.
After all...how can we, the living, teach others about dying? We
cannot. The dying are our teachers and we the pupils.
I am deeply grateful to have been their pupil.
