HSC384 Grief and loss

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<ol><li> 1. Course Author: Malcolm Woods (Masters in Social Work) Facilitators: Astell Evans &amp; Jennifer Roy. Haringey Male Foster Carers Support Group (17th March 2016) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) www.emptlondon.com 1 Grief is the price we pay for love (John Bowlby) </li><li> 2. Transitions Some children may have to face very particular and personal transitions not necessarily shared or understood by all their peers. These include: family illness or the death of a close relative; divorce and family break-up; issues related to sexuality; adoption; the process of asylum; disability; parental mental health; and the consequences of crime. All looked after children and young people will experience loss, separation and varying degrees of trauma when they come into foster care. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) www.emptlondon.com 2 </li><li> 3. Exercise one (1) How many different kinds of loss can you think of? (2) Do these have anything in common? (3) What was the first loss you can remember? (4) (4) How did this loss impact on your life? Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 3 </li><li> 4. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 4 Learning Outcomes To discuss how: You seek and access information and support to help you understand, deal and cope with the likely consequences of the individuals being told about bereavement You take action to ensure that individuals are in an appropriate place which allows them privacy when they first hear about bereavement You seek and access additional support for individuals where you are unable to provide appropriate support </li><li> 5. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 5 Learning objectives (2) To discuss how: You work with individuals to enable you to understand their thoughts, feelings and distress and to help them through the bereavement and mourning You allow individuals private time to adjust to the bereavement, taking account of any risks to the individual You observe changes to individuals that are not normally found with bereavement and mourning, and that may give cause for concern You seek additional support for yourself and individuals where you are unable to respond to the individuals needs You work with the individuals, key people and others to identify whether the individuals need additional or specialist support and who will take responsibility for doing this </li><li> 6. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 6 Learning objective (3) To discuss how: You work in ways that are sensitive to the individuals distress, grief and mourning You support individuals to: A communicate and explore their experiences of bereavement and mourning, taking into account their preferences and beliefs B understand any changes that might have to be made because of bereavement C identify their needs and preferences regarding their options for change due to loss and bereavement D deal with any changes positively, encouraging them to recognise and focus on their strengths and building towards the future E access additional and specialist support when this is needed </li><li> 7. TSDS Standard 5 1 a: Understand the basic principles of how children and young people of all ages form attachments, how these attachments affect their development, and the impact of interrupted development, trauma, separation and loss Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) www.emptlondon.com 7 </li><li> 8. TSDS Standard 5 2.a: Understand how Foster carer can help children and young people develop resilience and self-esteem. 3.b: Understand how to support individual children and young people through significant life changes and challenges Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 8 </li><li> 9. TSDS Standards 5.6.c: Understand the impact of abuse, separation and loss on the behaviour of children and young people 7.1 b: Understand how being a foster carer may affect you personally and where you can get support Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) www.emptlondon.com 9 </li><li> 10. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 10 At management level, you may want to consider the following areas Design and implement a service which addresses the needs of individuals experiencing significant life events Ensure the service responds effectively to individuals experiencing major life changes or losses Develop and support practice which acknowledges and helps children and young people to address losses, dilemmas and conflicts they are, and have been faced with </li><li> 11. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 11 ATTACHMENT An attachment is an emotional bond with another person. It is important that everyone involved in working with adults and children has a basic understanding of attachment theory. Working with issues of attachment and separation are at the heart of the work done by foster carers and other social care professionals. </li><li> 12. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 12 Vera Fahlberg, an American psychiatrist, whose work on attachment, separation and loss has greatly influenced child care practice in the UK, says that healthy attachments are the foundation for healthy physical and emotional development as well as the ability to learn </li><li> 13. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 13 She says: When children have a strong attachment to a parent, it allows them to develop trust for others and self reliance. These earliest relationships influence both physical and intellectual development as well as forming the foundation for psychological development. The childs earliest attachments become the prototype for subsequent interpersonal relationships </li><li> 14. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 14 Exercise 1 Think of someone that you are significantly attached to: (1) What makes that attachment special for you and for them? (2) What benefits have there been to you from knowing that person as well as their benefits? (3) What would be the impact on your life if you no longer had that person around or you become deceased? </li><li> 15. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) www.emptlondon.com 15 Anticipatory Grief Anticipation can be an exciting thing e.g. anticipating a holiday that we have been looking forward to for some time. But anticipation also magnifies the possibility of reality of a loss. Knowing that we and all our loved ones will die one day creates anxiety. We see this early on in life. This is the beginning of our anticipatory grief, the pain we will one day experience. </li><li> 16. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 16 A deeper anticipatory grief occurs when someone we love or we ourselves have a terminal illness. Anticipatory grief is the beginning of the end in our minds. We now operate in two worlds. The safe one that we are used to and the unsafe one in which a loved one might die. </li><li> 17. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 17 Anticipating a loss is an important part of experiencing that loss. We often think of it as part of the process our loved ones go through as they face their own death themselves. Yet for those who will survive the loss of a loved one it is the beginning of the grieving process. </li><li> 18. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 18 Forewarned is not always forearmed. Experiencing anticipatory grief may not make the grieving process shorter or easier and we may also experience the limbo of loss in anticipatory grief when our loved one is not getting better and not dying yet but in a state of poor health with little quality of life. </li><li> 19. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 19 Elizabeth Kubler-Ross a worldwide leading authority on grief and loss, identified five stages of grief. Not everyone will go through all of them or in a set order but can be useful tools for helping us to frame and identify what we may be feeling </li><li> 20. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) www.emptlondon.com 20 1. DENIAL In a person who is dying, denial may look like disbelief. They may be going about life and actually denying that their illness exists. For a person who has lost a loved one this doesnt mean that literally you dont know that your loved one has died. It means you come home and cant believe they arent going to walk in any minute. It is not denial of the death its more like This is too much for me to take in at the moment. </li><li> 21. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 21 This first stage of grieving helps us to survive the loss. As we try to just get through each day, a common reaction after someone has just died, we are protecting ourselves by only letting in as much as we can handle. Letting in all the feelings associated with a loss at once would be overwhelming emotionally. We cant believe what has happened because to fully believe it at this stage would be too much. </li><li> 22. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) www.emptlondon.com 22 2. ANGER This can take many forms anger at your loved one for leaving you behind, angry that you couldnt prevent them from dying, angry at doctors for not making them well again, angry that you and your loved one didnt have more time together etc. </li><li> 23. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 23 Anger comes along when you are feeling safe enough to know that you will probably survive whatever comes. It often appears at the same time as other feelings such as sadness, panic, hurt and loneliness. </li><li> 24. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 24 Anger is a necessary stage of the healing process. There are many other emotions underneath the anger and we have to be able to first let ourselves experience the anger if we are to tackle those underlying feelings eventually. </li><li> 25. Letting in anger Letting in the anger first allows us to go deeper about other feelings later. At first grief can make you feel lost like you have no connection to anything. Then you get angry at someone- e.g. a person who didnt attend the funeral and suddenly you have a structure, your anger towards them. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 25 </li><li> 26. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 26 Anger means you are progressing, that you are allowing all those feelings that were too much before to come to the surface. You may also experience feelings of guilt, which is anger turned in on yourself. Anger affirms that you can feel, that you did love, that you have lost. </li><li> 27. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 27 3. BARGAINING Before a loss you will probably do anything if only our loved one would be spared e.g. Please God, Ill never be angry at my husband again if only you let him live. </li><li> 28. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 28 We become lost in a maze of If only or What if, guilt often accompanies bargaining. The If onlys cause us to find fault with ourselves and what we think we could have done differently. We even bargain with the pain well do anything not to feel the pain of this loss. </li><li> 29. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 29 Bargaining is about our need to have life returned to what it was before our loved one became ill or died. We want them restored to life. We want to go back in time its the If only that accident hadnt happened or If only they hadnt got ill. </li><li> 30. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 30 4. DEPRESSION Usually comes along after bargaining is over. Our attention moves into the present and we feel a sense of emptiness and grief, deeper than we imagined. It feels as if it will last forever. </li><li> 31. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 31 Its important to remember that this depression is not a sign of mental illness. It is an appropriate response to a great loss. Many people see it, however, as an unnatural state, something to be fixed or to snap out of. This overlooks the fact that to not feel depression after a loved one dies would be unusual. </li><li> 32. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 32 A bereaved person should allow themselves to feel depression. Elizabeth Kubler- Ross says it will leave as soon as it has served its purpose in your loss. It can be helpful in grief by allowing us to take stock of our loss. It makes us rebuild ourselves from the ground up. </li><li> 33. Course Author: Malcolm Woods (Masters in Social Work) Slides design and TSDS reference links by: Astell Evans (2008, updated 2016) 33 5. A...</li></ol>