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A social care policy and framework that takes account of the many aspects of bereavement and loss in client’s lives.

A social care policy and framework that takes account of the many aspects of bereavement and loss in client’s lives.

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An essay for the 2011 Undergraduate Awards (Ireland) Competition by Jenny Kinsella. Originally submitted for Applied Social Studies at Institute of Technology Carlow, with lecturer Sheelagh Collier in the category of Social Studies
An essay for the 2011 Undergraduate Awards (Ireland) Competition by Jenny Kinsella. Originally submitted for Applied Social Studies at Institute of Technology Carlow, with lecturer Sheelagh Collier in the category of Social Studies

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Published by: Undergraduate Awards on Aug 31, 2012
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05/13/2014

 
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In order to understand the many aspects of loss and bereavement it is necessary to explore thecomplexities of this topic, in order to develop a theoretical framework and form a knowledgebase to work with clients from. There are three main aspects to loss through death; grief,mourning and bereavement.Grief, according to Worden (2001), is the experience of losing someone through death, or any
loss that is incurred in one’s life. Farberow (2009) expands on the definition of grief to state,
that it is the emotional reaction to a loss which features distressing reactions physically,psychologically, socially and behaviourally. Faberow goes on to say that grief work is theprocess which a bereaved person goes through, this consists of reflections of the deceasedperson and their death and works towards acceptance of a new life without the deceasedperson.
Mourning encompasses the process of adapting to the loss within the person’s life. Faberow
(2009) states mourning styles depend on the culture or social group the bereaved personbelongs to. Mourning is an expression of rituals within this culture, for example the Catholicburial and wake.Bereavement considers the actual loss the person must adapt to. Loss is defined as no longerhaving something that you once possessed or were attached to (Martin and Doka, 2000: 12).Loss in itself can apply to many things, Martin and Doka (2000) explain there are three mainareas that can be applied to understanding loss in its entirety; physical loss, in whichsomething or someone is no longer physically present.Relational loss, which refers to the loss of a relationship in which there was an attachment.This can occur through death, a relationship break up, or any form of breaking the attachmentbond. Lastly, there is symbolic loss, which Martin and Doka (2000: 12) describe as;
“...the loss of a psychological or spiritual attachment such as the loss of one’s dreams, hopesor faith.”
 This can occur with someone who has been diagnosed with a terminal illness for example.This person may experience anticipatory grief, through which they grieve the loss of all of theabove three facets of loss. This is due to the expectation of what will happen to themthroughout the illness and the inevitable death.
 
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Rando (1993) contends that loss can be physical, psychosocial or even competency based.Secondary loss is another factor that must be considered, these are losses that occur as aresult of the main loss, such as social network, money, faith or self 
 – 
esteem, unmet needsand the loss of a future. These losses are highlighted when the dependencies within arelationship are discovered when one person is no longer there.Rando (1993) would state that all aspects of life have some degree of loss, even happy eventssuch as weddings, changing job, moving house, children growing up and the aging process.Rando goes on to state that the intensity of these losses will vary from person to person andthat the social support network they have in place acts as a buffer to the sense of loss.
Theories of Grief 
 
Faberow (2009) contends that the purpose of theories of grief are to create an understanding
of the traits of grief, such as, the effect grief has on a person’s physical and mental health and
to prevent the onset of complicated grief. Complicated grief is a deviance of normal grief and it includes aspects such as prolonged or acute grieving or a delay in the onset of grief.There are two main schools of thought within grief theories. Models of grief from thepsychoanalytic and attachment paradigm and models of stress and trauma theories.Psychoanalytic and attachment models of grief focus on the emotional reactions to a loss andtry to explain the psychological elements which exist in the behaviours that are displayed bygrieving people.The stress and trauma paradigm explores grieving symptoms from a physical approach. It
considers the detrimental effect to a person’s physical health caused by stress and trauma
experiences during the mourning process. Faberow (2009) explains that this paradigm alsoconsiders other traumatic events such as illness, relationship breakdown and unemploymentfor example.
Psychoanalytic and Attachment Paradigm
From the psychoanalytic perspective Rando’s
(1993) theory can be expanded to explain thatshe considers that there are six stages people go through whilst they are grieving. They arerecognition of the loss, emotional reaction to the loss, recollection and re-experience of thememories of the deceased person, relinquishing their past world and the beginning of anacceptance that they can not change things. The last two stages are a readjustment to their
 
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new world and finally the ability to re-invest in new relationships and to move on with theirlife.In support of the above approach Elizabeth Kubler
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Ross (1989) devised a model of whichencompasses five stages of grief. These stages are also known as the grief cycle. The stagesare denial, anger, bargaining, depression and acceptance.Kubler
 – 
Ross states that not everyone will experience all of the stages and they are notlinear. She goes on to express that the stages are not a process, but a framework, as eachindividual experiences grief differently. This has been a major criticism of this model, as itwas considered that all stages must occur in order according to Worden (2001).The model can be applied to the stages experienced by people who have been diagnosed witha terminal illness. For example the may use denial as a defence mechanism at the start andthen become angry at the prognosis. There may be a bargaining stage in which the personwill promise certain things if they can live for some reason for example to see an event such
as a child’s wedding. The person may become depressed due to feelings of fear and sadness.
This is the start of an acceptance of the situation. Finally there is acceptance of the inevitableoutcome.Kubler
 – 
Ross (1989) states that this model can also be applied to traumatic events in a
 person’s life such as illness or losing a job and it is not confined to death. This makes it a
use
ful psychological stage theory from which to examine people’s reactions to trauma.
Both of these models could be used by a social care worker to observe the reactions of 
client’s if they have been bereaved or have experienced a trauma or a major life eve
nt. Thesestage theories add to the knowledge base a social care worker has, to identify what ishappening with their client and how they can work with them to create the best outcome.With regards to mourning and grief Martin and Doka (2000: 14) expand on these concepts by
stating that grief and the grieving process is psychic energy that comes from a person’s desire
to retain the world they belonged to before the loss. The person experiences tension fromdoing this and from trying to adjust to their new world without the person he or she has lostand the reality that they will not return. This tension creates the psychic energy that ismourning.

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