Empathy Towards Bereaved Families - Grief Counselling.pptx

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Empathy Towards the Bereaved Families-Grief Counseling Dr. Sheila Daniel, Associate Professor, Psychiatric Social Work, Department of Psychiatry, St. John’s Medical College Hospital

GRIEF:

GRIEF Characterized by the physiological, psychological and behavioural responses to bereavement.

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GRIEF Anticipatory Delayed, Inhibited, Denied Grief Chronic Grief

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FACTORS THAT DETERMINE THE NATURE OF GRIEF

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DECEASED Mode of Death Catastrophic /violent Survivor Guilt Age Unfinished Business Commitment & Responsibilities Role, Financial & Occupational Status Nature of the relationship

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BEREAVED Personality Variables Previous mental illness Inability to express emotions Excessively angry/self reproachful. Coping Skills Other Losses “Bereavement Overload” Detached from Traditional cultural & Religious support systems Historical Antecedents Previous complicated grief Previous unresolved losses. Unemployed Financial Problems Religious & Cultural influence on perception & expression of loss Dependent Children at Home (Can be a protective factor) Family Cohesion / or seen as unsupportive Stage of Grief Grief prone Insecure, anxious

STAGES OF GRIEF:

STAGES OF GRIEF Denial /Shock Anger Bargaining Depression Acceptance Shock / Denial Protest and Anguish Pining and yearning Despair and disorganization Reorganization and recovery

PRE-REQUISITES OF A COUNSELLOR:

PRE-REQUISITES OF A COUNSELLOR Genuiness Warmth Concern Empathy Communication Listening SKILLS USED

GRIEF COUNSELLING:

GRIEF COUNSELLING Empathetic listening. Psychological support. Begin communicating early with the family. Follow thoughts and feelings of the family / friend. Educate about their loved ones’ condition. Use Short simple sentences. Choose a stable person in the family for discussion.

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Give as much information or as little information as a family wants. Check if information has been understood. Convey that you could give time for discussion. If dead, break ‘bad news’ gently and honestly.

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Offer condolences. Repeat information at various intervals. Evoke emotional responses – to help them ventilate their feelings – whether anger or grief. Handle silence – observe for non-verbal cues.

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Reflect emotions and summarize what they have spoken. Educate families of ways to cope with grief. Attend family needs (appropriate referrals may be needed).

FACTORS INFLUENCING GRIEVING FAMILIES FOR ORGAN DONATION:

FACTORS INFLUENCING GRIEVING FAMILIES FOR ORGAN DONATION Confidence of the counselor Early referrals which facilitate a good rapport with the family. Conducive atmosphere. Family’s satisfaction that the best has been done by the treating team. Proper understanding of brain death – irreversibility of the condition.

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Giving families time to discuss with significant family members / friends after the donation request. Positive attitude of family member/friend whose advise is sought by the immediate family. Desire that the organs of their loved one could give life to others rather than be wasted. Altruistic attitude of the family. Transparency of the programme.

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THANK YOU

CONSEQUENCES OF BEREAVEMENT:

CONSEQUENCES OF BEREAVEMENT Emotional Reactions Irritability, moodiness Increase in tension Decreased appetite and weight loss Compulsive eating and obesity Insomnia Physical illness Psychiatric illness – especially depression Higher mortality rate in the first year of bereavement Social behaviour – seek out excessive support or become withdrawn and indifferent

GRIEF COUNSELLING WITH FAMILIES OF BRAIN DEAD PATIENTS:

GRIEF COUNSELLING WITH FAMILIES OF BRAIN DEAD PATIENTS Psychological support and grief counseling Assessment of families General information regarding patient Identify the next of kin Assess stage of grieving process Assess the family dynamics Religious orientation and socio-eco-status Determine family’s level of understanding regarding brain death.

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Discussing Donation Concerns of family to be addressed Informed consent to be taken Documentation Contacting organ / tissue procurement agency

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