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Grief in LD "more like everyone else than different" Myres 1980
Grief in LD
"more like everyone else than different" Myres 1980
Evidence
Groups
Stodart 2002:
Shared experience
Decrease depression and less evidence of impact on unders
Staff Training
Reynolds 2008
Increase confidence
How Understand Death
McEvoy 2012
34 interviewed - 25% full und, 2/3 partial
+ve corr of understanding with high funct and cog ability
Grief Responses
Dodd 2005
Increase in behaviour, anx, dep
Scales not appropriate
Diag overshadowing
Same reactions - treated like children
Models
Kubler-Ross 1969
Worden 2003 Tasks
Dual Process: Stroebe 1995
Loss orientated<->Restoration orientated
(secondary loss)
Worden's Mediators 2010
Relationship, Hx, Personality, Social, Circumstances
Piaget 1980 5 factors
Kenyon added to this
Le Poidevin 1999 7 Dimension Model
Emotions, Social, Physical, Lifestyle,
Practical, Spiritual, Identity
Complex Grief
Types
Prolonged
Absent
Exaggerated
Masked
Recognition
Fresh Grief
Talks themes of loss
Preserve environment
Symptoms similar to deceased
Radical changes
Phobia
Unaccountable sadness
Normalisation
Oswin 1991
Delayed
Same stages
Need support
Same rights
For LD
CPPCRSM
Conception
Piaget 1980 - Cause, Finality, Cessation, Universality, Inevitability
Not pre-requisite for mourning (Dodd 2005)
Prep for Impact
Sudden shock if not involved
Participation
Fewer opportunities to say goodbye
Communication
Need concrete
Relationship with deceased
Social Support
Experience loss as rejection?
Multiple Losses
Differ in LD
#
Diagnostic overshadowing
Carer's ability
Assumptions about em/cog
Delayed/longer
Behavioural expression
Internalised - difficult to detect
Ax and
Formulation
Measures - Grief
GAS/GDS/HoNOS/Complex grief Qu :
Assessment of Understanding
Death concept qu, BPVS, Bereavement Needs
Ax Tool: Blackman 2008 - based on Le Pidevin's 7 dimens.
Emotional Literacy
Cognitive/Beliefs of death
Emotional/Behavioural/Bio
Reaction
Onset, intensity, development
LD Complex Grief factors
Intervention
based on Worden
1.
Info on concepts
Rituals/Visits
Magazines/Comics
Resources
2.
Emotional Psychoed
Grief wheel
Diary/pics
Relationships
Life story
Empty Chair
Releasing Balloon
Thoughts/emotions
3.
Promote supports
New Relationships
4.
Involve services work with carers:
Info, Advice, Cathcart books, Help communication