Supporting Significant Life Events - Coursework Example

Supporting Significant Life Events Teacher’s ID Introduction Bereavement over partner’s loss and changing life can be a stressful event for many of us and trauma may increase depending on the age. Although grieving over such events is a normal reaction and many individuals may not need any professional intervention, a risk of mortality along with physical and mental impairment is associated to it. Effects of bereavement are likely to result in adverse psychological and physiological reactions especially in elderly individuals suffering from life threatening conditions like dementia. In order to assist individuals undergoing significant life changing events, there is a requirement of sound healthcare and social care model that can help them overcome the physical and psychological effects of bereavement and grief. It is further important that organizational policies and procedures of social and health care services are adequate enough to address expected and unforeseen bereavement. Other than organizational structure of these services, another important element in coping with bereavement caused by significant life changing events is friends’, familial and social support. In addition to that, information about specialised services (i.e. counselling, psychotherapy) and financial assistance should be readily available to general public. 1.1 Physical, Psychological and Social Impact of Bereavement According to Stroebe, Schut and Stroebe (2007), loss of a spouse and related bereavement enhances the risks of developing chronic health conditions including heart and lung disorders, increased rate of alcoholism, drugs abuse, suicidal attempts and also accidental death. Also, there are greater risks of unnatural death in such segment. As far as general pattern of physical health are concerned, symptoms related to stress such high blood pressure, indigestion, chest pains, headaches and greater use of medical assistance along with medical drugs abuse is common. Some somatic physiological responses may include loss of appetite, exhaustion, somatic complaints, suppressed immunity and endocrine changes resulting in increased vulnerability to sickness (Stroebe, Schut and Stroebe, 2007). It is further important to note that these responses are also gender specific with women showing more bereavement and deteriorating health in the earlier phase of loss which shows improvement later; however the case is opposite as far as male individuals sustaining similar loss are concerned (Stroebe and Stroebe, 2003). Such physical responses to bereavement are also higher in case of older individuals. Other physical reactions to bereavement over life changing event may include current activity limiting pains, loss of sleep and weight loss requiring medical assistance. These physical symptoms are also accompanied by psychological responses to bereavement. Some of the common reactions are suicidal thoughts, loneliness, denial of loss, self-reproach and sense of unreality, loss of memory, agitation, fatigue, crying, social withdrawal and insomnia (Stroebe and Stroebe, 2003). Also bouts of anxiety, depression and distress are common in early period of loss. It is important to note that factors like culture, age, and ethnicity are responsible for different reactions of individuals to similar situations. 1.2 Analyse possible group responses to bereavement. In the given case, Mrs. J was already a patient of dementia who was unable to take care of herself in routine activities. In addition to that, she was also grieving over her spouse of almost four decades as she was in controlled stage of dementia and well aware of her life history and current state. Although the case study did not mention any major physical and mental impairments that Mrs. J sustained as a result of bereavement however there is a vast research available to indicate possible outcomes of bereavement in elderly individuals that are also expected in Mrs. J’s case. Sometimes these responses may take place in the form of group reactions such as episodes of depression, loss of appetite, insomnia and weight loss taking place simultaneously (as these conditions are mostly co-morbid in nature) (Stroebe and Stroebe, 2003, p. 86). Where elderly individuals are in a greater need of social support, they may seem to withdraw from the situation and also avoid social contact that may indicate worsening of overall state of health. Intensity of these group reactions may also vary dependent on whether the death of closed one was anticipated or not. 1.3 Analyse the impact for others in health and social care when an individual is bereaved. Bereavement of one individual may have significant impact on their social network as well especially close family and friends that have an obligation of providing health and social care. The support group may also experience grief (of lower intensity) however it is expected to be not having an activity limiting impact on the individuals present in health and social care. For families, the responsibilities may increase as they may be required to provide physical care along with financial and social support to bereaving family members. Even in Mrs. J’s case, her daughter had to take initiative to move her to elderly care facility after contacting relevant social services. The time taken by grieving members can also be difficult for support group however communication among grieving elderly members and their family is specifically stressed upon for betterment of the situation (Peechioni, Wright and Nussabaum, 2005, p. 77). Also, there is significant evidence available which asserts that support of close family members assists in speedy recovery from bereavement as explained by Antonucci and Akiyama (in Nestmann and Hurrelmann, 1994, p. 44). 2.1 Evaluate the effectiveness of organisational policies and procedures. In case of individuals having conditions like dementia in which state of patient is likely to get worse over the period of time, the role of social and health care individuals enhances as they are not only required to provide physical care but also provide spiritual and social support to them (Gardner, 2007). Such states can be highly frustrating for those working in health and social care since elderly patients are less likely to benefit from support provided to them and their physical and mental health is likely to get deteriorated over the period of time (Sanders and Swails, 2009). However, in case of younger individuals, the support of health and social care professionals may assist in overcoming grief in a period ranging from weeks to a year. Professional individuals providing health and social assistance to grieving individuals are also required to ensure that all the legal and organisational requirements are duly met for ensuring best interests of individuals at the core of support being provided to them by managing related risks and avoiding conflicts between individuals’ rights and one’s own professional responsibilities (Gardner, 2007; Sanders and Swails, 2009). 2.2 Explain how others in social networks may provide support to bereaved individuals. Local and private institutions have various methods of supporting those experiencing bereavement. Since grief is the primary phase of such loss, counsellors can be contacted through national and non-profit social services along with community health centres. In addition to that, losing someone close to one can lead to immediate feeling of loneliness which may further alleviate the risks of physical and mental trauma, therefore joining social groups, participating in activities and volunteering can help in regaining social support. In case of elder individuals feeling bereavement, negligence towards one’s diet, medication and care of overall wellbeing can be an issue, therefore services of community nurses, local councils, community groups etc can be used for care of overall health (Australian Department of Health Services, 2014). 2.3 Evaluate the suitability of external sources of support available for bereaved individuals & 2.1 Analysis of ElderCare Services Experiencing bereavement although being a natural process requires support from external social network. Where some individuals may find it difficult to cope with significant changes in their life on their own, professional assistance may help in speedy recovery. In the given case study, Mrs. J was not only going through bereavement of her husband’s death but was also about to experience major changes in her lifestyle including change in residence and surroundings and departure from familiar figures and social settings. Major events like death need closure and assistance in moving on with life. Furthermore, other major transitions also require pleasant endings and assurance that future still contains hope. Therefore, in order to mitigate this fear of unknown for Mrs. J, she was initially given ample counselling comprising of weeks and then assistance in leaving familiar environment behind. For general population experiencing grief, contacting social services, counsellors and psychiatrists is a viable option. Bereavement is often accompanied with clinical depression and natural support system may not assist in that (Zisook and Shear, 2009). In order to overcome bereavement, suitable sources can be professional counselling, community support (palliative care, Church, community centres etc) and bereavement support groups. A significant amount of research indicates that therapeutic interventions like counselling and psychotherapy may deem helpful in overcoming bereavement (The Joanna Briggs Institute, 2006). According to findings of Stroebe and Stroebe (2003), interventions like counselling and social groups have limited efficacy in cases of elderly individuals. Also, social support from family members and friends proves more effective in the later phase of bereavement i.e. depression and acceptance. However in initial stages of grief (denial, anger and bargaining), a personalised approach is more suitable (Gardner, 2007, p. 247). Considering this finding, the approach used by ElderCare Solutions was fairly useful. It is further important to note that family members of elderly individuals who are facing bereavement also require professional assistance and guidance in providing necessary services to the elderly individuals like Mrs. J. Here, the role of ElderCare Soltuions is rather critical because the quality of Mrs. J’s future life is depends on decisions made by her family. ElderCare provided a roadmap to Mrs. J’s daughter regarding making her ready for two consequent life changing events till the time she was actually transferred to elderly care facility. 3.1 Analyse possible organisational responses to the need to support individuals experiencing a significant life event Support of family, friends and community also has a significant role in overcoming bereavement. According The British Psychological Society (2013), role of family, friends and social support is highly important in overcoming grief and bereavement. However, it is imperative to connect with those who understand the phase of emotions one is going through. Connecting with others further assist in overcoming depression and loneliness associated with old age (Krause and Rook, 2003). The gravity of situation further enhances due to role changing in case of elderly women like Mrs. J. Therefore, rebuilding social bonds and having familial support can not only assist in overcoming bereavement but can also reduce difficulties related to daily household maintenance, finances, transportation etc (Krause and Rook, 2003). Also, informal support of neighbours, friends etc can play an important role in overcoming loss. In the given case study, Mrs. J was already leaving familiar settings to live in healthcare facility; therefore she needed parting to be performed at a positive note which was performed by ElderCare by arranging the large community support and a good bye ceremony. In addition to family and friends, external sources can also assist in dealing with bereavement. Such sources may include trained professionals from social and healthcare who are competent and well versed with the coping techniques required by bereaving individuals (“Review of General Bereavement Support”, n.d). Most of the national healthcare regimes also have options that can allow bereaving individuals to contact counsellors and other professionals. According to the BPS (2013), if failed to cope through social support, one should opt for seeking guidance from GP and seek help from social services such as CRUSE Bereavement Care, The Compassionate Friends UK etc. Such services are further effective in case of elderly individuals if provided one to one. Such external sources also assist in legal matters including transfer of benefits and utilizing other facilities available to bereaving individuals. Use of such services further reduces the responsibility of family and friends by providing specialised assistance (NHS Choices, 2014). Other than national services, self-help groups and charities can also play a significant role in reducing bereavement in elderly people. A multidisciplinary care entailing physical and mental health along with social support is a prerequisite of adequate elderly care (Abou-Saleh, Katone and Kumar, 2011, pp. 737-759). Considering example of Mrs. J, it can be seen that immediate and adequate responses of health and social care services to support individuals experiencing significant life events have a critical importance. These responses can be categorised into proactive and reactive responses. There can be a series of planned response when bereavement due to death is expected (McDonald, 2010, p. 72). In this regard, pre-bereavement services are available through national healthcare services that can assist in accepting death as a part of life (NHS Choices, 2013). In circumstances where bereavement was unforeseen, emergency responses are of significant stature. Mrs. J’s case is an example of proactive response where stages of bereavement were known and suitable services were acquired in order to assist her get through it. ElderCare Solutions further provided framework of recovery from grief and ensured her smooth transition from domestic settings to elderly care. This case study also sheds light on importance of organisational responses in cases of bereavement. Presence of proper organisational policies and procedures provided guidelines with reference to accessing professional caregivers who assisted her in daily life and also provided emotional support followed by getting her mentally prepared for imminent change (McDonald, 2010, p. 93). A detailed literature review further pointed towards importance of sound national social care model and organisational support for emergencies. Bodies like NHS Choices provide guidelines in unforeseen and least expected circumstances by allowing access to medical care, social care services, financial support and guidance. 3.2 As a health and social care professional reflect on your own personal contributions to the support of individuals experiencing significant life events such as bereavement. The importance of health and social care services in case of significant life events was also learnt in personal life by me. My grandfather lost his wife of forty five years around three years back. My grandmother had served in government department and was entitled to various financial benefits. Although my grandfather was in suitable health before her demise and we were also expecting this significant event because of ongoing heart condition; he seem to lose his health and interest in surrounding settings and preferred to stay alone after her death. Where social support of family and friends is highly important in such scenarios, he chose to shut out all kind of social interaction which worried us. Therefore, we contacted local social services provider and discussed his case with them. They appointed a trained counsellor for him who assisted him in sharing his anger and frustration. Later on, we came to know that he was often suggested by family and friends to just forget everything and was also mentioned time and again that his coping should be speedy. He perceived it as a criticism and preferred to stay alone. The given event highlighted importance of appropriate social support according to needs of bereaving individual. We were also suggested that he should be allowed to take care of his own self i.e. daily routine, medication etc., as he felt guilty about disturbing his family and becoming burden on them. Since his health was satisfactory, this measure was recommended to make him feel self-sufficient. He was also referred to self-help group where no one knew him that well initially and he would feel more comfortable spending time with those facing the same situation. We further contacted NHS services so that financial benefits of my grandmother could be transferred to him. Since we had not encountered such situation earlier, the support of national organisation was very helpful. The overall experience indicated that sound organisational structure, policies and procedures are highly important for elderly individuals as well as other people facing bereavement caused by loss of dear one. 3.3 Make recommendations for improving the support available in a Care Home for residents and their social networks when affected by significant life events such as bereavement. In the light of literature review and personal experiences, there are several recommendations that can further increase effectiveness of health and social care services that are designed to support individuals experiencing significant life events. In this case study, the social care services were accessed by family of Mrs. J. The given incident highlighted an area of further improvement related to elderly individuals with no family. It can be expected that such elderly individuals facing deteriorating conditions like dementia are unable to recruit suitable care on their own. Therefore, it is important that there is a national framework available that can assist in identification of such individuals through general practitioners and referrals. Rewards can be attached to referrals in order to ensure effective recognition of such individuals. Another important part of bereavement support is allowing individuals to be aware of services that are available to them. Local social services can take initiatives in disbursing information about facilities available to the relevant community in case of bereavement. The role of community social services is highly significant in providing proactive and reactive support to local community members. Since individuals facing trauma may opt for staying isolated or may not be aware of their rights, they should be contacted by social and health services. Suitable cost benefit model, effective policies and procedures, helpful mode of accessing healthcare and social care services and resourcing external support are a prerequisite for ensuring that there is a reasonable scope of support available to those facing bereavement. References Abou-Saleh, M.T., Katona, C.E., and Kumar, A., 2011. Principles and Practice of Geriatric Psychiatry. West Sussex: John Wiley & Sons. Australian Department of Human Services., 2013. What to do After Death. [online] Available at: http://www.humanservices.gov.au/customer/subjects/what-to-do-following-a-death#a10 [Accessed 28 January, 2014]. Bailey, G., 2014. NASW Standards for Social Work Practice in Palliative and End of Life Care. [online] Available at: https://www.socialworkers.org/practice/bereavement/standards/default.asp [Accessed 28 January, 2014]. Gardner, H.(ed)., 2007. Responsibility at Work: How Leading Professionals Act (or Dont Act) Responsibly. CA: Josey-Bass Publishers. Krause, N., and Rook. K.S., 2003. Negative interaction in late life: issues in the stability and generalizability of conflict across relationships. Journal of Gerontology: Psychological Sciences 58B: 88-99. McDonald, A., 2010. Social Work with Older People. Cambridge: Polity Press. Nestmann, F., and Hurrelmann, K. (eds.)., 1994. Social Networks and Social Support in Childhood and Adolescence. Walter de Gruyter. NHS Choices., 2014. Coping with Bereavement. [online] Available at: http://www.nhs.uk/Livewell/bereavement/Pages/coping-with-bereavement.aspx [Accessed 28 January, 2014]. Pecchioni, L.L., Wright, K.B., and Nussabaum, J.F., 2005. Life Span Communication. NJ: Lawrence Erlbaum Associates. “Review of General Bereavement Support and Specific Services Available Following Suicide Bereavement”., (n.d). Available at: http://www.nosp.ie/review_of_bereavement_support_services-1.pdf [Accessed 28 January, 2014]. Sanders, S., and Swails, P., 2009. Caring for patients with end-stage dementia at the end-of-life: A specific focus on hospice social workers. Dementia, 8, pp. 117-138. Stroebe, M., Schut, H., and Stroebe, W., 2007. Health outcomes of bereavement. Lancet, 270, pp. 1960-73. Stroebe, W., and Stroebe, M.S., 2003. Bereavement and Health: The Psychological and Physical Consequences. NY: University of Cambridge Press. The British Psychological Society (BPS)., 2013. Coping if You Have Recently or Suddenly Bereaved. [online] Available at: http://www.bps.org.uk/psychology-public/information-public/coping-if-you-have-been-recently-or-suddenly-bereaved/coping-if [Accessed 28 January, 2014]. The Joanna Briggs Institute., 2006. Literature Review on Bereavement and Bereavement Care. [online] Available at: http://www4.rgu.ac.uk/files/BereavementFinal.pdf [Accessed 28 January, 2014]. Zisook, S., and Shear K., 2009. Grief and bereavement: what psychiatrists need to know. World Psychiatry, 8(2), pp. 67-74. Read More