Family Focused Grief Therapy: A Model of Family-Centered Care during Palliative Care and Bereavement

By David W. Kissane; Sidney Bloch | Go to book overview

Introduction

The philosophy of palliative care in the late twentieth century emphasized movement from death in the hospital, where there was risk of isolation and relative neglect, to dying at home or in the hospice (the traveller's place of rest). This was inextricably linked to ideologies of the 'good death'. Notions of 'open awareness' and 'heroic dying' corresponded with 'truth telling' and psychospiritual care, sustaining a sense of meaning and authentic living until death supervened. Clark and Seymour (1999) described this as a 'new subjectivity' in which clinical interest extends beyond the physical to encompass the biopsychosocial in a genuinely holistic model of care. This new approach also embraces systems theory, the myriad of intersecting influences that contribute to context and shape the environment of palliative care. The family is actively involved in such deaths, commonly as primary carers and eventually as the bereaved. Achieving the 'good death' depends substantially on the family's competence in offering support, facilitating preparation for dying and affirming the patient's dignity, as well as saying farewell.

In this book we present a model of family-centred care in which a collaborative relationship with the family and their full participation in clinical care is promoted. This approach involves actively assessing families, harnessing their strengths and bolstering their capacity to cope adaptively, with the goal of optimizing their supportive role. Specifically, we offer an account of a treatment for the relatively vulnerable family in palliative care and one that is extended into bereavement as a preventive therapy, reducing the morbidity that may otherwise follow loss. The central thrust of this book is on authentic living, yet we recognize that periods of transition are inevitable across the life cycle, that sadness, loss and tragedy occur, and that people need to mourn to restore creativity and happiness. Healthy

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