 Lesson 1: GRIEF

1. Mr and Mrs Simons had been married for 50 years. Five years ago Mrs Simons had a heart
attack and was left disabled. Her husband cared for her full time, giving up many of his
hobbies and relationships to be with her. Mr Simons’ own health was increasingly failing.
Mrs Simons had another heart attack and was admitted to hospital. Mr Simon visited twice a
week. The most he could manage as it was a long journey. Mrs Simons died when Mr
Simons was not there. She asked for him to come to her, but he was unable to get there in
time. Mr and Mrs Simons had two children who felt that their father should not attend the
funeral as he was so ill.

a) What losses had Mr Simons experienced?

One of life's most difficult events is the death of a loved one, which may result in a severe
emotional crisis. Mr Simons also experienced an emotional crises due to loss of his beloved
wife. He feel grief after the loss of wife he care about, which literally means "to be bereft by
death." Grief is defined as the uncontrollable emotional and behavioural reaction to loss.
Mourning is the deliberate display of socially sanctioned behaviours and rituals in reaction to
loss.

b) How do you think Mr Simons would feel about not attending the funeral?

As he was a very loving and caring husband, not attending the funeral of his wife would be
definitely a most difficult time for him. He would feel helpless because he is physically
unable to attend a funeral, it is simple to justify their absence. It is certainly appropriate to be
bedridden with sickness or to be dying.

c) In what way could Mr Simons be supported to accept the death of his wife?

There are many approaches to grieving and learning to accept loss. Make an effort not to
disregard the sadness. Mr Simons may be able to get help until he is ready to handle his
sorrow on their own. Feeling overwhelmed or sad by a wife loss, it's particularly essential to
get assistance for Mr Simons.

Family such as two children and kind friends may be invaluable resources. They're mourning
as well, and some individuals find that sharing memories is one way to support one another.
Feel free to tell tales about the wife who has passed away. People are often hesitant to bring
up the loss or mention the deceased person's name for fear of offending them. However, some
individuals may find it beneficial to speak openly about their grief.

d) eg. Bereavement counselling.

Loss therapy/counselling may sometimes make it easier for individuals to get through their
grief. Regular talk therapy with a grieving counsellor or therapist may assist Mr Simons in
learning to accept death and, eventually, begin a new life.

2. What are contemporary attitudes toward death in your society and how do they
affect the treatment of dying?

In Australian society, People would like to die quietly in their sleep without suffering because
they believe it would be simpler for their loved ones instead of watching them suffer.” Apart
from this believe expressing worries about pain and pain treatment, this set of believes are by
far the most popular among people. The perfect death, according to these, is one that catches
a person off guard, as shown by the closely related options of "rapid" or "sudden."

Some people viewed death during sleep as the last stage of dying from an illness, but they
still wanted to be able to say farewell and die with company in their preferred setting.

This was sometimes tempered by the acknowledgement that their desire was only that. Some
have recognised conflicts in this desire, such as the possibility of not being able to say
farewell to loved ones or the possibility of leaving other parts of life unfinished.

3. Submit your list from the set task 1 and 2.

 List of losses
 Disasters
 Alcoholism
 Life transitions
 Being dismissed from your job
 Status
 Relationships breaking up/divorce/growing up
 Miscarriage
 Marriage
 Emigration/immigration
 Going to hospital
  List of organization providing support to bereaved people.
 Australian Centre for Grief and Bereavement
 Cruse Bereavement Support
 The Bereavement Care Centre
 Canberra Grief Centre
 The Compassionate Friends Victoria
 Stillbirth and Neonatal Death Support (SANDS)

 LESSON 2 : STAGES OF GRIEF

1. Briefly describe the stages of grief.

The five stages of grief are as follows:

1. Denial: It's easy to dismiss the possibility that someone or something significant to us
has died. As a result, we may separate ourselves in order to avoid being reminded of
the reality. Others who want to console us may inadvertently aggravate our pain while
we are still grieving.
2. Anger: When denial is no longer an option, it's natural to feel irritated and furious.
We may feel as though something has been done to us that is completely unjust, and
we may question what we did to deserve it.
3. Bargaining: We may try to alter the conditions of the scenario that is giving them
pain at this point. A devout individual whose loved one is dying, for example, may try
to bargain with God to keep the person alive. By giving the mourning individual a
feeling of control in the face of helplessness, bargaining may help them deal.
4. Depression: At this point, we are fully aware of our grief over the loss. It's natural to
feel depressed after a loss; nevertheless, it's essential to understand that clinical
depression differs from grieving, and mental health experts manage both differently.
5. Acceptance: The bereaved individual may eventually come to grips with their loss.
Accepting a loss does not imply that the individual is no longer mourning. Many grief
specialists believe that sorrow may last a lifetime following a significant loss, and that
dealing with the loss becomes better with time. Long after the loss has occurred and
the individual has "accepted" it, reminders of the loss may provoke waves of sorrow.
These waves may potentially lead to a transition into one of the other four stages of
grieving.
2. Why do you feel that people pass through different stages at different times and not
in a particular order? Add any notes from your research in the set task on criticisms of
the model.

The idea that denial and acceptance are helpful in the mourning process has been questioned
by the researchers. Denial may act as a barrier between the patient and health-care
professionals, limiting their capacity to educate and treat them. Accepting a fatal prognosis
may sometimes cause people to give up and forego therapies that might help them feel better.
Indeed, some studies indicates that being optimistic about one's diagnosis may help one adapt
and live longer.

Another critique is that others have believed that these phases apply to everyone who is
mourning, rather than Kübler-work. Her study was limited to individuals who are not healthy.
This is not to say that those who are mourning the death of a loved one would inevitably feel
the same way.

3. How might awareness of the stage process help a counsellor in supporting someone
who is grieving?

Having awareness regarding grief process help counsellor in the following manner

 Despite the fact that people in denial seldom seek help, professional grief therapy may
aid those in denial in acknowledging their loss and moving on with the grieving and
healing process.
 A competent grief counsellor can assist someone in this stage of grieving in coping
with their emotions and finding productive outlets for their anger so that their work
and personal relationships are not strained.
 Regardless of the nature of the loss, bargaining is unlikely to provide long-term
answers, and grief therapy may assist us in expressing our need to bargain without
being trapped in outcome expectations.
 Depression is a natural and essential aspect of grieving, and it should not be ignored.
A grieving support group or a professional counsellor, on the other hand, can assist
you in working through your depression so that it does not interfere with your ability
to function.
  While sadness and anger may resurface from time to time throughout the acceptance
stage, they become less common as we go, and bereavement therapy may assist you in
gaining the coping skills and support you need to rebuild your life.

Professional grief therapy or a grief support group, on the other hand, may be very helpful if
you or someone you love lacks a support network or seems to be suffering with sorrow
indefinitely with no apparent end in sight. A professional grief counsellor can assist you in
working through your feelings at each step of the grieving process, expressing any unresolved
emotions, and providing the objective, sympathetic support we all need while mourning and
resuming our lives with confidence.

 LESSON 3:CHILDREN AND GRIEF

1. Mr Simons (who we discussed in lesson 1) also had a grandson who was five years old. He
was very close to Mrs Simons. His parents would not let him attend the funeral. How do you
think this would make the grandson feel?

a. Do you think it is appropriate for young children to attend funerals? Explain your
answer.

Funerals may play a significant role in the mourning process. They are a moment to say
goodbye symbolically and begin the process of recognising that a loved one is no longer with
us. There is no right or wrong answer when it comes to children attending funerals. The
grandson shouldn’t attend the funeral as he is just five years old, he may aware of objects
being "living" and "dead," but they do not comprehend death's inevitability.

b. In what ways do children respond to grief?

Children, like adults, may be profoundly impacted by loss and sorrow. While everyone
grieves in their own unique manner, typical grief responses in children include:

 Experiencing grief in stages, such as weeping one minute and then playing the next.
 Rather than talking, they act out emotions.
 alterations in eating, sleeping, as well as behaviour
 showing signs of immaturity, like as wetting the bed or sucking their thumb
 being enraged, furious, and agitated
 At school, lacking in focus and energy.
 They have a sense of responsibility for their parents.
c. Why do different children respond to grief in different ways?

The age, stage of development, familial background, personality, and prior experience with
death all influence a child's comprehension and react accordingly. Children grow at different
rates - they are all unique. Therefore, two children of the same age from the same household
may respond to a death in quite different ways.

d. Provide an overview of counselling strategies for supporting the grieving child.

It's important to pay attention to grieving children and adolescents so that we can understand
their needs.

1. They may need the assistance of people they can rely on.
2. They must be free to express themselves without fear of being judged or criticized.
Disapproval or apathy will not assist them if they are already feeling vulnerable.
3. Tears must be encouraged and permitted."
4. Recognize that they may not be able to weep readily.
5. Provide them with a safe environment and methods to vent their anger and emotions.

2. Submit your comments from the set task.

I would tell the truth by ensuring that his dad is not coming back. He is in a heaven and show
him stars in the sky, demonstrate him the stars in the night sky and tell him that one of them
is his father. He had gone to a very long journey. He will remain in your memory for as long
as you remember him. Moreover, I would ensure him that I am not going anywhere and with
him at every step.

 LESSON 4: ADOLESCENT GRIEF

1. Discuss how adolescents respond to grief. You might want to do a little additional
reading on the internet or from books to answer fully.

Adolescents express and process grief in a number of ways, depending on their age,
personality, previous loss experience, support networks, and mourning environment.

Adolescents' reactions to death and dying will vary, just like adults'; nevertheless, there are
certain typical emotions that may impact them.

• astonishment and shock at the person's death

• grief at the death of the individual
• inability to focus or recall information
 • anxiety about attending classes
• obnoxious behavior/fighting on a regular basis
• failure to follow up on requests
• restlessness
• heightened demand for focus
• feelings of desertion, uncertainty, and fear for one's safety
• apprehension, guilt, relief, wrath, regret, and befuddlement
 fear of being mistreated
• a shift in values, leading to a re-evaluation of what matters
• obsessive need for information about death
• a desire to contact surviving parents, siblings, and other relatives
• alterations in family roles and relationships
• a desire to be in close proximity to responsible adults
• sleep and appetite changes
• nausea, headaches, fatigue, and muscular pains
• Anxiety about what is next.
2. Write a report on the findings from your set task (up to 500 words).
Suicide is the top cause of mortality among Australian teenagers and young adults aged
15–24. Because children and young people do not likely to die from other causes, the
percentage of suicide fatalities is unusually high among them. Suicide may be caused by
the following factors:
 Life situations that are distressing
 Drug or alcohol abuse is linked to trauma, 
 A low standard of life

In 2019, 384 young Australians (18–24 years old) committed suicide. Suicide claimed the
lives of 96 children and adolescents (aged 5–17), the bulk of them were aged 15–17 (80%
in 2019). Suicide claimed the lives of 40% of young people aged 15–17 and 36% of those
aged 18–24, up from about 25% of all fatalities in these age groups in 2010. When
compared to the two older age groups, the percentage of children aged 14 and under who
die by suicide is modest; suicide fatalities accounted for 7.4% of all deaths in this age
group in 2019.
 Suicide rates by age group between 2010 and 2019: rose among young people aged 18–24
(from 10.8 deaths per 100,000 population in 2010 to 16.1 in 2019), while staying largely
constant in those aged 15–17 (7.9 to 8.9 deaths per 100,000 population). Varied from 0.5
fatalities per 100,000 population in 2010 to 0.6 in children aged 14 and below.
“We know that more than half of Victorians who commit suicide had contact with health
services in the six weeks leading up to their death. “Many chances for intervention are
being overlooked,” she added.
A new Orygen research evaluating the worldwide effects of suicide prevention methods
in young people discovered that youth-specific treatments delivered in clinical,
educational, and community contexts may reduce suicide-related behaviour in at-risk
adolescents.
“There has been a lot of investment in suicide prevention in Australia, but these efforts
must be strategically focused toward evidence-based interventions.” According to Dr.
Krysinska,
“There should be a special emphasis on the problems that young people confront, as well
as focused suicide prevention initiatives in this population.”
Orygen is aware of a number of national and local programmes aimed at raising
awareness about suicide prevention. Prime Minister Scott Morrison has pledged to attain
a suicide death rate of zero, and we've seen the formation of an expert advisory group to
offer strategic advice to the Prime Minister in order to accomplish this goal.
“A National Productivity Commission Inquiry is now underway, as is a Royal
Commission into Mental Health Services in Victoria, which we hope will find
possibilities for reform and enhance the service system to react to individuals in crisis,”
Dr. Krysinka said. “Youth-friendly services and intervention programmes are in high
demand because they meet both the requirements and preferences of young people.”
3. Provide an overview of counselling strategies for supporting the grieving adolescent.
 Encourage teen to talk about how they are grieving.
 Inform parents about how their children may respond to death.
 Encourage the maintenance of a peer network.
 Parents should encourage their children to participate in family rituals.
 Encourage continuous discussions about loss and adjustment.
 Encourage parents to establish clear and acceptable boundaries for their children.
 Encourage altruistic activities that promote self-control.
  Discuss the significance of gradually assuming adult responsibilities.
 Create a safe space for the teenager to express his or her grief.
 Encourage others to reminisce.
 Encourage family members to participate in therapy.

 The preceding list emphasizes the need for teenagers to feel supported and
involved in the grieving process, as well as the significance of social ties in
healing after a parent's death.
4. Describe suicide prevention strategies.

 Persons at Risk must be identified and assisted.

Many individuals in need of assistance or support do not seek it on their own. Identifying
individuals who are at danger of suicide may assist you in reaching out to those who are most
in need and connecting them with care and assistance. Gatekeeper training, suicide screening,
and teaching warning signals are examples of actions included in this approach.

 Increase the number of people seeking assistance.

You may help individuals decrease their risk of suicide by educating them to identify when
they need assistance and assisting them in finding it. Self-help tools and outreach efforts are
examples of methods to reduce an individual's obstacles to seeking assistance, such as a lack
of knowledge about available resources or a belief that aid would be ineffective. Other
treatments may focus on the social and structural environment, such as establishing peer
norms that encourage people to seek assistance or making services more accessible and
culturally acceptable.

 Ensure that effective mental health and suicide prevention and treatment are
available.

One of the most important aspects of suicide prevention is ensuring that people who are at
risk of suicide have prompt access to evidence-based therapies, suicide prevention
interventions, and well-coordinated care systems. Suicide prevention strategies including
safety planning and evidence-based treatments and therapies administered by competent
practitioners may result in substantial improvement and recovery. SPRC urges health and
behavioural health care systems to use the Zero Suicide framework to integrate these
methods. Another essential approach for improving access to good mental health and suicide
care is to reduce financial, cultural, and logistical obstacles to care.

 Supporting Safe Care Transitions and Linking Organizations

You can lower the risk of patients committing suicide by providing a smooth transfer of care
and allowing the sharing of information across the different people and organisations
involved in their care. Individuals at risk of suicide, as well as their support networks (e.g.,
families), must be included in the conversation. Formal referral procedures, interagency
agreements, cross-training, follow-up contacts, fast referrals, and patient and family
education are all tools and practises that promote continuity of care.

 Effectively Respond to Individuals in Crisis

Individuals who are suffering significant emotional distress in your school, organisation, or
community may need a variety of assistance. Mobile crisis teams, walk-in crisis clinics,
hospital-based psychiatric emergency services, and peer-support programmes are all part of a
comprehensive continuum of treatment. Suicide risk is immediately addressed through crisis
services, which include assessment, stabilisation, and referrals to follow-up treatment.

 Make provisions for both immediate and long-term prevention.

A postvention strategy is a collection of procedures that will assist your organization or

community react to a suicide death efficiently and compassionately. Immediate reactions are
aimed at assisting those who have been impacted by the suicide death as well as minimizing
the danger to additional vulnerable people. People who have been bereaved by suicide should
get intermediate and long-term assistance as part of postvention efforts.

 Reduce the availability of suicidal methods.

Preventing people in suicidal crisis from acquiring and utilizing fatal self-harm techniques is
one key approach to decrease the probability of suicide death. Educating relatives of people
in crisis about how to properly store medicines and weapons, providing gun safety locks,
altering prescription packaging, and erecting barriers on bridges are all examples of measures
that may be taken to limit access to deadly methods.

 Improve resiliency and life skills.

You may equip individuals to properly handle difficulties such as economic hardship,
divorce, physical disease, and ageing by helping them develop life skills such as critical
thinking, stress management, and coping. Resilience, or the capacity to deal with hardship
and adapt to change, has been linked to a lower risk of suicide. While resilience has certain
characteristics with life skills, it also includes traits like optimism, a positive self-concept,
and the capacity to stay optimistic. Increased life skills and resilience may be achieved via
skill training, smartphone applications, and self-help resources.

 Encourage social interaction and cooperation.

Despite the existence of risk factors in their life, supportive connections and community
engagement may help people avoid suicide. Social programmes for particular demographic
groups (such as elderly people or LGBT adolescents) and other activities that decrease
loneliness, create a feeling of belonging, and build emotionally supportive connections may
all help to increase connectivity.

 LESSON 5: ADJUSTMENT TO BEREAVEMENT

1. Going back to Mr Simons in the previous lessons.

a) How can Mr Simons adjust to his loss? Describe the process.

While mourning a loss is an unavoidable part of life, there are methods to deal with the
sorrow, come to terms with his grief, and ultimately pick up the pieces and go on.

 Acknowledge his pain

 Recognize that grieving may elicit a wide range of feelings, some of which may be
unexpected.
 Provide help from individuals such as their children who care about him in person.
 Take physical care of himself to support his emotional well-being.
 Distinguish between sorrow and depression.
 A grief counsellor can assist with the grieving process by enabling a Mr Simons to go
through the stages of grief in a supportive and private environment. The grief counsellor
will work with him to help him accept and speak about their loss. They will urge
grandson also to recognise and express their negative emotions such as anger, guilt,
sorrow, helplessness, and worry.
 The grief counsellor will also assist the Mr Simons in adjusting to life without the dead,
encouraging them to make choices on their own.
 The grief counsellor will also provide support and help Mr Simons find strategies to cope
with his loss.
 The grief counsellor will also assist Mr Simons in understanding that what they are going
through is normal and typical of sorrow, and that they are not "going insane."
b) What are some of the dangers of loss for Mr Simon and for his grandchild?
o Loneliness
o Increased or decreased apatite
o Lack of stamina
o Depression
c) How might bereavement affect Mr Simons?

Mr Simons and his grandchild’s body, minds, emotions, and spirits may all be affected by
grief. Mr Simons health may be endangered in such a manner as he is already sick person.

Changes in appetite or sleep, an upset stomach, a tight chest, weeping, tense muscles,
difficulty relaxing, poor energy, restlessness, or difficulty focusing are some of these
consequences.

Grief may include symptoms that are similar to depression, and Mr Simons do acquire
depression as a result of a major loss. When he begin to comprehend the truth of death, they
may feel deep sorrow, emptiness, or loneliness, as well as rage or guilt. The emotions may be
unpleasant, persistent, or overpowering. Grief may come in waves, seeming to drift away for
a period of time before reappearing. However, the emotions progressively go away with time.
2. Using the information you found in your set task, discuss what support is available to
aid the recovery of Mr. Simons and of his grandchild.

Provide tangible support as well as tactical support.

 Assist Mr Simons in recognizing previous achievements in order to re-establish self-

esteem.
 Assure him that he will be able to overcome the present setback.
 Assist him in examining the unique traits and abilities that endeared him to the dead.
 Assist him in recognizing and experiencing loss and sorrow. Recognize that suffering
is a normal component of sorrow; tell him that the agony will not last forever.
 Give him permission to weep, as well as permission to feel relieved if he does.
 Recognize that setbacks will occur and encourage him or her not to panic. Explain
that these are leftovers of sorrow, not an indication that it's beginning all over again,
since grieving may seem like an emotional roller coaster at times.
 Grief drains him both physically and emotionally. Encourage the bereaved to look for
themselves by eating well-balanced meals, drinking enough of water, getting enough
sleep and exercising frequently, which may all slow down the grieving process.
 Encourage him to take each day as it comes. It may be simpler to divide the day into
manageable chunks at times.
 Enable Mr Simons in Writing that may assist him in more freely expressing their
emotions and ideas. Grief recovery requires such unrestricted expression. Allowing
Mr Simons to write a letter to the late wife, for example, may assist them in
completing "unfinished business" by allowing them to convey things that were left
unsaid prior to the loss. The therapist may urge the client to write long and honest
letters if and when it is suitable, in order to foster a genuine and free expression of
ideas and emotions.
  LESSON 6 ABNORMAL GRIEF

Mrs Jones is a 65 year old woman. Twelve years ago, she moved with her husband to a
remote part of the country. Her son and other family members lived several hundred miles
away. Eight years ago, her husband was tragically killed in a car accident. They were due that
evening to go Christmas shopping. Sometime later, Mrs Jones’ son met and married. They
had two children. Mrs Jones resented her new daughter-in-law and has shown very little
interest in her grandchildren. She hardly ever visits. She wants her son to visit her by
himself. He finds this difficult as he has a demanding job and his own family to think about.
When asked to move in with her son, Mrs Jones refused, saying she had lots of friends where
she now lives. However, she often phones her son late at night saying how lonely she is as
she has no friends. She often refuses to speak if her daughter in law answers. Every
Christmas she visits but often sits alone in the corner of the room, not interacting with the
children and making it plain that she is very upset that it is Christmas.

1. Mrs Jones may be experiencing an abnormal response to grief. Do you agree?

Explain your answer.

Yes, she has experienced a sudden loss of her husband leading to sadness, grief, and
rumination. She may suffer complex grief, in which the natural reactions to the loss of a
loved one do not diminish with time and may make it difficult or impossible for them to lead
regular lives.

2. What factors may have complicated her grief?

o Sudden death of husband

o Anger
o Separation from a family
o Son marriage
o Daughter in law
o Loneliness

3. Outline a treatment method you would suggest for Mrs Jones.

Treatment for complex grief focuses on assisting individuals who are grieving to start the
healing process. The most frequent treatment option for this illness is bereavement
counselling.
It's also essential to address another mental health issue if complex sorrow develops or is
accompanied by one. Antidepressants, for example, may assist Mrs Jones to alleviate the
symptoms of complex mourning when it is accompanied with depression.

A bereavement counsellor will urge Mrs Jones to keep track of her sorrow so she can have a
clearer sense of where she is emotionally. Joining a grief support group may also assist Mrs
Jones in coping with her emotions of loss and sorrow. Learning that she is not alone and that
there are others who understand and share her emotions may make her feel better. she may
also seek the help of a psychodynamic therapist. This therapist may be able to assist her
figure out what losses she've had in the past and how they relate to her present loss.

Traumatic grief therapy is another treatment option for complex grieving that has been shown
to be successful. A therapist will utilise behavioural and interpersonal approaches to assist
Mrs Jones in overcoming her loss.

4. Submit your findings from the set task.

Suicide

 Australian Centre for Grief and Bereavement: The Centre is dedicated to a

future Australia in which bereaved and mourning individuals are accepted and
supported by all members of society.
 Cruse Bereavement Support
Survivors of Bereavement by Suicide (SoBS) is a self-help organisation that
aims to address the needs of individuals who have lost a close family or friend
to suicide. There is an online forum for SoBS. This is an online forum for
survivors of suicide bereavement that provides peer-to-peer assistance.
 Lesson 7 PREPARING FOR GRIEF AND BEREAVEMENT

1. Write a brief report of your findings in the set task (500 words max.)

It is found that Hospice care is provided to patients who are approaching the end of their
lives. The services are given by a team of health care experts who reduce pain and treat
physical, psychological, social, and spiritual needs for people who are terminally ill.

Discussions that have taken place earlier may help with the management of the last days of
life. The timely provision of information, the provision of comfort via the treatment of
physical, emotional, and cognitive symptoms, and the consideration of spirituality, sorrow,
and mourning are all examples of best practice in end-of-life care.

Separate from hospice, palliative care programmes give comfort treatment with the option of
continuing to concentrate on curative therapy. An multidisciplinary team of healthcare
providers who are palliative care specialists and experienced in addressing end-of-life care
objectives will offer assistance in any environment. Palliative care is covered similarly to
other medical treatments. Palliative care is covered in whole or in part by most insurance
plans, including Medicare and Medicaid.

Home-based care: Individuals' capacity to benefit from home-based care is mainly

determined by whether or not they have the necessary means to do so. This is inextricably
connected to the patient's care objectives, his or her health, and the quantity and quality of
caregiving assistance provided. Patients who get end-of-life care at home benefit from a
variety of factors, including the opportunity to stay in a familiar and comfortable setting—as
well as greater control over their treatment, visitors, and surroundings.

2. Veronica is a 40 year old woman. She discovers that she has a terminal cancer. She
has several months to live. She has a husband and two children.

a) How might Veronica experience grief?

Veronica might experience anxiety, sadness, anger, and guilt are common with a terminal
disease. These responses are influenced by a variety of variables, including their personality,
the amount of quality support they get from friends, family, and caregivers, whether they
believe in a hereafter, and their age.

b) How might her relatives prepare for grief?

A dying patient's relatives and close friends may experience guilt, rage, or denial. As a result,
individuals may have communication difficulties with their dying family, spouse, or friend,
as well as the counsellor and other caregivers. They need chances to express their emotions
about the approaching loss in order to avoid alienating the patient and family.

It is essential to guide these people through the mourning process. They may be cautioned
about the usual grieving experiences. This may involve describing odd sensations that may
occur, such as feeling as though a deceased person is there, illusions, hallucinations, and so
on, so they are not frightened if they occur.
Accepting that the loss is genuine will need assistance. Work your way through the grieving
process. Make the necessary adjustments to live without the dead.

After the terminally ill person has died, the grieving individual may need assistance in
moving from the first stage to acceptance of reality. To assist with the adjustment, they may
need to be encouraged to see the deceased's corpse and perhaps put away some of the
deceased's possessions.

c) Using your notes from your set task, what choices are available for terminal care
for Veronica? How do they differ?

Palliative Care, Hospice Care, Care provided in the client's home, Assisted living and skilled
nursing facilities, the timely provision of information, the provision of comfort via the
treatment of physical, emotional, and cognitive symptoms, and the consideration of
spirituality, sorrow, and mourning are all options in end-of-life care.

3. What counselling strategies might you use to help Veronica

Counsellors may use the following techniques, although they are not restricted to them:

Assisting clients in the processing of emotions

Counsellors provide assistance to clients who are experiencing these difficult emotions and
teach them techniques to help them work through and process their feelings. Counsellors may
assist clients in navigating these complicated emotions, in addition to working one-on-one
with them, by suggesting or enabling treatment in a variety of ways, as recommended by the
National Association of Social Workers:

Information and education on the disease are provided.

Therapy for the whole family.

Therapy in a group setting.

Assessments of mental health.

Dealing with Death Anxiety

Clients, for example, often feel terrible about dying and leaving loved ones behind. When
clients choose to stop receiving medical treatment because the discomfort becomes
unbearable, they often feel guilty. Clients often express anxiety about the uncertain nature of
death and the possibility of additional agony and suffering. Helping clients work through
their concerns may take a variety of forms, but it usually entails one-on-one therapy, in which
a counsellor assists the client in discussing and analysing how he or she is experiencing. A
counsellor, for example, may arrange sessions with family members where the emotions are
addressed and reframed if a client is suffering guilt about leaving family members behind.

 Lesson 8: FUTURE OUTLOOK AND LONG-TERM GRIEF

1. Discuss separation and loneliness.

Unlike the grief that follows a death, the grief that follows a divorce is likely to be confused
as well as mixed with intense anger, leading to doubts about one's own acceptability as well
as worth.

When a relationship ends, there are conflicting desires to re-establish the relationship, as well
as deep mistrust of the relationship. Persistent tension is likely to manifest as preoccupations
and sleep problems. For a period of time, each partner may have an anxious, driving desire to
reclaim the other, a desire that can coexist with intense anger and determination to get rid of
the other. Friends may choose sides or withdraw, leaving one or both partners socially
isolated.

Parents who are experiencing the separation distress that comes with the end of a relationship
are likely to have little energy to care for their children's needs. Children of a couple who is
divorcing, on the other hand, will inevitably be distressed and in need of parental attention.
They are likely to be saddened by the departure of one of their parents, to be concerned about
the well-being of both parents, and to be concerned about their own well-being. We associate
loneliness with the much defined notion of being alone, which means "without other people,"
and it is due to "lonely individuals" that we have come to this conclusion.

When a person's network of social connections is substantially lacking in either quality or

quantity, they suffer subjective psychological discomfort.”

Loneliness arises when a person's interpersonal wants or desires are not met by their social
connections. Loneliness is determined by a person's "needs and wants," and this metric is
subjective and varies greatly from one person to the next. Prototypical characterizations of
"loneliness" seem to be incorrect in light of this concept.

Individual loneliness is characterized by a person's desires in relation to their possessions. So,

even if a person has 100 wonderful relatives and friends, they are likely to feel lonely if they
yearn for something or someone they don't have – such as an intimate partner, a friend with
whom they can open up, a group of people who "understand them," a family, etc.

Grieving people are at a disadvantage when it comes to loneliness since the person they miss
is no longer alive. I've learned that loneliness following the loss of a loved one may take
various forms. Beyond everything, it's the agony of loving someone so deeply that parts of
yourself became them, as well as pieces of them became you.

2. Discuss the effects of long term grief.

Complicated sorrow is a long-term grieving condition that hinders a bereaved person from
moving on after the loss of a loved one.

It has a significant effect on the sufferer's capacity to live a full and fulfilling life. Chronic
grieving may have a detrimental effect on a person's mental health and well-being.
Complicated sorrow is sometimes known as chronic complex bereavement disease because of
this.

An unexpected or abrupt loss of a loved one, particularly a close family member, kid, or
friend, is the most common cause of complicated sorrow.

and a sharpened focus on the loved one who has died Many individuals who are grieving in a
complex way develop bitterness as a result of their loss.

They lose their capacity to appreciate life. People suffering from complicated sorrow may
withdraw themselves or find it difficult to maintain their regular habits. They grieve and feel
guilty because they believe life isn't worth living without their loved one.

Following the death, these symptoms persist without relief for an extended length of time.
They may continue for years and have a severe impact on a person's health, career, and
relationships.

Among the potential reasons are post-traumatic stress disorder and severe sorrow. Losing a
kid or witnessing a horrific death of a loved one are two examples.

3. Discuss long term counselling support strategies.

 Guided Mourning: This is the term used to describe the counselling process that
aims to decrease avoidant behaviours that are believed to prolong sorrow. The
grieving individual is helped to face memories of the dead and encouraged to
 participate in activities and circumstances that bring up recollections of them. As can
be seen, this is an example of exposure therapy.
Typically, the client is progressively exposed to circumstances that cause a modest
level of anxiety (actual or imagined), and then gradually progresses to more
challenging situations. Desensitisation is the term for this procedure. The customer is
placed in a distressing position.

They're at ease, and the goal is for them to be at ease in all grief-inducing circumstances.

 Groups of Support Some individuals are able to effectively cope with grief by
sharing their storey with others. These types of groups also provide practical guidance
and explore various coping strategies.
 Medication is sometimes given to help people cope with acute anxiety or disrupted
sleep habits. If the criteria for a depressive illness are fulfilled, antidepressants may be
needed in the latter phases of grieving. Prescriptions will not alleviate the pain of
natural sorrow and are only required in the specific situations mentioned above.
 Counselling or Psychotherapy: Between psychotherapy and counselling, there is a
lot of overlap. Psychotherapists, on average, have more training than counsellors.
Counsellors may place a greater emphasis on current events than on underlying
issues. This may be beneficial for some individuals, but it is generally only needed for
those who are at risk of having an atypical grieving response.

4. What are the characteristics of effective and ineffective support for people going
through the process of grief and loss?

Patience: counsellor must be very patient. Only proceed to the next stage of explanation once
the patient/client has grasped the substance of the information you're providing. As a result,
he’ll require plenty of time for the customer or patient.

Listening Skills: Counsellor must be an excellent listener. Never interrupt a patient/client

who is speaking. Only add your thoughts once the client or patient has done speaking.

Observant: Counsellor must be extremely attentive and able to understand nonverbal

communication, for example, if the patient/client seems furious, first determine what is
causing his/her anger.

Warm: In a therapy setting, provide non-possessive warmth. Smile at the patient/client and
express compassion and acceptance.
Knowledgeable: should be well-versed in the topic/problem, such as medication adherence.
Some individuals refuse to take medicine for various reasons, while others are in desperate
need of medications or prescription. Muslims, for example, do not take oral medications
when fasting, and Jehovah's Witnesses do not use blood transfusions. Understanding the
reasons why individuals may refuse to perform particular tasks at various times can help you
better support them.

Empathy for the patient or client: In the counselling process, try to comprehend the patient's
or client's emotions. To put it another way, put yourself in his or her shoes.

Keeping a therapy connection with a patient alive and well:

Allow the patient/client to make his or her own choice based on your message.

Confidentiality: Although anonymity is essential in health care, it may not apply to all
circumstances; for example, most individuals will freely express how they feel or the issue
they are experiencing. However, make sure that anything the patient/client says you is kept
private. If you reveal any information about the patient/client to others, he or she will be very
upset. This need personalised and confidential therapy.

Integrity of character: As a counsellor, maintain a high level of personal integrity, credibility,

and mutual trust.