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Bereavement 

Bereavement
Chapter:
Bereavement
Author(s):

David W. Kissane

and Talia I. Zaider

DOI:
10.1093/med/9780199656097.003.0177
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date: 07 May 2021

The phenomena and trajectory of mourning as a normal adaptive process are differentiated from clinical depression, avoidant and complicated grief, post-traumatic distress disorder, and other forms of pathological grief. Anticipatory grief can be a particular challenge during palliative care. The family is recognized as the major source of social support and the environment in which grief is shared with others. Key risk factors for pathological bereavement outcomes can be identified on admission to palliative care, permitting preventive models of psychological care to be used through palliative care into bereavement. Models of therapy include supportive-expressive, interpersonal, cognitive behavioural, family focused, and specific therapy for complicated grief. Pharmacotherapy can judiciously accompany psychotherapy. Life-cycle issues include bereaved children, siblings, parents, and grief for the very elderly. Grief can be stigmatized and ambiguous in special circumstances, yet positive growth is a desirable outcome from any loss.

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