Bereavement and End-of-Life Issues

This program is approved for 4 continuing education hours by:
The California Board of Behavioral Sciences # PCE 3457
The California Board of Registered Nursing # CEP 14462
The National Association of Social Workers (NASW) # 886463870
The Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling #50-14000
Texas Board of Examiners of Marriage and Family Therapists # 628
Texas State Board of Examiners of Professional Counselors #1646
The Texas Board of Social Worker Examiners # 5547

At the completion of this course the healthcare professional will be able to:

1. Identify and discuss the assessment and treatment of bereavement issues.
2. Discuss proper treatment for bereaving family members.
3. Identify and explain end of life issues such as:

• Pain Management
• Hospice Care

4. Educate clients about the need for advance directives.

I. Introduction

This course addresses the issues that clients and their families face during the last months of a person's life, and the bereavement that comes surrounding the illness and death of another. Case studies are provided to illustrate the assessment of issues that accompany bereavement in addition to effective interventions for treatment.Some of those who have suffered a loss may have additional emotional complications beyond the "normal response" to loss. Others will have an intense, yet normal response referred to diagnostically as bereavement.

Bereavement is a diagnostic category given a V code in the DSM-IV-TR (APA, 2000) signifying it as a "focus of attention or treatment not attributable to any of the mental disorders" mentioned in the manual (p. 359).Specifically, this diagnosis is used when the "focus of treatment is a normal reaction to the death of a loved one..." (p. 361).The manual goes on to note that a person suffering from this diagnosis may suffer a "full depressive syndrome" including symptoms such as feelings of depression, weight loss, insomnia, and poor appetite.In addition, feelings of guilt may be present for things the survivor did not do at the time of death, and thoughts of the deceased being better off dead, or that the survivor should have died with the deceased person are common.

However, if there is a morbid preoccupation of worthlessness, prolonged functional impairment, and psychomotor retardation, it is probable that this condition is complicated with Major Depression.Also as a qualifier the manual states that the major depression does not usually develop until two to three months after the death of the one being bereaved.

To add to the diagnostic definition of bereavement in the DSM-IV-TR Edelstein classifies bereavement as a "subcategory of the mourning process" and writes that much of the work done on mourning is an off take of work done on bereavement.For the purpose of this course words such as mourning, grief, and bereavement will be used interchangeably.