Responding to Grief Also by Caroline Currer Concepts of Health, Illness and Disease (editor with M. Stacey) Responding to Grief Dying, Bereavement and Social Care Caroline Currer Consultant Editor: Jo Campling © Caroline Currer 2001 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No paragraph of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Designs and Patents Act 1988, or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages. The author has asserted her right to be identified as the author of this work in accordance with the Copyright, Designs and Patents Act 1988. First published 2001 by PALGRAVE Houndmills, Basingstoke, Hampshire RG 21 6XS and 175 Fifth Avenue, New York, N.Y. 10010 Companies and representatives throught the world PALGRAVE is the new global academic imprint of St. Martin’s Press LLC Scholarly and Reference Division and Palgrave Publishers Ltd (formerly Macmillan Press Ltd). ISBN 978-0-333-73639-5 ISBN 978-1-349-87635-8 (eBook) DOI 10.1007/978-1-349-87635-8 This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. A catalogue record for this book is available from the British Library. 10 9 8 7 6 5 4 3 2 1 10 09 08 07 06 05 04 03 02 01 Contents List of Tables viii Acknowledgements ix 1 Introduction: Dying, Bereavement and Social Care 1 1.1 Dying, Bereavement and Social Care: An Ambiguous Relationship 2 1.2 Aims, Approach, Sources and Structure 7 2 Social Care 11 2.1 Care and Carers: Some Definitions 11 2.2 Structure of Services 15 2.3 Essential Features of Social Care 17 2.4 The Social Context of Social Care: Current Issues and Trends 19 3 Understanding Death and Dying 22 3.1 The Relevance for Practice of Theoretical Understandings 22 3.2 Defining Death: Biological and Social Death 24 3.3 The Demography of Death 27 3.4 Changed Social Understandings of Death 29 3.5 Rites of Passage 31 3.6 Dying: Introduction 32 3.7 Who is Dying? 33 3.8 What is Dying? 37 3.9 Facing Death: Psychological Perspectives 38 4 Facing Death 43 4.1 Managing the Present 44 4.2 Abandoning the Future 47 4.3 Separation, Loneliness and the Social Bond 51 4.4 Some Reflections upon Theory 54 v vi Contents 5 Care Workers’ Involvement with Those Facing Their Own Death 58 5.1 Social Care with People Facing Death: A Broad Spectrum 59 5.2 The Social Care Response 77 5.3 Issues of Training and Support 86 5.4 Conclusion: Social Care with People who are Dying 88 6 Understanding Grief and Bereavement 90 6.1 Defining Key Terms 91 6.2 The Grieving Process and the Grief Work Hypothesis 94 6.3 Theoretical Developments and Debate 101 6.4 A Child’s Grief 107 6.5 Consequences of Grief 110 6.6 Conclusion: Understanding Grief 111 7 Experiencing Bereavement 113 7.1 Individual Aspects of the Experience of Grief 115 7.2 Social Aspects of the Grieving Experience 118 7.3 Responding to Grief: The What and Who of Receiving Help 120 8 Care Workers’ Involvement with Those Who are Bereaved 124 8.1 Bereavement: A Significant Feature in All Areas of Social Care 126 8.2 The Social Care Response 140 8.3 Issues of Training and Support 149 9 Responding to Grief: Conclusions for Social Care 155 9.1 Why Should Social Care Workers be Involved with Those Who are Dying or Bereaved? 156 9.2 What Can Social Care Workers Do? 156 9.3 What Do We Need if We are to Do this Well? 157 9.4 How is this Particular to Social Care? 157 Contents vii Organisations 159 Bibliography 160 Index 173 List of Tables 3.1 Deaths in given age bands, as a percentage of all deaths, by gender, England and Wales, 1998 27 3.2 Selected major causes of death, as a percentage of total deaths in each age group, England and Wales, 1998 27 viii Acknowledgements It would not have been possible to write this book without the support and encouragement of Kate Atherton, Judy Hicks, Carol Holloway, Jenny Pardoe and Margaret Wareing and of colleagues in the Social Work Department at Anglia Polytechnic University. I am grateful too to Jo Campling for guiding me through the process, to Jeanne Katz for her helpful comments on an early draft, to librarian Thelma May and to David Oliviere for some timely help. In researching the experience and role of social care practitioners, anumber of people have given generously of their time, and it has been a privilege to hear from them about their work. In addition to those already mentioned, particular thanks are due to Graham Badger, Jane Burditt, Lyn Crisp, Grace Cunningham, Chris Davis, Judy Edwards, Julia Franklin, Leila Gordon, Dini Hardy, Carla Hodgson, Nicki Hone, Joyce Jones, Joyce MacDonald, Greg Mantle, Christina Mason, Ian Morris, Mary Pennock, Sue Percival, Valerie Peters, Jill Rapoport, Clare Seymour, Jean Swanson, Tessa Sowerby and Nick Tyndall. I trust that they will feel that the whole does justice to the parts that they will recognise. Each year, I learn afresh from the second-year Diploma in Social Work students who take the ‘Loss and Social Work’ elective module. Whilst preparing this book, I invited one cohort of students to con- tribute examples that relate theory to practice in responding to grief. Iam grateful to all those who responded, especially Jill Ahmet, Colette Boukhoufane, Lucy Firmin, Sue Foster, Fiona Flynn, Sharon Gage, Audrey Hornsey, Vic Inderjeet, Helen Jocelyn, Glenda Lanoix, Melvyn Plum, Karin Roberts, Louisa Ruff, Cherie Smith, Paula Stockwell, Marion Talbot, Jocelyn Trent and Barbara Vincent. They will recog- nise some of the examples given, but I hope that no-one else will. All details have been altered, and any errors are mine, not theirs. Chapters 4 and 7 draw heavily on published accounts by dying and bereaved people of their experiences. Those of us who seek to under- stand these aspects of life owe much to others who have written or spoken about their own feelings and experiences. I hope that what is here does justice to the accounts from which I have quoted. Particular thanks are due to Andrew Pearmain and Richard Davies for permission to use the ix