Bereavement, Loss and Learning Disabilities: A Guide for Professionals and Carers

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Losing a loved one and coping with the subsequent adjustments that follow are difficult facts of life, but people with learning disabilities face specific problems in processing and managing these changes. This book outlines how loss and bereavement is experienced differently by people with learning disabilities and acknowledges the importance of the helping professions in supporting this vulnerable group through periods of loss and bereavement.

Addressing the spectrum of learning disabilities, this book examines common difficulties that may be faced, outlines the different stages of loss and addresses factors to consider when assessing risk. The author discusses the importance of understanding and communication in resolving distress around bereavement and loss, and explains how to engage someone with a learning disability in talking therapy by creating an open dialogue. The book also covers issues such as how to work with family members, the role a carer provides in bereavement and the role of supervision in counselling.

Bereavement, Loss and Learning Disabilities will be a much-valued source of understanding and advice to counsellors, therapists, carers and health and social care students who are working with or caring for people with learning disabilities.

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Product Details

  • ISBN-13: 9781849050203
  • Publisher: Kingsley, Jessica Publishers
  • Publication date: 2/28/2010
  • Pages: 178
  • Product dimensions: 6.00 (w) x 8.90 (h) x 0.60 (d)

Table of Contents

1 Introduction and Overview 7

The purpose of this book 7

Terminology 9

Facts and figures 10

Relevant UK legislation and policy 11

Context of the work 12

The focus of different practitioners 13

Routine as safety 14

Is talking therapy the appropriate treatment? 15

Problems that may be faced 15

Associated losses 17

Physical sensations 20

Psychic or spirit sensations 20

Collective grief 20

Witnessing other people's illness 21

Conclusion 22

2 How Bereavement and Loss can be Different in Learning Disabilities 23

Introduction 23

Why the experience of bereavement might be different for someone with a learning disability 23

Self-blame 35

Not knowing when grieving 'stops' following bereavement 36

3 Stages of Loss 37

Introduction 37

Shock 37

Denial 38

Bargaining 38

Searching 39

Anxiety 39

Anger 40

Guilt 40

Depression 41

Grief and mourning 42

Acceptance 42

How we can help this process 43

4 Assessment 47

Introduction 47

Background to risk 48

Care plans 49

Managing greater risks posed to the individual 49

Relevance to bereavement and loss 50

Depression 51

Anger 53

Physical manifestations of grief 53

Self-esteem 55

Assessment of behaviours that may be seen as attention seeking 55

Factors to consider when assessing for any therapeutic work 55

History of attachments 58

Factors to consider in grief work 59

Unresolved grief 62

5 Developing Understanding around Bereavement and Loss 65

Context of the work 65

Practical considerations 66

Blocks to understanding 67

Building on previous understanding 69

Autism and understanding of bereavement and loss 70

Developing an understanding of illness 72

Developing an understanding of what death is 73

Breaking news of sudden illness or death in residential settings 73

Reading social cues 75

Different attachments in residential care 75

Difficulty in locating the body 75

Explaining change to people with learning disabilities 76

Health education and awareness 78

Specific illness 79

Impact of a death within a shared supported house 80

Avoiding euphemisms 81

Thinking about funerals and attending funerals 82

Finding it hard to move on from worry 83

Growing older 85

6 Therapeutic Tasks 86

Introduction 86

Types of referrals 86

Establishing a good therapeutic relationship 87

Consent 88

Contract 88

Confidentiality 89

Boundary setting 89

Environment and room setting 90

Goal setting 90

Tasks of counselling 91

Endings 92

7 Working with Families 94

Introduction 94

Life cycle issues 94

Beliefs and customs 96

Loss felt by parents 96

Loss of being parents 96

Issues for older parents 97

Preparing for the future 100

Being honest about health needs 101

Managing the effects of moving home 102

Managing when parents become ill or hospitalized 103

Dealing with structural change 105

8 The Carer's Role in Bereavement 106

Introduction 106

Knowing someone's history 106

Who is a carer? 107

Staff training needs 107

Supporting a client who is facing a bereavement 107

Systemic implications of a loss 109

The role of carers 109

National Service Framework for Mental Health and the Carers Act 110

Caring for someone with learning disabilities 110

Long-term foster placements 111

Supporting people in residential care facing loss and bereavement 112

End of an adult fostering relationship 114

9 Working with Clients who have Additional Communication Needs 115

Language and meaning 115

Identifying non-verbal change 116

Behavioural changes 117

Echolalia 117

Involving speech and language therapy 118

MakatonĀ® 118

Using Makaton to communicate emotions around loss and bereavement 119

Talking MatsĀ® 120

Hearing loss 121

Sight loss 121

Creative therapies 122

Dementia and learning disabilities 123

10 Role of Supervision 126

Introduction 126

Why supervision work in learning disabilities is essential 126

Establishing the contract 127

Functions of supervision 128

Issues that often present in learning disabilities supervision 130

Difficulties in obtaining appropriate supervision around bereavement and loss 132

Encouraging self-reflection 133

Working with trainees 133

Supervising trainee counsellors 135

Supervising residential staff 135

Supervising day care staff 136

'Death and loss' for trainees 136

11 Working with Terminal Illnesses 138

Introduction 138

Why terminal illness is a difficult area 139

Delays in diagnosis 139

Assumptions made by others 140

National Strategy for End of Life Care 2008 140

The concept of death 141

Knowledge of what a terminal illness is 142

Maintaining identity 143

Specific issues for adults with learning disabilities facing end of life illness 144

Explaining a terminal diagnosis 147

Palliative care 148

Health education 148

Supporting people with learning disabilities who have terminally ill relatives and friends 149

12 Remembering and Anniversaries 151

Introduction 151

Functions of remembering 152

Recalling the past 153

Recognizing attachments 153

Problems with remembering 154

When remembering is not helpful 156

Managing unpleasant memories 157

Unwelcome reminding 157

Loss felt by a centre or home 158

Continuity 158

Problems with anniversaries 159

Doubts about memory and relationships 160

Creating a focus 161

Unresolved grief appearing some time after a loss 161

Seasons and festivals 163

Voices, accents, smells and sounds 163

Dementia 164

Managing change 165

When to end mourning and remembering 166

References 168

Useful Organizations and Resources 170

Index 172

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