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bereaved, who frequently feel confused in such circumstances, will be of great importance in such cases.


The reluctance of people to talk about death contributes to the

difficulty of preparing them for the impending death of somebody close. Evidence shows that where bereaved people have been prepared for the death, and for the events which follow death, the bereavement experience

is usually easier.

The Department of Health’s End of Life Care Strategy

(Department of Health [DoH] 2008) states:

“there is some evidence to suggest that assessing and addressing these issues early and providing appropriate support, is preventative healthcare, helping carers to prepare for their loss.

The Marie Curie Palliative Care Institute publish a leaflet as part of the Liverpool Care Pathway entitled Coping with Dying which helps people understand, and therefore be better prepared for, the dying process.


Where decision making has been shared with the patient and those

who will be bereaved, and areas such as place of death, and funeral arrangements have been discussed openly, both the death and the grieving can be easier. The current developments in advanced care planning provides an excellent opportunity to promote such discussions, which may include issues such as post mortem, organ donation and Do Not

Attempt Cardio-Pulmonary Resuscitation (DNACPR) instructions.


Explanations of an impending death, and of the dying process need

to be given in a way which is sensitive to the cognitive ability of those being addressed. It is important that children and those with learning difficulties, for example, be included in the discussions at an appropriate level, and that information is presented in a way and at a level which they can understand. The involvement of guardians or those holding a power of attorney can be helpful here. Collusion around the likelihood of death is particularly common with children and young adults who are often shielded from death, with the consequence that they do not develop coping strategies

around bereavement.

Shaping Bereavement Care 19

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