DEATH, DYING AND BEREAVEMENT
How to assess the victim’s mother of bereavement
Bereavement is a status which results due to loss of a loved one through death. This results into great longing for the person who is dead followed by a period of adjustment that may take years. It affects emotional, social, spiritual and physical being of the survivors due to the intense pain or grief the person feels. There are five stages of grief. Alarm is the first stage that is characterized by physiological changes like increase in heart rate. It is followed by numbness which makes a person to appear as if they are affected by the loss superficially whereas in reality they are preventing themselves from suffering acute distress. The third stage is pining or searching where a person looks for the dead person or is reminded of them. Depression follows in which the bereaved person has no hope for the future and does not feel like life is worth living. This is normally accompanied by withdrawal from family and friends. The final stage of bereavement is recovery and reorganization which comes after a period of time has elapsed after death which can be even after years when a person comes to accept that life needs to continue and makes the necessary adjustments in their lives.
Each loss is unique and the need for support varies thus creating the need for bereavement needs assessment to establish who needs help in coping with the loss. Many feel that with their inner resources and the help from families and friends they can make it through grief and so for them to seek help is just a confirmation of whether they are suffering from normal bereavement. In this situation the mother of Pitcairn may be a vulnerable person who needs extra assistance given that she was the talking to her son when he was stabbed as she might find it hard to adjust to life without her son.
Assessment for bereavement needs is done using a checklist that acts as a guide to the accumulated vulnerability depending on the Bereavement Risk Index (BRI) which is used in combination of formal and informal discussions on the needs of the person ( Machin & Archer, 2008). Assessment is normally conducted using the Response to Loss assessment that categorizes the loss into overwhelmed, controlled and resilience. In overwhelmed, the feelings of distress are the dominant response, in controlled the person maintains emotional control in managing the problems and dealing with life situation which is the dominant response while in resilience, the person shows the ability to manage the social, emotional and practical aspects in equilibrium. Response to Loss model is the basis of the self assessment tool, Adult Attitude to Grief (AAG) which is used to help people describe what they feel.
Overwhelmed response is characterized by the person showing frequent intrusion of thoughts about the person while conveying that the current distress will go on and that everything is changed for the worst since life has lost meaning as specific indicators. General indicators are anxiety, tears, fear, mistrust in themselves, pessimistic, frequently seeking reassurance, demanding for attention from staff and they are unable to process information. Controlled response is indicated by the following specific indicators, they show courage while talking about the outcome, the person believes that feelings and emotions should be controlled to show strength, they feel like telling others about how they feel is a burden and the person believes that to better manage loss, it is important to get on with life. The general indicators include no or little emotion to the loss, discussions about the outcome of the situation are as a matter of fact, shows difficulty in responding to other people’s emotions, does not trust others and neither do they seek support, the patient tends to focus on practicality of the situation, they are self-reliant and they are able to manage the demands in life. Specific indicators for resilience include the patient’s ability to cope with the issues while showing strategies of coping using inner resources and available external sources while at the same time acknowledging the impact on their loss on their emotions ad social status. General indicators include the ability to coherently describe the situations and the person is also able to discuss about it, the person shows emotions that are not accompanied by distress and the person accepts help and support. A vulnerable person avoids facing the issues of loss and does not show any coping strategies. The person cannot acknowledge that the loss has impacted their emotional and social life and does not believe that they will emerge out of the situation stronger. General indicators of this kind of person include unpredictability of the responses while asked about the situation, The person is angry and frustrated, depressed and is difficult to handle and is unsure of whether they need support.
Using the Response to Loss model, it will be possible to assess the bereavement of Pitcairn’s mother through observation and her description of what she feels.
In this case there are psychological stressors. These results from the state of bereavement that is felt by Higgins who was the last person to see Pitcairn alive, friends who worked with Pitcairn in the Hopkins laboratory and professors who have had previous experience with Pitcairn (Marbella, 2010). All this individuals feel that they have lost an important person in their life who used to make life more bearable. This is especially so for the colleagues at work who were used to Pitcairn lightening the intensity associated with intensive research. They feel that the workplace is sad and empty without the presence of Pitcairn. Another stressor associated with the case is social stressor which mainly comes after the loss of a person in a place where interpersonal relationships have been in existence. Many people who worked with Pitcairn stay away from families for a long time and so they feel the stress of being away from their families. Pitcairn too was away from his family and had no friends in Washington. The social stressor is also indicated by the racism because the people who killed Pitcairn were black while Pitcairn was white which caused a huge debate that the blacks targeted the whites. It emerges that the only person who was there to help Pitcairn, Higgins is black which indicates that racism still dominates the community. Racism is a factor that stresses every person in Charles Village because they do not know who might be the next target. The persons working at the Hopkins Laboratory deal with research to find possible treatment for diseases like cancer are exposed to the possibility of being infected by the chemicals, microorganisms and technology that they use every day which contributes to the intensity that is felt when conducting experiments.
A major stressor is the fear of being attacked and mugged. Pitcairn’s death was as a result of being stabbed on the chest as he was walking home even after giving the muggers what they wanted. Professor Richardson had previously warned Pitcairn of the occasional crimes that used to occur at Hopkins (Marbella, 2010). The two suspects who were arrested had previous criminal records which indicate that they had committed other crimes in the area. The place is thus unsecure especially for people walking alone at night. The people in the Charles Village live in fear of being attacked on their way home from work. This is indicated when Higgins calls out the neighbors to help, no one shows up. Stress is also caused by demands of every day life where Pitcairn always had a busy schedule. Demands in life are great and each person has to work towards fulfilling those demands. These demands are often accompanied by time pressure where one does not see time pass by if busy. This demand to succeed saw Pitcairn move far away from home to a place where he knew no one so that he could make it in life. Due to Pitcairn and Higgins having a busy schedule, they had not previously met each other until that unfortunate night.
Machin, L and Archer N (2008). Guidance for bereavement needs assessment in palliative care. Help the Hospices. England
Marbella, J (2010). A year in Baltimore, ended with a final, human touch. The Baltimore Sun