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There are certainly different approaches to the theory of anticipatory mourning. Clearly, one of the major issues within the literature surrounds the communication between the dying person and the caregiver, and both caregiver and patient and those who will be most affected or will mourn their loss. Conventional theory finds that preparing for loss involves experiencing most of the features of grief prior to the demise of the patient; numbness, anger or blame, fear, desperation, and even despair. However, an important difference is that the period of mourning begins before death occurs, and while contact and communication with the dying person is still a viable option. Because of this, there are additional emotions involved; hope, nostalgia, kindness, tenderness, and opportunity for closure (Fulton, 2003). It is this sense of hope, this feeling that there may still be something that can be done for the patient that is the focus of alternative theories regarding the efficacy of anticipatory grief as a positive aspect of caregiving. Some, of course, view the idea of dealing with as many of the emotions prior to death as positive -- it allows greater closure, greater sharing, and even at times can be more comforting to both caregiver and patient (Moorey, 1995, 92-6). However, other research shows that in some cases anticipatory death prolongs the grief experience; in some individuals it has the effect of mitigating the overall process once the patient has died. But in others, the feelings of hope, of a miracle cure, of something new in medical science that will change the outcome, becomes so strong that there is far more anger and denial if a cure is not forthcoming (Rando, 2000).
Conclusions- Mourning is a process, it is fluid, individualistic, and personal. But it is also part of what makes us human, what makes empathy part of the human condition, and what allows us to project into a caring mode. Each culture has, of course, developed its own way of dealing with the process of death and dying, yet the medical-social paradigm of the West tends not to always allow and acknowledge carefiver grief. Caregivers, in fact, are often more uniquely involved in the dying process, becoming not just an advocate, but often an extension of that person for a brief, but critical time. By the very nature of human psychology, then, the caregiver-patient bond becomes even more critical and grief, loss, and mourning a very real part of the caregiver's experience. The research clearly shows, though, that the length and seriousness of grief, as well as the psychological and physical symptoms, can be mitigated with a very few practices that are easily implemented. First, the social service and healthcare models need to provide as much information as possible to both the caregiver and patient. Lack of knowing and understanding contributes to stress and an unhealthy atmosphere for all. Second, the caregiver's needs prior to, during, and after the death-event should never be minimzed or ignored. The more supportive mechanisms available, the easier it is for caregivers to return to a semblance of productivity and normalcy within their lives (Doka, 2002).
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