1 Bradford & Airedale Palliative Care Who Cares for the Carers – Who cares for you?

2 WHO Definition of Palliative Care retrieved 19th Oct 2010 Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

3 provides relief from pain and other distressing symptoms affirms life and regards dying as a normal process intends neither to hasten or postpone death integrates the psychological and spiritual aspects of patient care offers a support system to help patients live as actively as possible until death offers a support system to help the family cope during the patients illness and in their own bereavement

4 uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated will enhance quality of life, and may also positively influence the course of illness is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications

5 Cruse Bereavement Care Cruse Bereavement Care exists to promote the well being of anyone bereaved by death and to enable bereaved people to understand their grief and cope with their loss. Whoever has died: whenever they died

6 We do this in a variety of ways 1: Individual bereavement support – children, adolescents, adults - “normal grief” Individual bereavement counselling - “complicated grief” Group support Telephone support Information

7 We do this in a variety of ways 2 Initial & ongoing training for our volunteers Informing and lobbying government to include consideration of bereavement issues in policy making Resources, training and education services on bereavement issues for anyone – members of public; professionals; organisations

8 We do this in a variety of ways

9 Understanding grief: coping with loss 1 Understanding Grief

10 What is grief and what is it for? Grief encompasses a wide range of reactions –Behaviours –Physical sensations –Cognitions –Feelings Grieving is a normal life process—an adjustment reaction to a loss

11 Behaviours Sleep disturbance Appetite disturbances Absent-mindedness Dreams/nightmares Searching Sighing/crying Hyperactivity Treasuring objects Avoiding reminders

12 Physical sensations Hollowness in stomach Tightness in chest Tightness in throat Breathlessness Lack of energy Dry mouth Oversensitivity to noise

13 Cognitions Disbelief Confusion Preoccupation Sense of presence Hallucinations

14 Feelings NumbnessWorthlessness ShockGuilt FearYearning AnxietyTiredness / Exhaustion SadnessJealousy HelplessnessRelief AngerEmancipation Sense of depersonalisation (nothing seems real including self)

15 Understanding grief: coping with loss 2 Contemplating our own losses

16 Please draw a ring around any of the following losses you have experienced & add others that you can think of Cat died Home broken into Purse/wallet stolen Car accident Hamster diedLoss of health Children left home Grandmother died Friendship ended Moved away from country of birth Failed exams Brother died Loss of home Miscarriage Dog died Leaving first home Child died Marriage Good neighbour moved away Job lost Birth of a child Depression Left a happy school Retirement Had a relationship breakdown Credit card lost/stolen Mother died Father died Broken limbLoss of faith Moved away from place where grew up Sister died Loss of financial security Friend died promotion at work Partner died Parents divorced Grandfather died Mobile phone lost/stolen

17 Understanding grief: coping with loss 3 Contemplating what helped What was helpful What was unhelpful How I helped myself What help was missing

18 Feedback from Exercise

19 In Conclusion Grieving is a normal life process—an adjustment reaction to a loss When we lose something or when someone dies, we experience some or all of the symptoms of grief – which can be behavioural, physical, psychological or emotional What helps is very individual and situation specific. Those of us who are carers need to remember to care for ourselves too

20 Remember: Give of your bucket not of your well

21 Bradford & Airedale Palliative Care Who Cares for the Carers – Who cares for you?