Bereavement Health Dictionary

The active total care offered to a person and that person’s family when it is recognized that the illness is no longer curable, in order to concentrate on the person’s quality of life and the alleviation of distressing symptoms. The focus of palliative care is neither to hasten nor postpone death. It provides relief from pain and other distressing symptoms and integrates the psychological and spiritual aspects of care. It offers a support system to help relatives and friends cope during an individual’s illness and with their bereavement.... palliative care

Psychological support and advice provided by a trained therapist or health professional. The aim is to help an individual manage a particular personal or family problem: this may be a diagnosis of cancer, mental and physical trauma following an accident or assault, or a bereavement. Counselling can help people cope with a wide range of demanding circumstances. It is usually done on a one-to-one basis – sometimes in small groups – and needs to be provided with skill and sensitivity or there is a risk of worsening the individual’s diffculties. There has been rapid growth in counselling services and it is vital that those providing them have been properly trained.... counselling

A service provided by a religious denomination, primarily aimed at meeting the spiritual and religious needs of patients in hospitals. In the UK, NHS hospital trusts employ both full-time and part-time chaplains, usually representing the mainline Christian churches (Anglican, Free and Roman Catholic). Their duties vary but always at the least involve meeting the speci?cally religious needs of patients as well as of relatives and sta? who may ask for help. Public services in chapels, the bedside administration of the Word and Sacraments, and prayers and radio services are among chaplains’ duties. When requested by patients, chaplains also liaise with representatives of other world faiths.

Chaplains have a broad responsibility for the spiritual health care of all in hospital. They share this with other sta? members, particularly the nursing sta?, for whom the chaplains can be a resource. Chaplains also train and use volunteers from local churches to help with ward visiting and other chaplaincy duties. Much of the time spent with patients takes the form of a listening ministry, helping patients to ?nd their own answers to what is happening to them in hospital and in life generally. Spiritual health can be seen as a quest for the right relationships in four areas – with other people; with oneself; with the world around; and with ‘Life’ itself. The religious person subsumes all that in his/ her relationship to God.

The link between spiritual disease and physical ill-health is well established; the chaplain therefore helps a hospital to provide a HOLISTIC approach to health care. Chaplains also give time to the care of sta? who face increasing levels of stress at work, making use of support groups, counselling, meditation, etc. Chaplains support patients’ relatives facing a crisis, for example, by being with them over the period of a death, and by providing regular bereavement services for those who have lost babies. Some chaplains have a particular expertise in ETHICS and are members of the various hospital ethics committees. A chaplain may have a ‘nonmanagement’ view of the health of the hospital itself, which can be of use to hospital management. (See also SPIRITUAL PAIN.)... hospital chaplaincy

These are drugs that induce SLEEP. Before a hypnotic is prescribed, it is vital to establish – and, where possible, treat – the cause of the insomnia (see under SLEEP, DISORDERS OF). Hypnotics are most often needed to help an acutely distressed patient (for example, following bereavement), or in cases of jet lag, or in shift workers.

If required in states of chronic distress, whether induced by disease or environment, it is especially important to limit the drugs to a short time to prevent undue reliance on them, and to prevent the use of hypnotics and sedatives from becoming a means of avoiding the patient’s real problem. In many cases, such as chronic depression, overwork, and alcohol abuse, hypnotics are quite inappropriate; some form of counselling and relaxation therapy is preferable.

Hypnotics should always be chosen and prescribed with care, bearing in mind the patient’s full circumstances. They are generally best avoided in the elderly (confusion is a common problem), and in children – apart from special cases. Barbiturates should not now be used as they tend to be addictive. The most commonly used hypnotics are the BENZODIAZEPINES such as nitrazepam and temazepam; chloral derivatives, while safer for the few children who merit them, are generally second choice and should be used in the lowest possible dose for the minimum period.

Side-effects include daytime drowsiness – which may interfere with driving and other skilled tasks – and insomnia following withdrawal, especially after prolonged use, is a hazard. Occasionally benzodiazepines will trigger hostility and aggression. Zolpidem and zopiclone are two drugs similar to the benzodiazepines, indicated for short-term treatment of insomnia in the elderly. Adverse effects include confusion, incoordination and unsteadiness, and falls have been reported.

FLUNITRAZEPAM is a tranquilliser/hypnotic that has been misused as a recreational drug.... hypnotics

n. no longer having some valued aspect of one’s life, such as a relationship, a job, or a home, that one has previously enjoyed. This may have health consequences: shock, disbelief, and emotional numbness may be followed by anger, guilt, anxiety, or profound sadness. Such emotions may lead to behavioural changes or symptoms that bring people to health care. Encouraging the patient to talk about the loss will require *empathy, sensitivity, and *judgment from the professional, both to obtain the history of the events and to provide helpful advice and direction to assist in adjustment. See also bereavement.... loss

n. 1. (social withdrawal) (in psychology and psychiatry) the removal of one’s interest from one’s surroundings. See also bereavement. 2. see coitus interruptus. 3. see thought withdrawal. 4. (of treatment) the correct change to *palliative care when someone is *dying.... withdrawal

EDUCATIONAL PSYCHOLOGISTS Working in schools and in local education authorities, they are concerned with children’s learning and development. They carry out tasks aimed at improving children’s learning and helping teachers to become more aware of social factors that affect teaching and learning. Chartered educational psychlogists have a graduate degree in psychology and also a teaching quali?cation, with experience; in addition they have completed a one-year postgraduate course in educational psychology with supervised experience. COUNSELLING PSYCHOLOGISTS apply psychology to working in collaboration with people across a range of human problems. For example, helping people to manage di?cult life events, relationship issues, BEREAVEMENT and issues raised by mental-health problems. Their usual route to qualify is completing a three-year postgraduate training in counselling psychotherapy. CLINICAL PSYCHOLOGISTS have completed a three-year doctorate training course as well as having their ?rst degree in psychology. They work in health and care settings. Their aim is to reduce psychological distress and to promote psychological well-being. They work with individuals, families, groups and organisations: the individuals are people who have problems such as anxiety, DEPRESSION, serious and enduring MENTAL ILLNESS, brain injuries, addiction, child and family problems, LEARNING DISABILITY and the after-effects of trauma. They provide various types of treatment, for example COGNITIVE BEHAVIOUR THERAPY and family therapy, based on psychological theories and research. They also carry out research, training, consultation with other professionals involved with clients, and supervision of colleagues.

(See also NEUROSIS; PSYCHOTHERAPY.) FORENSIC PSYCHOLOGISTS work in the

criminal and justice ?elds, applying psychological theory to aspects of legal processes in courts, criminal investigation, and understanding and treating psychological problems associated with criminal behaviour. They will have completed an accredited training course in forensic psychology. HEALTH PSYCHOLOGISTS apply psychological methods to studying behaviour relevant to health, illness and care including health promotion and education. OCCUPATIONAL PSYCHOLOGISTS are concerned with how people perform at work and how organisations function. They work in management, personnel, selection and careers advice. They have a postgraduate degee in occupational psychology and will have had to undertake three years’ supervised practice.... types of psychologist

A group of rheumatoid conditions of unknown causation with onset before 16 years. Girls more than boys. Still’s disease being the form presenting with enlargement of spleen and lymph nodes, high temperature with macular rash comes and goes. Children usually ‘grow out of it’ although stiffness may continue. Deformities possible. Tardy bone growth of the mandibles giving the face a birdlike look. May progress to rheumatoid arthritis (girls) or ankylosing spondylitis (boys). So strong is psychosomatic evidence that sociologists believe it to be a sequel to broken families, divorce or bereavement. Few patients appear to come from a balanced environment or happy home.

Treatment. BHP (1983) recommends: Meadowsweet, Balm of Gilead, Poke root, Bogbean, Hart’s Tongue fern, Mountain Grape.

Teas: Singly or in combination (equal parts): Chamomile, Bogbean, Nettles, Yarrow. 1-2 teaspoons to each cup boiling water; infuse 5-10 minutes. 1 cup thrice daily before meals.

Tablets/capsules. Blue Flag root, Dandelion root, Poke root, Prickly Ash bark.

Formula. White Poplar bark 2; Black Cohosh half; Poke root quarter; Valerian quarter; Liquorice quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon) (children 5-12 years: 250mg – one 00 capsule or one-sixth teaspoon). Liquid extracts: 1 teaspoon: (children 5-12: 3-10 drops). Tinctures: 2 teaspoons: (children 5-12: 5-20 drops).

Evening Primrose oil. Immune enhancer.

Topical. Hot poultice: Slippery Elm, Mullein or Lobelia.

Diet: Lacto vegetarian. Kelp. Comfrey tea. Molasses. Low fat.

General. Adequate rest, good nursing, gentle manipulation but no massage to inflamed joints. Natural lifestyle. Parental emotional support.

Oily fish. See entry. ... arthritis, juvenile, chronic

One of life’s most stressful experiences is associated with bereavement following the death of a partner and which may give rise to the “I am out of control” syndrome.

Evidence exists that bereavement is related to a suppression of white cell function. As long as one year may elapse before a normal blood pattern is regained. (Dr Stephen Schleifer, Mount Sinai School of Medicine, New York City)

To help restore lymphocyte count and relieve depression/anxiety: Combine equal parts Red Clover (blood): Valerian (nerves) and Motherwort (heart).

Tea: 1-2 teaspoons to each cup boiling water; infuse 15 minutes; half-1 cup 2-3 times daily.

Alternative. Tea: equal parts Motherwort, Balm and Chamomile. 2 teaspoons to each cup boiling water; infuse 5-15 minutes. 1 cup as desired.

Liquid Extracts: 20-60 drops in water, 2-3 times daily.

Pulsatilla. (Nalda Gosling, FNIMH, Herbal Practitioner: Apr 79, p.11)

Note: Grief is known to make changes in hormone production and invariably centres on the reproductive system manifesting as a uterine or prostate disturbance. ... grief

Prescribed according to mental symptoms or personality traits:

1. Agrimony. Those who suffer considerable inner torture which they try to dissemble behind a facade of cheerfulness.

2. Aspen. Apprehension and foreboding. Fears of unknown origin.

3. Beech. Critical and intolerant of others. Arrogant.

4. Centaury. Weakness of will; those who let themselves be exploited or imposed upon – become subservient; difficulty in saying ‘no’. Human doormat.

5. Cerato. Those who doubt their own judgement, seeks advice of others. Often influenced and misguided.

6. Cherry Plum. Fear of mental collapse/desperation/loss of control and fear of causing harm. Vicious rages.

7. Chestnut Bud. Refusal to learn by experience; continually repeating the same mistakes.

8. Chicory. The over-possessive, demands respect or attention (selfishness), likes others to conform to their standards. makes martyr of oneself.

9. Clematis. Indifferent, inattentive, dreamy, absent-minded. Mental escapist from reality.

10. Crab Apple. Cleanser. Feels unclean or ashamed of ailments. Self disgust/hatred. House proud.

11. Elm. Temporarily overcome by inadequacy or responsibility. Normally very capable.

12. Gentian. Despondent. Easily discouraged and dejected.

13. Gorse. Extreme hopelessness – pessimist – ‘Oh, what’s the use?’.

14. Heather. People who are obsessed with their own troubles and experiences. Talkative ‘bores’ – poor listeners.

15. Holly. For those who are jealous, envious, revengeful and suspicious. For those who hate.

16. Honeysuckle. For those with nostalgia and who constantly dwell in the past. Homesickness.

17. Hornbeam. ‘Monday morning’ feeling but once started, task is usually fulfilled. Procrastination.

18. Impatiens. Impatience, irritability.

19. Larch. Despondency due to lack of self-confidence; expectation of failure, so fails to make the attempt. Feels inferior though has the ability.

20. Mimulus. Fear of known things. Shyness, timidity.

21. Mustard. Deep gloom like an overshadowing dark cloud that descends for no known reason which can lift just as suddenly. Melancholy.

22. Oak. Brave determined types. Struggles on in illness and against adversity despite setbacks. Plodders.

23. Olive. Exhaustion – drained of energy – everything an effort.

24. Pine. Feelings of guilt. Blames self for mistakes of others. Feels unworthy.

25. Red Chestnut. Excessive fear and over caring for others especially those held dear.

26. Rock Rose. Terror, extreme fear or panic.

27. Rock Water. For those who are hard on themselves – often overwork. Rigid minded, self denying. 28. Scleranthus. Uncertainty/indecision/vacillation. Fluctuating moods.

29. Star of Bethlehem. For all the effect of serious news, or fright following an accident, etc.

30. Sweet Chestnut. Anguish of those who have reached the limit of endurance – only oblivion left.

31. Vervain. Over-enthusiasm, over-effort; straining. Fanatical and highly-strung. Incensed by injustices. 32. Vine. Dominating/inflexible/ambitious/tyrannical/autocratic. Arrogant Pride. Good leaders.

33. Walnut. Protection remedy from powerful influences, and helps adjustment to any transition or change, e.g. puberty, menopause, divorce, new surroundings.

34. Water Violet. Proud, reserved, sedate types, sometimes ‘superior’. Little emotional involvement but reliable/dependable.

35. White Chestnut. Persistent unwanted thoughts. Pre-occupation with some worry or episode. Mental arguments.

36. Wild Oat. Helps determine one’s intended path in life.

37. Wild Rose. Resignation, apathy. Drifters who accept their lot, making little effort for improvement – lacks ambition.

38. Willow. Resentment and bitterness with ‘not fair’ and ‘poor me’ attitude.

39. Rescue Remedy. A combination of Cherry Plum, Clematis, Impatiens, Rock Rose, Star of Bethlehem. All purpose emergency composite for causes of trauma, anguish, bereavement, examinations, going to the dentist, etc. ... bach remedies

A condition causing extreme fatigue over a prolonged period, often over years. It is most common in women aged between 25 and 45.

The cause of the condition is unclear. In some cases, it develops after recovery from a viral infection or after an emotional life event such as bereavement. In other cases, there is no such preceding illness or event. The main symptom is persistent tiredness. Other symptoms of the syndrome vary, but commonly include impairment of short-term memory or concentration, sore throat, tender lymph nodes, muscle and joint pain, muscle fatigue, unrefreshing sleep, and headaches. The syndrome is often associated with depression or anxiety.

There is no specific diagnostic test for chronic fatigue syndrome, and investigations are usually aimed at excluding other possible causes of the symptoms, such as anaemia.

A physical examination, blood tests, and psychological assessment may be carried out.

If no cause can be found, diagnosis of chronic fatigue syndrome is made from the symptoms.

Analgesic drugs or antidepressant drugs may relieve the symptoms.

Physiotherapy or psychotherapy may also be helpful.

Chronic fatigue syndrome is a longterm disorder, but the symptoms clear up after several years in some people.... chronic fatigue syndrome

Regions of the central nervous system consisting principally of closely packed and interconnected nerve cell bodies and their branching dendrites, rather than their filamentous axons, which make up the white matter. Grey matter is mostly found in the outer layers of the cerebrum (the main mass of the brain and the region responsible for advanced mental functions) and deeper regions of the brain, such as the basal ganglia. Grey matter also makes up the inner core of the spinal cord.grief An intensely painful emotion, usually caused by loss of a loved one. (See bereavement..

grip The ability of the hand to hold objects firmly. The hand is well adapted for gripping, with an opposable thumb (one that is able to touch each of the fingers), specialized skin on the palm and fingers to provide adhesion, and a complex system of muscles, tendons, joints, and nerves that enables precise movements of the digits.

Gripping ability can be reduced by any condition that causes muscular weakness or impairment of sensation in the palms or fingers (e.g. a stroke or nerve injury) or by disorders that affect the bones or joints of the hand or wrist, such as arthritis or a fracture.... grey matter