This article originally appeared in ehospice
Three years since its first initiation, the last knowledge sharing workshop of the Pal2Know project was held last month. Pal2Know is a national-level project that aims to raise palliative care awareness in Thailand.
The final panel was about bereavement care: how do we cope with our loss and how do we help those who are in need?
Participants who joined the session came from various disciplines and stakeholder groups, including healthcare providers, teachers, volunteers, and also people who had recently lost their loved ones.
“It helps a lot,” said one of the delegates. “I never spoke about how I felt when we lost our mother to anyone. Not even within my family.”
“It seems strange that I still remember that day so vividly even though it has been eight years already. This meeting helps me to reflect back on that very day, how I felt back then and how I feel right now.”
From the discussion, Pal2Know researchers identified factors that help with bereavement care, including:
Before the loss and in-between
Advance care plan and finishing unfinished businesses
A few participants remarked that what had been heavily stirred on their conscience was that they could not fulfil their loved one’s dying wish. And if they could go back through time, they would do anything just to accomplish that.
One participant said: “Even at the end, Mom just wanted to go home and we did not grant her that. We made her stay at the hospital then…she…passed away there, away from home…”
Being aware of the prognosis
Several delegates agreed that being aware of their loved one’s prognosis helped immensely. It made them aware that this was a real, final farewell.
Clear and thorough conversation with shared decision-making within the family
A thorough conversation within the family and doctor also helped them get through their ordeal.
Family consensus
It was helpful for the family to have the same decisions for the patient, and not to argue with each other about the choice of treatment.
“We were lucky because our family had the same decisions for our mother. I wouldn’t be so sure if I could get through my loss guilt-free had my family been disagreeing with each other,” said one participant.
After the loss
Rituals
A funeral, which may seemed to be held for the deceased, turned out to be the healing process for those who were left behind instead.
Another workshop participant said: “It feels rather unpleasantly pleasant. Grandma just died but my mom felt quite happy because all of her relatives came to the funeral and we all just sat there, talking, doing stuff. Grandma would be so pleased if she could see so many family members gathering here just for her sake.”
Distraction
Distractions also helped people to occupy their mind with the present, not the past. For example, exercise, or a change in scenery. For one participant this entailed a move to a new home: “I was fortunate in a way since my mother passed away just before our new house was finished. When we moved, I felt that mother was living in our old house and we had moved on literally and metaphorically.”
Private time and reflection
Some delegates agreed that after the loss, they needed some private time to collect their thoughts so that they could function again: “I need some time just to be with myself. I knew that I was not ok but superficial sympathies from others like, “sorry for your loss,” or “my condolences,” were not helping at all. If you don’t know what to say just don’t say it. A hug or just being there could be better than words.”
Support group
Some delegates also shared their insight about support groups for bereavement care: “We have the support group for parents who had lost their children. There are various kinds of activities, memorial services, photo sessions, writing sessions, and so on.”
Other activities such as art therapy also proved to be helpful: “To meet and lose someone is a natural process in human life. But if we look into ourselves close enough, we may see that our bonds and memories are there, inside of us, as always.”
Next steps
Following this final Pal2Know knowledge-sharing workshop, a specialist group of palliative care researchers and practitioners will meet to conduct a literature review on palliative care in Thailand.
The team will analyse the data from all the participatory workshops, along with the literature review, and publish a handbook which will be distributed nationally free of charge.
This project is supported by THAPS (Thai Palliative Care Society) and Thai Health Promotion Foundation.
For more information, please contact pal2know.thaps@gmail.com or visit the Pal2Know Facebook page (Thai language).