Death and Grieving for Family Caregivers of Loved Ones With Life-Limiting Illnesses in the Era of COVID-19: Considerations for Case Managers.
Death and Grieving for Family Caregivers of Loved Ones With Life-Limiting Illnesses in the Era of COVID-19: Considerations for Case Managers.
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DOI：
10.1097/ncm.0000000000000485
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发表时间：
2021-03-01
影响因子：
1.5
通讯作者：
Griffin JM
中科院分区：
文献类型：
--
作者：
Holland DE;Vanderboom CE;Dose AM;Moore D;Robinson KV;Wild E;Stiles C;Ingram C;Mandrekar J;Borah B;Taylor E;Griffin JM
患有限制生命或晚期疾病的亲人的家庭照顾者经常被他们的责任压得喘不过气来，而且准备不足。他们经常需要家人和朋友的帮助来提供全面的照顾。当死亡发生时，葬礼和其他与死亡相关的仪式将家庭和社区聚集在一起，纪念生命，哀悼亲人的去世，并为家人和照顾者提供必要的支持。这些集体仪式往往根深蒂固地植根于文化上的价值观，可以促进悲伤，帮助理解失去的意义。仪式是一种搭建桥梁的活动，它允许人们在失败后组织和评估情绪、信息和行动。随着冠状病毒疾病-2019年(新冠肺炎)大流行的出现以及为减少感染和传播而建议的限制措施，家庭成员和照顾者经常面临着权衡各种荣耀仪式的选择，以帮助他们哀悼。大流行期间的悲痛已经变得杂乱无章。本文的目的是为病例管理人员和其他临床工作人员提供建议，根据美国疾病控制和预防中心的指导方针，在亲人死于限制生命的疾病或在大流行期间死于新冠肺炎时，指导照顾者/家庭采取安全措施。作者还提供了有关复杂悲痛和支持应对死亡的方法的信息，并提出了新冠肺炎时代传统死亡相关仪式和葬礼的安全替代方案。主要实践环境包括家庭保健、临终关怀、医院出院计划、病例管理和初级保健。新冠肺炎时代的必要预防措施可能会给本已艰难的处境增加焦虑和压力，比如在生命的尽头照顾亲人，并为失去亲人而悲痛。CDC指南的使用减少了感染的风险，同时尊重了亲人的意愿和围绕死亡和埋葬的文化传统。还必须考虑到安慰哀悼者的社会和精神联系。
Family caregivers of a loved one with a life-limiting or terminal illness are often overwhelmed by, and underprepared for, their responsibilities. They often need help from family members and friends to provide comprehensive care. When death occurs, funerals and other death-related rituals bring family and communities together to honor the life and mourn the death of a loved one and provide needed support to family and caregivers. These collective rituals are often deeply rooted in culturally-bound values and can facilitate grief and help make sense about loss. Rituals act as bridge-building activities that allow people to organize and appraise emotions, information, and actions after a loss. With the emergence of the coronavirus disease-2019 (COVID-19) pandemic and the recommended restrictions to reduce infection and transmission, family members and caregivers are often faced with weighing options for honored rituals to help them grieve. Grieving during the pandemic has become disorganized. The purpose of this article is to provide case managers and other clinical staff with recommendations on guiding caregivers/families through safety precautions when a loved one dies either because of a life-limiting illness or from COVID-19 during the pandemic using guidelines from the Centers for Disease Control and Prevention (CDC). The authors also present information about complicated grief and ways to support coping with death and suggest safe alternatives to traditional death-related rituals and funerals in a COVID-19 era. Primary practice settings include home health care, hospice, hospital discharge planning, case management, and primary care. Precautions necessary in a COVID-19 era may add anxiety and stress to an already difficult situation of caring for loved ones at end-of-life and grieving with their loss. Utilization of CDC guidelines lessens the risk of infection while honoring loved ones’ wishes and cultural traditions surrounding death and burial. Recognition of social and spiritual connections that comfort mourners must also be considered.