We All Looked Up

Tommy Wallach

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Myriad people and processes may influence decision-making and decision-makers. Three classes of variables influence anticipatory grief: characteristics related to the nature and meaning of the person and relationship to be lost: unique nature and meaning of the specific loss to be experienced. the qualities of the relationship to be lost. the roles that the dying person has occupied in the family or social system of the griever. the characteristics of the dying person. the griever's perception of the dying person's fulfillment in life. the number, type, and quality of secondary losses that result from the terminal illness and that will be caused after the death. the personal characteristics of the griever: the griever's level of maturity and intelligence. the griever's age and developmental stage. the presence of concurrent stresses or crises in the griever's life. the griever's sense of fulfillment in life. characteristics that pertain to the illness and type of death with which the griever must contend: the griever's specific fears about illness, dying, and death. the griever's previous experience with and personal expectations about illness, dying, and death. the griever's knowledge about the illness. the personal meaning of the specific illness to the griever. the type, frequency, and intensity of the griever's involvement in the dying person's care and treatment. the griever's perception of the preventability of the illness. the length of the illness. the nature of the illness (death trajectory, problems of the particular illness, treatment regimen and side effects, amount of pain, degree of deterioration, rate of progression, number and rate of secondary losses). the quality of the dying person's life after the diagnosis. the location of the dying individual (home, hospital, nursing home, relative's house). the griever's evaluation of the care, treatment, and resources that the dying individual is provided and to which he or she has access. characteristics of the dying individual's knowledge and response to the illness and ultimate death: the dying individual's subjective experience of the illness (course of illness, treatment regimen and side effects, amount of pain, degree of deterioration, rate of progression, number and rate of secondary losses, proximity to death). the dying individual's attitude toward and response to the illness and its ramifications (physically, emotionally, cognitively, philosophically, behaviorally, socially, spiritually). the personal meaning of the specific illness and its location to the dying individual. the dying individual's feelings, fears, and expectations about the illness, dying, and death. the degree of the dying individual's knowledge of the illness and its ramifications. the dying individual's comfort in expressing thoughts, feelings, and needs and the style and extent of that communication. the dying individual's feelings of being supported, understood, and helped by others. the dying individual's satisfaction with treatment. the degree of the dying individual's acceptance of or resignation to impending death. the dying individual's will to live. characteristics of the family and its members' responses to the illness and impending death: the family constellation (makeup of family, developmental stage, familial subsystems, specific roles of family members and appropriateness of roles). the specific characteristics of the family system (degree of flexibility, communication style, roles, norms, expectations, values, beliefs, types and quality of interrelationships, socialization patterns, family strengths and vulnerabilities, family resources, established patterns of transaction and interaction, habitual methods of problem resolution, anticipated immediate and long-range needs of the family, quality of communication with caregivers). current family awareness of and understanding about the illness and its implications. family members' specific feelings, thoughts, and fears about the dying individuals's particular illness, dying, and death. the number and type of roles the dying individual filled in the family and the degree of role reorganization required to ensure the roles are fulfilled. the role changes and psychosocial transition that are undergone by the griever as a result of family reorganization in the face of the dying individual's illness and impending death. the degree of strain that the illness and the family member's responses to it puts on the family system. the family's participation in the patient's care. the extent and quality of the family communication about the illness. the relationship of each family member with the dying individual since the diagnosis. the presence of family rules, norms, values, styles, and past experiences that might inhibit grief or interfere with a therapeutic relationship with the dying individual. the total impact on the family system of the sum (although the whole is more than the sum of its parts) of each family member's unique constellation of individual anticipatory grief-influenced variables. general socioeconomic and environmental factors: the type of relationships and communication with caregivers. quality and quantity of the griever's social support system (degree of acceptance, support, security, and assistance of its members, quality of communication with its members, and degree of access the griever has to it during the illness). the griever's and patient's financial resources and their expected stability. the educational, economic, and occupational status of the griever. the degree of access to quality medical treatment and caregiving intervention for the dying individual and griever. family and community rituals for illness, dying, and death. the amount of the griever's energy depletion. the amount of rest, sleep, and exercise available to and engaged in by the griever. the griever's use of drugs, alcohol, cigarettes, food, and caffeine.

Pages: 416

Publisher: Simon & Schuster Books for Young Readers; Reprint edition (August 30, 2016)

ISBN: 1481418785

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