Although the death of a child client is among the worst work-related events that a child welfare worker can experience, the phenomenon is tremendously understudied concerning how the event impacts the staff involved and how, or if, their employing agencies supported any mental health needs that may have arisen after the death. This study investigates what types of mental health/emotional support was made available to Northeastern Ontario child welfare workers following the death of a child client, and how effective that support was in helping the worker cope with any difficulties related to the death. This study was guided by principles of Constructivist Grounded Theory and semi-structured qualitative telephone interviews were conducted with five (5) participants. My analysis found that the death of a child client can negatively impact both the mental wellbeing of involved workers as well as the organizational climate of an agency. My analysis also found that workers may delay the emotions associated with the grieving process to effectively focus on the administrative requirements resulting from the child’s death, potentially to their detriment. The different ways child welfare organizations supported staff through these events included individual and group psychological debriefings, grief counselling, and providing information regarding additional support options. Only three of the five workers engaged in the strategies provided to them by their agency, and of those three, only one found the services to be helpful with managing emotional difficulties related to the child’s death. What remained true among all five participants was that they each had very personalized ideas as to what they felt would have best helped them through this difficult event. I conclude that based on related literature and the findings of this study, child welfare organizations are recommended to invest in a thorough and embedded agency framework of trauma-management that addresses policy and procedure development as well as support coordination at the pre-trauma, immediate trauma, and post-trauma levels. Additionally, trauma-management should not be a singular standardized response and should be tailored to the individualized needs of each worker. Agencies should be well-versed in delivering different strategies of trauma-management and letting the worker lead in determining what type of support they are looking for and when would be best to receive it. / Thesis / Master of Social Work (MSW)

This thesis examines attitudes and approaches towards death, as well as aesthetic representations of death, in Anglo-Saxon hagiography. The thesis contributes to the discussion of the historical and intellectual contexts of hagiography and considers how saintly death-scenes are represented to form commentaries on exemplary behaviour. A comprehensive survey of death-scenes in Anglo-Saxon hagiography has been undertaken, charting typical and atypical motifs used in literary manifestations of both martyrdom and non-violent death. The clusters of literary motifs found in these texts and what their use suggests about attitudes to exemplary death is analysed in an exploration of whether Anglo-Saxon hagiography presents a consistent aesthetic of death. The thesis also considers how modern scholarly fields such as thanatology can provide fresh discourses on the attitudes to and depictions of ‘good' and ‘bad' deaths. Moreover, the thesis addresses the intersection of the hagiographic inheritance with discernibly Anglo-Saxon attitudes towards death and dying, and investigates whether or not the deaths of native Anglo-Saxon saints are presented differently compared with the deaths of universal saints. The thesis explores continuities and discontinuities in the presentations of physical and spiritual death, and assesses whether or not differences exist in the depiction of death-scenes based on an author's personal agenda, choice of terminology, approaches towards the body–soul dichotomy, or the gender of his or her subject, for example. Furthermore, the thesis investigates how hagiographic representations of death compare with portrayals in other literature of the Anglo-Saxon period, and whether any non-hagiographic paradigms provide alternative exemplars of the ‘good death'. The thesis also assesses gendered portrayals of death, the portrayal of last words in saints' lives, and the various motifs relating to the soul at the moment of death. The thesis contains a Motif Index of saintly death-scenes as Appendix I.

A Síndrome de Asperger, um Transtorno Global do Desenvolvimento, pertencente ao espectro autístico caracteriza-se por dificuldades na comunicação, abstração e socialização. O conceito de morte é adquirido paralelamente ao desenvolvimento cognitivo e afetivo da criança, sendo descritos três estágios em seu desenvolvimento paralelos aos estágios piagetianos. Ele é composto pelas dimensões universalidade, irreversibilidade e não funcionalidade. O objetivo deste trabalho foi de verificar se o conceito de morte em portadores da síndrome de Asperger é similar ao observado em pessoas sem psicopatologia ou se relaciona com o observado em portadores de deficiência mental leve. Para isso foram avaliados indivíduos com Síndrome de Asperger, indivíduos com deficiência mental leve e indivíduos sadios, sem doenças mentais e/ou neurológicas, utilizando-se o Instrumento de Sondagem do Conceito de Morte elaborado por Wilma Torres. Os resultados apontaram prejuízo na aquisição do conceito de morte de acordo com a seguinte hierarquia, nas dimensões universalidade e não funcionalidade: Sadios > Síndrome de Asperger > deficiência mental leve. Na dimensão irreversibilidade a hierarquia encontrada foi Sadios > Síndrome de Asperger = deficiência mental leve. Esses resultados apontam déficits na aquisição do conceito de morte por indivíduos com Síndrome de Asperger, possivelmente relacionados a déficits na teoria da mente, função executiva e fraca coerência central. / Aspergers Disorder, a Pervasive Development Disorder, is part of the autism spectrum and is characterized by difficulties in communication, abstraction, and social interaction. The concept of death is acquired in parallel with cognitive and affective development of children, and three stages in its development are described in parallel with piagetian stages. It is made up of the dimensions of universality, irreversibility, and non-functionality. The objective of this work is to verify if the concept of death in people with Aspergers disorder is similar to the one observed in people without psychopathological symptoms , or if it relates to the one observed in people with mild mental retardation. With that purpose, individuals with Aspergers disorder, individuals with mild mental retardation and healthy individuals, without mental and/or neurologic diseases were evaluated by means of the Instrument of Investigation of the Concept of Death developed by Wilma Torres. The results indicated damage in the acquisition of the concept of death according to the following hierarchy, in the universality and non-functionality dimmensions: Healthy > Aspergers disorder > mild mental retardation. In the irreversibility dimension, the hierarchy found was healthy > Aspergers disorder= mild mental retardation. These results indicate deficit in the acquisition of the concept of death by individuals with Aspergers disorder, possibly related to deficits in the theory of mind, executive function, and weak central coherence.

A Síndrome de Asperger, um Transtorno Global do Desenvolvimento, pertencente ao espectro autístico caracteriza-se por dificuldades na comunicação, abstração e socialização. O conceito de morte é adquirido paralelamente ao desenvolvimento cognitivo e afetivo da criança, sendo descritos três estágios em seu desenvolvimento paralelos aos estágios piagetianos. Ele é composto pelas dimensões universalidade, irreversibilidade e não funcionalidade. O objetivo deste trabalho foi de verificar se o conceito de morte em portadores da síndrome de Asperger é similar ao observado em pessoas sem psicopatologia ou se relaciona com o observado em portadores de deficiência mental leve. Para isso foram avaliados indivíduos com Síndrome de Asperger, indivíduos com deficiência mental leve e indivíduos sadios, sem doenças mentais e/ou neurológicas, utilizando-se o Instrumento de Sondagem do Conceito de Morte elaborado por Wilma Torres. Os resultados apontaram prejuízo na aquisição do conceito de morte de acordo com a seguinte hierarquia, nas dimensões universalidade e não funcionalidade: Sadios > Síndrome de Asperger > deficiência mental leve. Na dimensão irreversibilidade a hierarquia encontrada foi Sadios > Síndrome de Asperger = deficiência mental leve. Esses resultados apontam déficits na aquisição do conceito de morte por indivíduos com Síndrome de Asperger, possivelmente relacionados a déficits na teoria da mente, função executiva e fraca coerência central. / Aspergers Disorder, a Pervasive Development Disorder, is part of the autism spectrum and is characterized by difficulties in communication, abstraction, and social interaction. The concept of death is acquired in parallel with cognitive and affective development of children, and three stages in its development are described in parallel with piagetian stages. It is made up of the dimensions of universality, irreversibility, and non-functionality. The objective of this work is to verify if the concept of death in people with Aspergers disorder is similar to the one observed in people without psychopathological symptoms , or if it relates to the one observed in people with mild mental retardation. With that purpose, individuals with Aspergers disorder, individuals with mild mental retardation and healthy individuals, without mental and/or neurologic diseases were evaluated by means of the Instrument of Investigation of the Concept of Death developed by Wilma Torres. The results indicated damage in the acquisition of the concept of death according to the following hierarchy, in the universality and non-functionality dimmensions: Healthy > Aspergers disorder > mild mental retardation. In the irreversibility dimension, the hierarchy found was healthy > Aspergers disorder= mild mental retardation. These results indicate deficit in the acquisition of the concept of death by individuals with Aspergers disorder, possibly related to deficits in the theory of mind, executive function, and weak central coherence.

This study examined death and dying in assisted living (AL) and the various factors that influence these processes. The study is set in a 60-bed assisted living facility outside of Atlanta, Georgia. Data collection methods included participant observation and in-depth interviews with 28 residents and 6 staff. Data were analyzed using the grounded theory approach and focused on the 18 residents who were dying and/or died during the study period. Findings show that AL residents experience a variety of dying trajectories that vary in duration and shape; for the majority of residents, hospice is an important element in their death and dying experiences. In general, death is not communicated or acknowledged formally within the facility. Responses to deaths depend largely on the nature of the relationship the deceased resident had with others. Findings have implications for how to handle death and dying in AL and to improve residents‟ experiences.

The objective of the submitted study was to find out and assess the specifics of transcultural features, rules and cultural patterns at dying and death in selected minorities in the Czech Republic in relation to nursing care, and to describe the experience of nurses with transcultural nursing and to evaluate the possibilities of using the Transcultural Assessment Model Joyce Newman Giger and Ruth Elaine Davidhizar and the Conceptual Model of Cultural Competencies Larry D. Purnell in transcultural aspects, rules and cultural patterns of dying and death in selected minorities in the Czech Republic. The stated objectives were achieved by a combination of qualitative and quantitative research methods, which were part of the research conducted with the financial support of the Grant Agency of the University of South Bohemia (GAJU) in České Budějovice within the team grant project called "Using Conceptual Models in Clinical and Community Practice ", No 048/2015/S. In the first part of the research, a pre-research with 50 informants was carried out by a semi-structured interview technique, each time with 10 representatives of Judaism, Christianity, Buddhism, Islam and atheism. The main objective of the pre-research was to specify the key data for answering research questions and for creating a self-constructed questionnaire that served together with the standardized DAP-R (The Death Attitudes Profile - Revised) questionnaire to complete quantitative data that analyzed the results of 1 700 respondents. The results of the pre-research study became the basis for the nursing documentation proposal, which was verified in the next phase of the qualitative research in a focus group interview, in which 35 nurses from clinical and community practice were involved. Based on the results of the pre-research study, it was found that the care of the dying and the dead is based on traditional values of human life. Informants demand that nurses have 7 virtues in the form of humility, generosity, compassion, peacefulness, chastity, temperance and activity, enriched with respect for human dignity, love, empathy and understanding. Quantitative research has shown that there is a statistically significant difference in transcultural features, rules and cultural patterns in the period of dying and death, depending on religion or personal belief, in which the degree of subjective identification with a religious belief or a personal belief plays an important role. According to the results of the investigation, it is obvious that de-taboooization of dying and death, as well as contact with the dying person and the deceased, greatly contributes to reconciliation with our own mortality. The results have also shown the presence of lower fears of death in women than men, which can also be seen from the results of the DAP-R questionnaire, which show that there is a statistically significant difference in the welcome acceptance of death by gender. The welcome acceptance to death is more expressed in believers than non-believers people. The focus group with nurses appears to have revealed the absence of cultural competencies that can greatly influence the quality of life of dying people and their families. The research study provides a comprehensive view of transcultural features, rules and cultural patterns in selected minorities in the Czech Republic. Based on data analysis, a nursing anamnesis, which can be an appropriate tool for the continual quality improvement of provided care, has been created. In view of the above mentioned, the research study is beneficial both for increasing theoretical knowledge of nursing and for clinical and community practice.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / When an illness tackles a child, the family structure as a whole is also undertaken, which brings many repercussions as for the child‟s life, as for its parents lives. When, yet, the kid dies, parents face the absence of explanations, since death provokes a lack of sense in the symbolic universe of the subjects. As a result of death, grief is settled, which refers to a reaction to a loss and evokes to a tough and painful psychic elaboration. In contemporary times, individuals often have difficulties to find space to elaborate and express such suffering, which may turn this process into something even harder. Therefore, this study aimed to comprehend how parents deal with the death of their children, still in childhood, due to some disease. It is understood that its importance is given by the fact that, with the study, there was promoted an approach to these parents‟ universe, providing theoretical comprehensions to the exercise of an adequate practice in front of the painful period that they are living. In that way, it was conducted a qualitative, exploratory and descriptive research. The participants were parents whose sons and daughters were kids, aged 0 to 12 years, who had died 4 months to 1 year and 4 months before the interview. Those parents were searched through death certificates that were available in the Sistema de Informação de Mortalidade (SIM) (Mortality Information System). Therefore, there were conducted 11 semi-directive interviews, when it was noticed the data saturation. The interviews were fully transcribed and analyzed by the content analysis, then constituting categories according to the repetition and relevance criteria. Some categories were organized in two articles in order to articulate them to theoretical postulates, which are: the nameless emptiness: the search for a sense in parents whose children have died and particularities of a loss with no designation: the grief of parents who have lost their children. In general, the results discussed in both articles pointed to an incomprehension of the loss, the search for a sense, that is often looked for in religiosity, the distrust on healthcare teams and parents‟ self-blame, the importance of a support network, the moves to avoid suffering in contemporaneity and narcissist aspects involved in the loss. Besides what is discussed in the articles, there were found issues related to parents whose sons are sick, such as anguish facing procedures, the organization of parents in the physical and emotional care of their kids, the powerless feeling and fully dedication to them. Yet, issues related to the grief for the ideal son, the over-investment in their children, the non-conformity facing death, living with the absence, among others. The research was approved following the Resolução 466/2012 (466/2012 Resolution), by the Comitê de Ética em Pesquisa (Research Ethics Committee) of the University that this research is linked to, by the number 52750016.6.0000.5346. There were followed all the Conselho Nacional da Saúde‟s ethical principles (National Health Council), that guide the research ethics with human being. In this way, there were respected all the principles of autonomy, beneficence, non-maleficence, justice and equality, assuring the rights and the duties to participants, scientific community and the State. / Quando a doença acomete uma criança, há toda uma estrutura familiar que se assola, isso traz diversas repercussões tanto para sua vida, como para a dos pais. Quando, por sua vez, ela morre, os pais se deparam com a ausência de explicações, uma vez que a morte abre uma lacuna de sentido no universo simbólico dos sujeitos. Frente à morte instala-se o luto, que se refere a uma reação a uma perda e remete a uma elaboração psíquica difícil e dolorosa. Na contemporaneidade, os sujeitos frequentemente não encontram espaço para elaborá-lo e expressar esse sofrimento, o que pode torná-lo um processo ainda mais difícil. Desse modo, objetivou-se compreender como os pais lidam com a morte de filhos, ainda na infância, em decorrência de alguma doença. Entende-se que sua importância se dá à medida que, com o estudo, foi possível promover uma aproximação do universo desses pais, podendo fornecer subsídios teóricos para exercer uma prática adequada diante do momento doloroso que estão vivenciando. Para tanto, foi realizada uma pesquisa qualitativa, de cunho exploratório e descritivo. Os participantes foram pais cujos filhos eram crianças, ou seja, entre 0 a 12 anos incompletos, e haviam falecido entre 4 meses a um ano e 4 meses a contar a data da entrevista. Esses pais foram buscados por meio das declarações de óbitos disponíveis no Sistema de Informação de Mortalidade (SIM). Diante disso, realizaram-se 11 entrevistas semidirigidas, quando houve a saturação da amostra. As entrevistas foram transcritas na íntegra e analisadas por meio da análise de conteúdo, constituindo categorias conforme os critérios de repetição e relevância. Algumas categorias foram organizadas em dois artigos para sua melhor articulação com os pressupostos teóricos, que são: o vazio sem nome: a busca por sentido para pais cujos filhos morreram crianças e particularidades de uma perda sem denominação: o luto para pais que perderam filhos. De modo geral, os resultados discutidos nos artigos apontaram para uma incompreensão da perda, a busca por um sentido, que, frequentemente, é procurada na religiosidade, a desconfiança da equipe e autoculpabilização dos pais, a importância da rede de apoio, os movimentos de barramento do sofrimento na contemporaneidade e os aspectos narcísicos que envolvem a perda. Para além dos artigos, foram encontradas questões referentes ao adoecimento do filho, tais como a angústia frente aos procedimentos, a articulação dos pais em torno do cuidado físico e emocional dos filhos, a impotência e a dedicação integral a eles. Ainda, problemáticas referentes ao luto pelo filho ideal, o superinvestimento dos filhos, o inconformismo frente à morte, a convivência com a ausência, entre outros. A pesquisa foi aprovada conforme a Resolução 466/2012, pelo Comitê de Ética em Pesquisa da Universidade a qual a pesquisa estava vinculada sob o número 52750016.6.0000.5346. Respeitaram-se todos princípios éticos referentes à do Conselho Nacional de Saúde, que guia a ética em pesquisas com seres humanos. Dessa forma, foram respeitados os princípios da autonomia, beneficência, não maleficência, justiça e equidade, assegurando os direitos e deveres dos participantes da pesquisa, à comunidade científica e ao Estado.

“Mindfulness gets thrown around all the time, but what does it actually mean in practice?” I interpreted this question posed by a nurse in this inquiry, as a statement of curiosity and concern. As conceptualizations, practices, and programs of mindfulness continue to diversify, there is a call to understand mindfulness as a socially and culturally embedded practice. Some critiques suggest mindfulness is moving too far from its ethical orientation and becoming instrumentalized as a tool. Therefore, the pervasive presence of ‘mindfulness’ across work and educational settings renders the question what does mindfulness actually mean in practice? an important one for nursing as a discipline, and within palliative care nursing practice. Mindfulness is proposed broadly here as an approach to meet therapeutic and relational aims for nurses within palliative care practice. What it means to be mindfully present and compassionate in the midst of suffering, strong emotion and profound uncertainty is rarely discussed. Grounded in conversations with nine palliative care nurses (their words italicized), I explored how mindfulness shapes relationally engaged ways of being while caring for people with terminal disease and existential distress. Using a contemplative dialogical narrative approach, I analyzed nurses’ stories as units of data to explore multilayered narratives with personal, social, and cultural storylines. Using an emergent and iterative design, I dialogued across various aspects of the research process enacting an integrative approach. Metaphorically, this dissertation is structured as a contemplative walk within a classical seven-circuit labyrinth; readers are invited to walk a circuitous path while following along as stories take the lead. Seven turns in the labyrinth outline a path conveying key recursive narratives of mindfulness. Turning in various directions three guiding story threads are woven together to create the path: 1) palliative care nursing as mindfulness is an embodied ethic creating space(s) for creativity and ‘connection’ through the ‘big stuff’; 2) such ‘space’ can be generated and accessed through somatic practices of ‘self-awareness’ and ‘self-care’; and 3) spaces of caring are continuously transforming within the communities in which they are practiced. Nurses’ stories foreground ways organizational and educational systems support or constrain how mindfulness as an embodied ethic of care can be enacted. This study adds to the ongoing conversation of mindfulness and its value when practiced/understood as palliative care nursing. As the historical Buddha was quoted to have said “of all mindfulness meditation, that on death is supreme.”

This dissertation is about pastoral care and counselling to elderly people to keep them visible within our faith communities. The research is a reflection and a re-telling of the lives of five elderly people who shared their stories with me. I heard them talk about ageing as an ongoing journey that is not always smooth. To grow older includes a lot of changes and a reassessment of lifestyles and goals as well as the danger of becoming invisible to others. Visibility cannot be maintained without communities of support, and care within communities of shared prophetic mission. A pastoral therapist must convey the Christian message of care by healing and caring solidarity, co-constructing new narratives of hope, and bringing back visibility to the elderly. / Practical Theology / M.Th. (Specialisation in Pastoral Therapy)

This diploma thesis looks into the issues of death and dying. Based on a chosen work of fiction, it endeavours to remit the topic of fear of dying and concerns on the possibilities of how to deal with it from points of view of a dying person as well as that of an accompanying one. By using and connecting approaches used in sociology of literature and social work, it aims to appraise the benefit of reading fiction on the given topic for social workers in their professional as well as personal life. The work of fiction therefore serves as an alternative receptive material. By its interpretation, a social worker or layman can gain a more profound knowledge of current social issues, which the last matters of a human unquestionably belong to.