Cautioning Health-Care Professionals:Bereaved Persons Are Misguided Through the Stages of Grief

Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to "prescribe" stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It has frequently been interpreted prescriptively, as a progression that bereaved persons must follow in order to adapt to loss. It is of paramount importance to assess stage theory, not least in view of the current status of the maladaptive "persistent complex bereavement-related disorder" as a category for further research in DSM-5. We therefore review the status and value of this approach. It has remained hugely influential among researchers as well as practitioners across recent decades, but there has also been forceful opposition. Major concerns include the absence of sound empirical evidence, conceptual clarity, or explanatory potential. It lacks practical utility for the design or allocation of treatment services, and it does not help identification of those at risk or with complications in the grieving process. Most disturbingly, the expectation that bereaved persons will, even should, go through stages of grieving can be harmful to those who do not. Following such lines of reasoning, we argue that stage theory should be discarded by all concerned (including bereaved persons themselves); at best, it should be relegated to the realms of history. There are alternative models that better represent grieving processes. We develop guidelines to enhance such a move beyond the stage approach in both theory and practice

From dementia mindsets to emotions and behaviors:Predicting person-centered care in care professionals

Background and Objective: High-quality care standards for dementia care are increasingly based on person-centered care principles. To better understand facilitating factors of person-centered care this research focuses on individual characteristics of care professionals. Applying mindset theory to dementia care, we examined dementia mindsets (viewing dementia symptoms as either malleable or fixed) in care professionals. We tested whether there is a positive relationship between a malleable dementia mindset and person-centered care as well as a negative relationship between a fixed dementia mindset and person-centered care. Moreover, we examined whether care professionals’ emotional responses in care situations help explain associations between dementia mindsets and person-centered care. Research Design and Method: In two cross-sectional studies, care professionals of long-term care facilities (total N = 370) completed a measure of dementia mindsets and reported their emotional and behavioral responses to five care scenarios. Regression and mediation analyses were performed. Findings: The tested hypotheses were partially supported. A fixed dementia mindset predicted reported person-centered care negatively, while a malleable dementia mindset did not. Mediation analyses suggest that reduced negative emotions may underlie the association between a malleable mindset and reported person-centered care, while reduced positive emotions in care situations may underlie the association of a fixed mindset and reported person-centered care. Study 2 partially replicated these findings. A fixed mindset and positive emotional responses were the most robust predictors of reported person-centered care. Discussion and Implications: This study extends knowledge on facilitators (positive emotional responses to care situations) and barriers (fixed dementia mindset) to person-centered care in care professionals working with persons with dementia. We discuss how dementia mindsets and emotional responses to care situations may be a fruitful target for trainings for care professionals

Dementia as fixed or malleable:Development and validation of the dementia mindset scale

Background and Objectives Care professionals differ in how they experience and respond to dementia caregiving. To explain such differences, we developed a new measure: the Dementia Mindset Scale. This scale captures the extent to which care professionals view dementia as stable and fixed (akin to the biomedical perspective) or as flexible and malleable (akin to the person-centered approach). Research Design and Methods We conducted four studies to develop the scale. We tested items for comprehensibility, assessed the scale’s factorial structure and psychometric properties, and investigated its predictive validity for care professionals’ well-being. Results A new scale with a two-factor structure—distinguishing a malleable dementia mindset from a fixed dementia mindset—was developed. Results showed good convergent and divergent validity. Moreover, the dementia mindsets predicted aspects of job-related well-being in care professionals. Discussion and Implications The scale allows for the assessment of individual differences in how care professionals see dementia. This insight can be used to improve interventions aimed at enhancing care professionals’ well-being and quality of care

Models of coping with bereavement:an updated overview

Bereavement research is reaching the hundred-year landmark of the publication of Freud's classic 1917 'Mourning and Melancholia', an essay of great significance for subsequent theoretical developments, particularly in the current context with regard to the centrality placed on grief work' in coming to terms with bereavement. Where do we stand now, a century on, in our understanding of the nature of adaptive coping? In this article, after providing a summary of theoretical approaches across the decades of the twentieth century, we illustrate an important direction in contemporary research on coping, tracing this from the grief work notion to what has evolved into fine-grained examinations of confrontational-avoidant processing. A main thrust of recent investigation has been (1) to postulate and (2) to evaluate the efficacy of underlying mechanisms in relation to (mal)adaptive coping with bereavement: there has been systematic examination of regulatory cognitive-emotional processes in both clinical trials and more theoretically-focused studies. Evidence has become more conclusive; both types of investigation have benefitted from employment of newly available designs and techniques, and novel statistical methods. However, further establishment of the role of coping processes in (mal)adaptation is needed. We suggest directions for future research in this domain

Cautioning Health-Care Professionals:Bereaved Persons Are Misguided Through the Stages of Grief

Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to "prescribe" stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It has frequently been interpreted prescriptively, as a progression that bereaved persons must follow in order to adapt to loss. It is of paramount importance to assess stage theory, not least in view of the current status of the maladaptive "persistent complex bereavement-related disorder" as a category for further research in DSM-5. We therefore review the status and value of this approach. It has remained hugely influential among researchers as well as practitioners across recent decades, but there has also been forceful opposition. Major concerns include the absence of sound empirical evidence, conceptual clarity, or explanatory potential. It lacks practical utility for the design or allocation of treatment services, and it does not help identification of those at risk or with complications in the grieving process. Most disturbingly, the expectation that bereaved persons will, even should, go through stages of grieving can be harmful to those who do not. Following such lines of reasoning, we argue that stage theory should be discarded by all concerned (including bereaved persons themselves); at best, it should be relegated to the realms of history. There are alternative models that better represent grieving processes. We develop guidelines to enhance such a move beyond the stage approach in both theory and practice

Plenary Session II – Policy Track: Policies That Work

This session will describe policies related to medical fitness to drive and medical reporting. Jake Nelson will provide an overview of the research related to medical fitness to drive. Best practices will be highlighted by Dr. Meuser, and clinical geriatric issues will be discussed by Dr. Marottoli

Recent Parental Death and Relationship Qualities Between Midlife Adults and Their Grown Children

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149257/1/jomf12549_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149257/2/jomf12549.pd

A systematic review of loneliness in bereavement:Current research and future directions

Bereaved people suffer from loneliness and loneliness is associated with poor mental health. In this study, this topic is reviewed. An agenda is suggested for future research. Research that is theory-driven, addresses measurement consistency, correlates of loneliness in bereaved and non-bereaved, and treatment is necessary for prevention and intervention

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements