Self-assessment Cases

Chapter 59 Bereavement

Robert, a 19-year-old young man, asks for help following the sudden death of his father from pancreatic cancer. He is at university in a town 100 miles from the family home. His father had been unwell for several months but was only diagnosed 3 weeks ago following extensive test. The family knew that the diagnosis was not good but hoped that with treatment he would live for several months, so Robert was encouraged to go back to college after the summer break.

Robert had a phone call to say that his father had been admitted to hospital as an emergency and died soon afterwards. Robert had gone straight home and stayed for 2 weeks and attended the funeral. He did not see his father before the funeral and he felt that he was not included in the arrangements. This was his first week back at the university. He is also worried because he is behind with his work.

Robert is the youngest of three boys. His brothers are a good deal older and have left home. He was not close to his father and chose the university because it was a long way from home. His father once said that he wished Robert had been a girl and Robert always felt a disappointment but now wants to go home and give up his course. He says that he is very worried about his mother, as she is at home on her own.

Robert was happy at the university and has some close male friends. However, his girlfriend who he had met at the beginning of his course had ended the relationship during the summer holidays. He says that nobody wants to listen to him when he talks about his father. They tell him that he should be glad, as he was always moaning about him. He wants to tell his ex-girlfriend but fears rejection.

• 1. What are the bereavement risks for this young man?

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  Correct answer:
  The death was sudden and Robert had not been able to process the serious illness of his father before he died. Robert had a poor relationship with his father. He is living a long way from his family support systems, and he has suffered another recent loss of his relationship with his girlfriend.

• 2.Is his college work likely to suffer because of his bereavement?

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  Correct answer:
  

  He is likely to find concentration difficult and research has shown that the concentration of children and young people can be affected for at least 2 years following a close bereavement.

• 3. Could Robert still think that his father is alive?

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  Correct answer:
  It is possible that Robert cannot understand the death of his father. Sometimes it helps to see the body if the person was not there when he died.

• 4. We know that Robert felt excluded from the funeral arrangements. Do you think that this often happens and is it important for young people to feel included?

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  Correct answer:
  Yes. Children and young people have been treated as forgotten mourners in the past. They need to feel part of the family and their grief acknowledged. We do not know if Robert felt that he had said goodbye to his father. As the youngest child, he may also feel that he is less important than his mother or older brothers.

• 5. Robert was not close to his father and Robert has already said that he was a disappointment to his father. Is it important for Robert to spend time talking and thinking about what this relationship meant to him?

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  Correct answer:
  All bereaved people review the meaning of the relationship with the deceased. Robert is still only 19 years old and developing his own identity as a man, which involves physically and psychologically separating from his father. This was a complicated relationship and now his father is dead. Robert will not be able to talk to him about his feelings.

• 6. Robert is asking for help but it is early days. What do you think he wants to talk about?

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  Correct answer:
  Robert has some immediate things to sort out. He may question whether to stay at college where he feels he has no support. He is already behind with his college work. He has only just been back at college for a week so we do not know if things will settle down. It would be important to find out what support he would have if he went home.

• 7. What sort of feelings might he be experiencing? Could he be feeling very desperate?

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  Correct answer:
  Robert may not be sleeping or eating. We know he feels different and excluded. We know that he had been happy at the university and now he wants to leave. He may be frightened of his grief reaction, perhaps very remorseful. It is common to feel angry and guilty when you are bereaved. It is also common to feel that things are pointless. Most bereaved people find it useful to have a leaflet explaining common grief reactions.

• 8. Do you think that Robert should be seen by a counsellor?

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  Correct answer:
  Yes. Given the risk factors, he needs to have an assessment. Most universities have a counselling service as part of the student health services. He also needs to make sure that his GP has written a medical certificate stating that he has been bereaved and this has been given to his university tutor.