OMEGA - Journal of Death and Dying

The Spanish-speaking people of northern New Mexico have a long tradition of written and oral culture that assists them in dealing with death. The recuerdo (remembrance) serves to memorialize the dead and to bring comfort to the family members. This leave-taking is known as la despedida and is normative in the lives of Hispanics. Alfred Schutz's phenomenology of everyday life and contributions by philosophers and folklorists are called upon to examine the recuerdo tradition as it continues to function today.

Previous research has demonstrated that client issues related to death and dying are more problematic than other serious client issues for beginning counselors. The present study attempts to ascertain whether this holds true for counselors who have considerable experience counseling on issues of death or loss, and whether counselor comfort with and empathy toward death-related situations is related to demographic, professional, or personal variables such as death anxiety. Seventy-one experienced death counselors were asked to rate their degree of comfort with a variety of presenting client scenarios. Counselors were also asked to respond to four case vignettes, two of which were death related and two of which were serious, but non-death related. Results indicated that the experienced death counselors in our study were actually more comfortable and empathic with counseling vignettes that involved death and dying issues and that their level of empathy with such clients was positively correlated with their years of professional training and years of experience with death counseling. However, our findings also suggest that counselors whose case loads consist principally of the dying or bereaved may be less comfortable and empathic with other presenting problems.

Since most health care professionals are trained in acute care settings where all efforts are employed to prolong life, they may not be comfortable caring for dying patients. Hospice professionals have a lot of experience dealing with dying patients. The purpose of this study was to compare and contrast the death attitudes of hospice and hospital-based health care professionals. The construct theory for the study was that comfort in dealing with dying patients is based on 1) personal beliefs about death and 2) experience dealing with dying patients. Seventy-six hospital and 106 hospice workers participated in the study and completed the thirty-four-item Death Attitude Index (DAI) and the fifteen-item Death Anxiety Scale [1]. The results showed that hospice employees had higher DAI scores (greater comfort caring for the terminally ill), as predicted. Social workers had the highest mean DAI scores and the lowest scores on the DAS (low death anxiety). Nurses aides exhibited high death anxiety and low comfort in dealing with terminal clients. For all disciplines, DAI and DAS scores were highly correlated (coefficient = −0.91). Independent variables that correlated with high DAI scores were educational level and a sacred (versus secular) value system.

The resolution of grief has been frequently posited to progress through stages. Seventy-one widows and twenty-six widowers bereaved from five months to thirty-seven years were studied to determine if their resolution of grief-related symptoms could be mapped onto a stage theory of grief and to examine if men and women follow the same temporal course. An analysis of variance was used to test for differences in complicated grief symptoms over time and between widows and widowers. Widowers bereaved three years or longer were found to have increased bitterness. By contrast, widows who were bereaved three years and beyond were found to have lower levels of complicated grief. These preliminary findings suggest that grief may not resolve in stages and that symptoms of complicated grief may not decline significantly over time. Rather symptoms of complicated grief appear to remain stable at least for the first three years of bereavement for both men and women but, thereafter, among widowers tend to increase and among widows to decrease.

In both an American and Filipino population considerable family resemblance in death anxiety, death depression, and death distress was found. In both populations the death attitude measures of adolescents correlated with those of their parents, but the correlations were higher between the mothers and fathers. Most of the correlations were higher for the Filipino than for the American participants, and it was suggested that this is a function of closer family life in the Philippines. Although family resemblance on the Death Anxiety Scale was first reported by Templer, Ruff, and Franks [1] and confirmed by subsequent authors, the present study was the first study that addressed family resemblance on the more recently constructed Death Depression Scale or death distress (the sum of the z scores of Death Anxiety Scale and Death Depression Scale). In the American population, Catholics had significantly higher death anxiety and death depression and death distress scores than Protestants, and Hispanics had significantly higher death anxiety, death depression, and death distress scores than Euro-Americans. Clinical and research implications were discussed.