Parental bereavement and the loss of a child with intellectual disabilities: a review of the literature

Agency, social and healthcare supports for adults with intellectual disability at the end of life in out-of-home, non-institutional community residences in Western nations: A literature review

BACKGROUND

The nature and quality of end-of-life care received by adults with intellectual disabilities in out-of-home, non-institutional community agency residences in Western nations is not well understood.

METHOD

A range of databases and search engines were used to locate conceptual, clinical and research articles from relevant peer-reviewed journals.

RESULTS

The present authors present a literature review of the agency, social and healthcare supports that impact end-of-life care for adults with intellectual disabilities. More information is needed about where people with intellectual disabilities are living at the very end of life and where they die.

CONCLUSIONS

The support needs for adults with intellectual disabilities will change over time, particularly at the end of life. There are some areas, such as removing barriers to providing services, staff training, partnerships between agencies and palliative care providers, and advocacy, where further research may help to improve the end-of-life care for adults with intellectual disabilities.

Psychological and social consequences of losing a child in a natural or human-made disaster: a review of the evidence

Exposure to natural and human-made disasters is associated with long-term health consequences, including for mental health. Parents who have lost children, particularly their only children, in any circumstances are also at increased risk of developing mental health problems. The aim of this study was to review the available evidence about the psychological and social consequences for parents who had faced these circumstances simultaneously through losing children in a disaster. Systematic searching of the English and Chinese language literatures about the psychological and social functioning of bereaved parents after disasters revealed that a small number of studies met inclusion criteria. The results showed that bereaved parents had more mental health problems than bereaved spouses and non-bereaved parents, and mothers appeared to be more vulnerable to mental health problems than fathers. Potential protective factors for bereaved parents' mental health included having psychological interventions, having adequate social support, seeing their children's bodies and having a subsequent baby. Although the literature was modest and methodologically diverse, there was a consistent finding that parents who have lost children in disasters were at high risk of suffering mental health problems, especially bereaved mothers. As there was little evidence, further studies are needed to understand the best advice and interventions to offer bereaved parents and provide enhanced mental health care of such bereaved populations after disasters.

Life and death of a child with down syndrome and a congenital heart condition: experiences of six couples

Individuals with Down syndrome are at increased risk of congenital heart conditions (CHCs), and mortality is higher in people with Down syndrome and a CHC than those without (J. C. Vis et al., 2009). As a consequence, parents of children with Down syndrome and a CHC are more likely to outlive their child. In this research, semistructured interviews were used to explore the experiences of 6 couples whose child with Down syndrome and a CHC had died. The interviews were analyzed qualitatively using interpretative phenomenological analysis (IPA), and 4 themes emerged: dilemmas associated with the dual diagnosis; treatment decisions during the life and the death of their child ("We had to make a decision"); ways couples coped when bereaved ("We weren't really going through it together"); and ripples from the child's life. There was a high degree of similarity of experience within couples. Differences between couples existed in their experiences of coping and supporting each other. Practical implications include the importance of considering the specific needs of couples, individuals, and fathers within partnerships.