Kenneth J. Doka

Adolescent Attitudes and Beliefs toward Aging and the Elderly

This article reports the results of an oral history project that used adolescents to interview elderly informants. The adolescents had considerable misinformation about aging and anxiety about the later stages of the life cycle. They also had negative stereotypes toward the elderly. The adolescents who participated in the project expressed enthusiasm for the project and admiration for the elderly they interviewed. However, participation in the project did not significantly impact upon beliefs and attitudes toward aging or the elderly. Factors that might account for these results, and implications of these results, are discussed.

Silent sorrow: grief and the loss of significant others

Abstract Studies of grief and bereavement have long recognized that relationship and attachment to the deceased is a critical determinant of the intensity of grief. Yet most studies only examine the impact of death on the immediate family or close kin. There is often an implicit assumption that such close relationships only exist among spouses or other members of the immediate family. This paper considers the impact of grief on nontraditional relationships. These include extramarital affairs, cohabitation, and homosexual relationships. Utilizing existing literature and case studies, the paper discusses the ways in which the tasks of bereavement can be complicated in nontraditional relationships. While grief may be intensified, resources for resolving grief are often limited. It may not be possible to utilize formal and informal support systems effectively. Religion and rituals may constrain, rather than facilitate, grief work. The paper describes five dimensions that bear upon the resolution of grief in n...

An Internet Tool to Normalize Grief

This research evaluated the efficacy of a psycho-educational Internet self-help tool to educate and support recently (1–6 months) bereaved individuals. The goal of the website was to help users normalize their grief to enhance their adaptive adjustment. A randomized controlled trial evaluated the gains in social cognitive theory constructs and state anxiety. Compared to the control group (N = 34), treatment participants (N = 33) reported significant multivariate gains (eta-square = .191). Significant program effects were obtained on all three outcome measures: attitude (eta-square = .177), self-efficacy (eta-square = .106), and state anxiety (eta-square = .083). These findings suggest the potential efficacy of an Internet-based grief support tool to enhance adaptive adjustment of the bereaved.

Expectation of Death, Participation in Funeral Arrangements, and Grief Adjustment

This research investigated the hypotheses that prior expectation of death and participation of the bereaved in planning and conducting funeral rituals will facilitate grief adjustment. Fifty primary survivors were interviewed twelve to eighteen months after the death. The hypothesis that participation in funeral rituals will facilitate grief adjustment was not confirmed. Prior expectation of death was significantly related to subsequent grief adjustment. This led to further speculation that participation in funeral rituals is important in facilitating grief adjustment in those cases in which death was not expected. Evidence regarding this hypothesis is discussed.

Education About Death, Dying, and Bereavement in Nursing Programs

The authors report the results of a March 1992 survey of 650 baccalaureate nursing education programs concerning the education that they provide in the area of death, dying, and bereavement. The survey inquired about death education content in the curriculum, theoretic models, and whether organ/tissue donation is addressed. Results indicate that many schools are using outdated models. The authors suggest ways to address these issues more adequately.

Grief, multiple loss and dementia

Abstract Alzheimers disease and the other dementias bring with them multiple losses for the person with dementia, their spouse and family, and professional caregivers. The person with dementia will experience the major losses of memory, role and autonomy, and ultimately of identity and selfhood. Their spouse and other family members may lose the person they knew and loved, as well as their hopes and expectations for the future, and even their home, social networks and other important sources of identity and support. Their bereavement may start long before the person dies. Professional caregivers too may experience loss when a long-term relationship with a client and their family is brought to a sudden end by the death. This article reviews these losses and how bereavement counsellors and supporters can help.

Loss upon loss: The impact of death after divorce

Abstract Studies of grief and bereavement have long recognized that attachment and relationship to the deceased is a critical determinant of the intensity of grief. Research has also noted the effect of ambivalent relationships on grief resolutions. Yet, most studies have tended to focus on the bereavement of immediate family and close kin. This study explores the bereavement of persons who have been divorced and then experienced the death of their ex-spouse. Based upon indepth interviews with a limited sample, this exploratory study considers the ways in which the grief of ex-spouse differs from and its similar to the grief experienced by widows, with rising divorce rates, this is likely to be an increasing issue in the future. Generally, if there was sufficient time, the loss due to divorce was completed and this minimized the impact of the death. When there was not time for the initial loss to be resolved, grief was complicated. Funeral rituals, the fact that the loss was not socially recognized, the l...

Ethics, end-of-life decisions and grief

Ethical end-of-life decisions do more than prolong or terminate a life. These ethical decisions may haunt survivors long after the death occurs. They may complicate grief, creating family dissension, inhibiting support and increasing ambivalence over the nature or circumstances of the death. Conversely, end-of-life decisions may not always be negative. In other circumstances, they may facilitate the grief process, allowing survivors a meaningful end to the story of a loved one, providing survivors a modicum of control that ends a persons pain, following the deceased wishes, or simply seeming to survivors to be the right thing to do. This article explores the ways that end-of-life decisions influence grief, offering suggestions on factors that might mitigate problematic outcomes.

Religion and Spirituality: Assessment and Intervention

In this article, the author explores the ways that an individuals spirituality influences responses to life-threatening illness and dying. He begins by differentiating between religion and spirituality, and then delineates the spiritual issues that arise in a life-threatening illness including the spiritual needs that arise in the final phases of illness. Recommendations for spiritual assessments and interventions are offered.

Dying and its Interpreters: A Review of Selected Literature and Some Comments on the State of the Field:

What have been the major theoretical approaches that have been useful in the study of dying to date? What theoretical approaches hold promise for the future? Selected literature on dying and coping with dying is reviewed in an effort to describe the present state of our knowledge in this field and to contribute to an overall theory of dying. Three central topics are 1) awareness of and communication about dying; 2) processes of illness; and 3) coping with dying. Reflections are offered on the kinds[s] of theory that might be desirable in this field, together with a number of lessons that can be drawn from the existing literature. A continued exploration of the ways that theoretical perspectives from psychology and sociology such as developmental theory, Symbolic lnteractionism, or Reconstructism can lead to greater understanding of the dying process.