Bereavement,Lossand Learning DisabilitiesA Guide for Professionals and Carers -- 1 Introduction and Overview -- The purpose of this book -- Terminology -- Facts and figures -- Relevant UK legislation and policy -- Context of the work -- The focus of different practitioners -- Routine as safety -- Is talking therapy the appropriate treatment? -- Problems that may be faced -- Associated losses -- Physical sensations -- Psychic or spirit sensations -- Collective grief -- Witnessing other people's illness -- Conclusion -- 2 How Bereavement and Loss can be Different in Learning Disabilities -- Why the experience of bereavement might be different for someone with a learning disability -- Self-blame -- Not knowing when grieving 'stops' following bereavement -- 3 Stages of Loss -- Introduction -- Shock -- Denial -- Bargaining -- Searching -- Anxiety -- Anger -- Guilt -- Depression -- Grief and mourning -- Acceptance -- How we can help this process -- 4 Assessment -- Introduction -- Background to risk -- Care plans -- Managing greater risks posed to the individual -- Relevance to bereavement and loss -- Depression -- Anger -- Physical manifestations of grief -- Self-esteem -- Assessment of behaviours that may be seen as attention seeking -- Factors to consider when assessing for any therapeutic work -- History of attachments -- Factors to consider in grief work -- Unresolved grief -- 5 Developing Understanding around Bereavement and Loss -- Context of the work -- Practical considerations -- Blocks to understanding -- Building on previous understanding -- Autism and understanding of bereavement and loss -- Developing an understanding of illness -- Developing an understanding of what death is -- Breaking news of sudden illness or death in residential settings -- Reading social cues -- Different attachments in residential care.

Difficulty in locating the body -- Explaining change to people with learning disabilities -- Health education and awareness -- Specific illness -- Impact of a death within a shared supported house -- Avoiding euphemisms -- Thinking about funerals and attending funerals -- Finding it hard to move on from worry -- Growing older -- 6 Therapeutic Tasks -- Introduction -- Types of referrals -- Establishing a good therapeutic relationship -- Consent -- Contract -- Confidentiality -- Boundary setting -- Environment and room setting -- Goal setting -- Tasks of counselling -- Endings -- 7 Working with Families -- Introduction -- Life cycle issues -- Beliefs and customs -- Loss felt by parents -- Loss of being parents -- Issues for older parents -- Preparing for the future -- Being honest about health needs -- Managing the effects of moving home -- Managing when parents become ill or hospitalized -- Dealing with structural change -- 8 The Carer's Role in Bereavement -- Introduction -- Knowing someone's history -- Who is a carer? -- Staff training needs -- Supporting a client who is facing a bereavement -- Systemic implications of a loss -- The role of carers -- National S ervice Framework for M ental Health and the Carers Act -- Caring for someone with learning disabilities -- Long-term foster placements -- Supporting people in residential care facing loss and bereavement -- End of an adult fostering relationship -- 9 Working with Clients who have Additional Communication Needs -- Language and meaning -- Identifying non-verbal change -- Behavioural changes -- Echolalia -- Involving speech and language therapy -- Makaton® -- Using Makaton to communicate emotions around loss and bereavement -- Talking Mats® -- Hearing loss -- Sight loss -- Creative therapies -- Dementia and learning disabilities -- 10 Role of Supervision -- Introduction.

Why supervision work in learning disabilities is essential -- Establishing the contract -- Functions of supervision -- Issues that often present in learning disabilities supervision -- Difficulties in obtaining appropriate supervision around bereavement and loss -- Encouraging self-reflection -- Working with trainees -- Supervising trainee counsellors -- Supervising residential staff -- Supervising day care staff -- 'Death and loss' for trainees -- 11 Working with Terminal Illnesses -- Introduction -- Why terminal illness is a difficult area -- Delays in diagnosis -- Assumptions made by others -- National Strategy for End of Life Care 2008 -- The concept of death -- Knowledge of what a terminal illness is -- Maintaining identity -- Specific issues for adults with learning disabilities facing end of life illness -- Explaining a terminal diagnosis -- Palliative care -- Health education -- Supporting people with learning disabilities who have terminally ill relatives and friends -- 12 Remembering and Anniversaries -- Introduction -- Functions of remembering -- Recalling the past -- Recognizing attachments -- Problems with remembering -- When remembering is not helpful -- Managing unpleasant memories -- Unwelcome reminding -- Loss felt by a centre or home -- Continuity -- Problems with anniversaries -- Doubts about memory and relationships -- Creating a focus -- Unresolved grief appearing some time after a loss -- Seasons and festivals -- Voices, accents, smells and sounds -- Dementia -- Managing change -- When to end mourning and remembering -- REFERENCES -- USEFUL ORGANIZATIONS AND RESOURCES -- INDEX.