274 Grief and Loss Across the Lifespan
to regulate emotions and manage reactivity is common (Prakash et al., 2014).
Furthermore, mindfulness capitalizes on the older adult’s shift in motivational
goals from future—oriented desires to the present—focused emotion regula-
tion and gratification inherent in mindfulness meditation practices.
Meditation can be useful for bereaved older adults because traumatic
grief often produces a pattern of avoidance of emotions, thoughts, and memo-
ries surrounding the grief experience, a key aspect of complicated bereavement
(Cacciatore & Flint, 2012; Shear, 2010). This avoidance behavior interferes with
the ability of bereaved older adults to integrate the loss. A mindful meditative
approach can be used in the therapy to model for clients ways they may be
able to be with and surrender to their grief and be more likely to integrate their
loss, leading to a more meaningful, growth oriented perspective on life.End-of-Life Issues
Over the last decade, people have achieved a new candor in discussing end-of-
life issues, particularly death and dying. Death cafes (http://deathcafe.com/)
have sprung up in cities around the world, enabling adults to share their con-
cerns and questions about end-of-life issues, as well as worries/ concerns about
the dying process itself. As awareness and discussion become widespread, cli-
nicians will be asked to help adults deal with fears/concerns about end-of-
life issues for themselves or their loved ones (Reith & Payne, 2009). Questions
emerge as adults examine in detail what type of support and medical care they
may want at the end of their lives.
Defining a “good death” is as varied as each adult’s desires. Many fac-
tors shape the end-of-life experience including one’s health, one’s family, one’s
history with death, prevailing medical practices, and health care technologies
that encourage aggressive treatment. Most adults who are facing death are
most fearful of pain and suffering (Gamino & Moore, 2011; Hultman, Reder, &
Dahlin, 2008). In an era where contemporary medicine has the ability to keep
individuals alive long after a natural death would normally occur, many are
afraid they will not be able to avoid a lingering, painful death. These fears,
together with a sense that one’s discomfort was being dismissed, lead some
to request a hastened death, often in the absence of knowledge about other
alternatives for managing pain and suffering (Schroepfer, 2007). Yet, alterna-
tives such as palliative care and hospice can assist with pain, spiritual and
psychological suffering, and physical care needs.Palliative and Hospice Care
All hospice care is palliative care, but not all palliative care is hospice care
(National Caregiver’s Library, 2015). Palliative care is focused on limiting pain
and suffering while curative medical treatments continue, whereas hospice
care starts when curative medical care ceases and the focus of care becomes
easing pain, symptoms, and suffering while focusing on quality of life during
terminal illness. The World Health Organization defines palliative care as:Palliative care improves the quality of life of patients and families who
face life-threatening illness, by providing pain and symptom relief,