How understanding the pathways of grief after VAD can help health professionals provide better care for families

407 0

A blog written by Hayley Russell, Churchill Fellow, Senior Research Manager, Ovarian Cancer Australia, and Bereavement Counsellor

 

Hayley Russell is a passionate and committed clinician and researcher, working largely in areas which have traditionally held a level of stigma, including death and dying, and grief and loss. Over the last ten years her career has involved highly specialised clinical work alongside research collaborations which truly make a difference in the lives of bereaved and cancer impacted Australians. 

As a Victorian grief and loss counsellor working in community palliative care in mid- 2019, I was keenly aware of the changing climate within death and dying that could be approaching with the advent of voluntary assisted dying (VAD) legislation in our state. 

Very soon afterwards, the clients whose stories I am privileged to hear every day began to tell me about being with their loved ones as they undertook the application process and died using a VAD substance. They spoke of gratitude, of fears and worries, and of deep understanding of their family members values and motivations.

This exposure encouraged me to think outside the box in terms of how to learn more in a completely new area in the Australian context. Receiving a Churchill Fellowship Award in 2022 and travelling to the U.S, Canada, Switzerland and Belgium the following year allowed me to speak to clinicians, researchers and family members who had many more years of experience in the area. 

I found that grief after assisted dying was characterised by a multitude of seemingly dual experiences, including: 

• Preparedness - the sense of comfort and reassurance that a loved one died in a way which was aligned with their values and involved rituals and processes which were meaningful to them.
• Ambivalence, Worry and Hidden Experiences - at times, experiences of anxiety and ambivalence for family members regarding the process, guilt at participation and lack of support seeking.
• Stigma and Secrecy - particularly within some communities, stigma was significant and created social isolation. Experiences with health professionals could also create or maintain this stigma.

As health professionals, simply being aware of these potential responses can assist in providing psycho-education and normalisation for those families we see where VAD is involved. 

In addition, where possible we can create opportunities for families to access :

• comprehensive psychosocial support prior to the bereavement
• referrals to appropriate grief and loss services in the community afterwards

as well as seeking VAD education and support to explore your own responses as health professionals, all of which an create better experiences for families.

For a more in depth exploration of these themes, please see Hayley’s Churchill Fellowship Report Hayley Russell - Churchill Trust.

 

Hayley Russell

Churchill Fellow, Bereavement Counsellor

and Senior Research Manager