No such thing as 'uncomplicated bereavement' for patients in rehabilitation

Purpose : This review aims to: (1) discuss the reasons for the limited focus in the literature on the loss experiences of patients in rehabilitation; (2) highlight the importance of increasing our understanding of the loss reactions of these patients; and (3) offer suggestions for appropriate incorporation of bereavement issues into clinical practice and research. Method : The authors review articles and books from several disciplines to reveal and provide suggestions for overcoming limitations in application of current bereavement theory and practice with disabled populations. Results : The paper identifies problems with the descriptive and diagnostic 'language' of bereavement, a lack of empirical support for popular theory and assumptions about the grieving process and bereaved persons, disagreement among bereavement and rehabilitation clinicians on most appropriate interventions for facilitating adjustment, and compelling reasons to focus on bereavement issues with the disabled patient. Conclusions : The review reveals the need to clarify loss issues and terminology, develop appropriate measures of the loss experiences of patients with disability, identify variables affecting the process and outcome of grieving in this population, develop guiding theory and select interventions that meet the needs of these patients.