Dr Nathan MacArthur

I regularly meet with people challenged by what it means to prepare for the death and absence of someone they love and care for, and questioning if their experiences of grief and bereavement are ‘normal’. I was drawn to conduct research in this area to draw attention to the complex, diverse and nuanced lived experiences I was hearing about in my counselling room but rarely reading about in journal articles. I interviewed 36 adults whose relative died whilst receiving palliative or residential aged care. 22 of these participants went on to respond to questions sent to them over a six-month period. 

You can read about the findings of my research below.

Death is inevitable, yet it is only in certain circumstances, such as older age or advanced illness, that the anticipation of a death is expected to facilitate preparedness for loss in ways that mitigate the challenges of bereavement. Such logics are central to current end of life and thanatological research that seeks to develop effective assessment and intervention to promote preparedness for dying, and to accurately identify and reduce intrapsychic risk of prolonged or complicated grieving. Alongside this scholarship, a growing body of literature highlights the importance of attending to relational and social contexts to further develop rich understandings of the complexity and diversity within experiences of caregiving and loss. Adopting a qualitative approach, this study aims to contribute to this evolving area of research by collecting in-depth accounts of the lived experiences of bereaved adults following a death that was anticipated. A constructivist grounded theory methodology guided data collection and analysis, drawing upon a range of sensitising concepts, including ideas around anticipation, disruption and transition, relational moralities of care, and plasticity. During Stage 1, in-depth interviews were conducted to explore the bereavement experiences of 36 adults whose relative died whilst receiving palliative or residential aged care. Stage 2 employed a solicited diary methodology to ask 22 of these participants to respond to questions sent to them over a six-month period. The findings of this study reveal the plastic, relational, temporal, and social shaping of experiences of anticipation and bereavement. A key contribution of this analysis is the concept of anticipation fatigue, which draws attention to the pressures of preparedness, including maintaining a state of perpetual readiness for dying whilst negotiating relationships with family members in the pursuit of caring well. Further, the concept of bereavement affinities is developed as a way of thinking about new, sustained, and evolving experiences of connections and belongings following the death of a family member. Finally, this study identifies unmet support needs and offers suggestions for future developments in end-of-life and bereavement care.