Reflecting on family bereavement within the context of palliative care

Abstract

This theoretical essay discusses the grief experienced by families in the context of palliative care, understanding death not as an isolated event but as a relational process that runs through illness, reorganizes bonds and transforms identities. From a systemic and social constructionist perspective, the text traces the historical understanding of illness as punishment and its blaming effects, presents palliative care as an approach centered on the unit of care, formed by the ill person and their family, and reviews the evolution of theoretical models of grief, from stages and tasks to the dual process model, meaning reconstruction and continuing bonds. It argues that there is not a single grief but many griefs, experienced at the individual, family, group, community and public levels, and that, in the face of life-threatening illness, losses accumulate from the moment of diagnosis, configuring what is called total grief. Anticipatory grief, the ambivalence between hope for a cure and recognition of its limits, and the parallel grief experienced by health professionals are also highlighted. It concludes that caring for bereaved families requires the legitimation of losses, the support of difficult conversations and the shared construction of meaning, and that psychologists trained in family therapy contribute significantly to this care by integrating science, ethics and narrative.