What is good death: Bridging the gap between research and intervention

Research studies on "good death" have increased our awareness of what is important for both terminally ill patients and bereaved family members. Nevertheless, these findings should not be considered the "norm" for every individual, and those who cannot meet the criteria of "good death" as found in these studies should not be viewed as having "bad death". Walter25 also indicated that some norms in the culture may constrain how one should grieve, thus causing "policing grief which may not be adaptive. One of the reflections of this challenge is to reject the dichotomous thinking of death into just "good" and "bad". Masson26 indicated that the terminology of "good death" failed to reflect the complex process of death and dying. He suggested that the term "good-enough death" could better explain the situation, as it emphasized the realistic context and contingency. Instead of evaluating the death simply as "good" or "bad", helping professionals may facilitate bereaved persons' consideration of their specific contexts and appreciate the "good-enough death" under the circumstances. Another reflection on "good death" is that, no matter how good the death, it is still a great loss for many bereaved persons. Thus, by no means can "good death" necessarily predict "good bereavement" in all situations. As Chan9 proposed, both "good death" and "good life" are required for achieving "good bereavement". Ensuring a "good life" of bereaved persons, like reconstructing the meaning of life after loss27 in a totally different world after the death of loved ones,28 may better facilitate the bereaved in coping with their grief. Henderson and Hayslip29 have shown that general adjustment in life can better predict the level of bereavement-related distress, whereas the reverse is not true. Thus, instead of just focusing on grief work, helping the bereaved persons to adjust to changes in daily life circumstances may be effective in bereavement intervention. Moreover, intervention focusing on ensuring "good life" can be more proactive, and may match well the pragmatic orientation of bereaved persons.21 For example, it will be of great importance if bereaved older adults can be helped to spend time more meaningfully, in order to face loneliness in old age after the death of a spouse. There is room for further research on "good death", "good life" and "good bereavement". What are the long-term effects of "good death" on the adjustment of bereaved persons? Will "good death" predict the personal growth of bereaved persons? What is "good life" as perceived by bereaved persons in different age groups? What is "good bereavement" as perceived by bereaved persons? All these research findings will probably shed much more light on our intervention, and integrating this new knowledge into our practice will be the next step forward.