Challenges to bereavement support
Dealing with death and bereavement is often difficult while individuals seek to make sense of the loss, even with the support from those people within their own social circle. For people with learning disabilities there may be additional considerations related to the disability itself and the attitudes of others towards their disability, leading to what Oswin (1991; 2001) described as the "double taboo" of death and disability. People with learning disabilities have often been protected from the true impact of death, by well meaning carers who want to minimise their distress. As referred to above, people who do not have the opportunities to openly grieve, and who are not involved in the rituals surrounding death may be described as disenfranchised gnevers (Doka 1989) Therefore, people with learning disabilities may be vulnerable from a death and bereavement perspective (Read & Elliot, 2003) as they are often reliant upon others to facilitate such opportunities.

Over-protectiveness often leads to disempowerment, as some individuals may not be encouraged to say goodbye to their loved ones; may not attend the funeral and are often not informed about the death of their loved ones, until many months or years later. Such attitudes may not help bereaved individuals to accommodate their grief. Carers who support people with learning disabilities may find it difficult to help them talk about death and bereavement as it can be a very sensitive topic. Some carers may have limited knowledge and negative attitudes regarding death and bereavement; may not have received adequate training and may not be aware of the resources available to help them in this task. They may also harbour an innate fear of the individual's response and reactions during death and bereavement, particularly from people who react in a challenging manner.
Bereavement affects people in different ways, and familiar carers might offer a strong sense of social support whilst also having a pivotal role in anticipating identifying and acknowledging individual response and the need for additional specialist input. Support at this time is crucial, both to bereaved people and those responsible for their care. Service providers need to be mindful of the importance of support at such times, and that such support may be needed in the short and long term.

By identifying, acknowledging and addressing such challenges in an open, honest and sensitive way, carers can help the person with a learning disability to confront and deal with the sadness and other associated feelings following the death of a loved one.

When death and bereavement is dealt with in a supportive, sensitive and consistent way, individuals may learn to develop personal coping strategies and learn to cope with future losses in a more constructive manner. Meaningful support is crucial to this process.

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