Article Text

Loss responses at the end of life: a conceptual reflection
  1. Linda Machin, Visiting Research Fellow
  1. Keele University, Freelance Trainer and Hospice Bereavement Counsellor. Email: linda{at}


Professional service providers play a key role in understanding and facilitating best practice in end-of-life care, potentially helping to transform people’s experience at a time of vulnerability into one of discovering resilience. End-of-life care involves a three-way relationship between patients/residents, family carers and professional service providers. Individual circumstances generate varying responses to loss at the end of life. The Range of Response to Loss (RRL) model provides a framework for understanding general patterns of loss and individual reactions to it. Sometimes change and loss experienced at the end of life can be openly explored, shared and supported. At other times it is not possible to acknowledge and accommodate everyone’s needs. This dissonance may reflect pre-existing relationship patterns in families or in the working environment of healthcare professionals. This article explores the complex interplay of patients’/residents’, family carers’ and professional service providers’ loss responses. It also describes how the RRL model can provide a framework to understand individual variability in grief reactions. Conflicts of interest: none

  • Grief
  • End-of-life care
  • Loss
  • Resilience
  • Vulnerability

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