Letting go before a death: a concept analysis.
OBJECTIVE
This paper is a report of a concept analysis of letting go within the context of family caregivers and end-of-life care.


BACKGROUND
The term 'letting go' has been used in an informal manner by nurses and other clinicians working with patients and families with terminal illnesses to depict a lack of acceptance of a loved one's impending death.


METHODS
The CINAHL, Ovid Medline and PsychInfo databases were searched for the period of 1995-2007 for literature published in English in peer-reviewed journals from a variety of disciplines, using the specific keywords letting go or to let go.


METHODS
The Walker and Avant method of concept analysis was used, and the study was guided by Zerwekh's family caregiving model of core competencies for hospice nurses.


RESULTS
Letting go before the death of a loved one involves a shift in thinking in which there is acknowledgement of impending loss without impeding its natural progression. An emotional attachment and recognition that everything has been carried out usually precede the concept, followed by a peaceful death and acknowledgement of change.


CONCLUSIONS
The concept of letting go has been explored in many contexts but the core essence of the awareness and work towards the acceptance of an impending loss appears to be a universal domain. Research is needed to further explore and identify patterns of this phenomenon in family caregivers in the context of death of a loved one.
University of Rochester School of Nursing, Rochester, New York, USA. susan_lowey@urmc.rochester.edu
Susan E
SE
Lowey
D000223:Adaptation, Psychological; D001293:Attitude to Death; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D005260:Female; D005440:Fluid Therapy / Q000523:psychology; D017051:Hospice Care; D006801:Humans; D008297:Male; D008875:Middle Aged; D013727:Terminal Care / Q000523:psychology*; D009626:Terminology as Topic