Letting go before a death: a concept analysis


Susan E. Lowey: e-mail: susan_lowey@urmc.rochester.edu


Title. Letting go before a death: a concept analysis

Aim.  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.

Data sources.  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.

Conclusion.  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.