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The Biggest Crash In History Is Coming? Kiyosaki Says So…

The Biggest Crash In History Is Coming? Kiyosaki Says So…

Authored by Lance Roberts via RealInvestmentAdvice.com,

Robert Kiyosaki recently…

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The Biggest Crash In History Is Coming? Kiyosaki Says So...

Authored by Lance Roberts via RealInvestmentAdvice.com,

Robert Kiyosaki recently tweeted, “The best time to prepare for a crash is before the crash. The biggest crash in world history is coming. The good news is the best time to get rich is during a crash. The bad news is the next crash will be a long one.”

Is Kiyosaki just being hyperbolic, or should investors prepare for the worst?

Importantly, I received Kiyosaki’s comment in an email that I could find out more by just clicking on the link to get a “free” report.

I can save you time, and future spam emails, by telling you that Kiyosaki will be correct.

Eventually.

However, the problem, as always, is “timing.”

As discussed previously, going to cash too early can be as detrimental to your financial outcome as the crash itself.

Over the past decade, I have met with numerous individuals who “went to cash” in 2008 before the crash. They felt confident in their actions at the time. However, that “confidence” gave way to “confirmation bias” after the market bottomed in 2009. They remained convinced the “bear market” was not yet over, and sought out confirming information.

As a consequence, they remained in cash. The cost of “sitting out” on a market advance is evident.

As the market turned from “bearish” to “bullish,” many individuals remained in cash worrying they had missed the opportunity to get in. Even when there were decent pullbacks, the “fear of being wrong” outweighed the necessity of getting capital invested.

The email I received noted:

“If such a disaster could be in the making, your assets are at risk and this requires your immediate attention! And if you believe that now isn’t the time to protect yourself and your family, when will it be?”

Let’s start with that last sentence.

The Biggest Crash In History Is Coming

As I stated, Kiyosaki is right. The biggest crash in world history is coming, and it will be due to the most powerful financial force in the financial markets – mean reversions. The chart below shows the deviation of the inflation-adjusted S&P 500 index (using Shiller data) from its exponential growth trend.

Note that the market reverted to or beyond its exponential growth trend in every case, without exception.

(Usually, when charting long-term stock market prices, I would use a log-scale to minimize the impact of large numbers on the whole. However, in this instance, such is not appropriate as we examine the historical deviations from the underlying growth trend.)

Importantly, this time is not different. There has always been some “new thing” that elicited speculative interest. Over the last 500 years, there have been speculative bubbles involving everything from Tulip Bulbs to Railways, Real Estate to Technology, Emerging Markets (5 times) to Automobiles, Commodities, and Bitcoin.

Jeremy Grantham posted the following chart of 40-years of price bubbles in the markets. During the inflation phase, each period got rationalized as “this time is different.” 

Again, every financial bubble, regardless of the underlying drivers, had several things in common:

  1. Tremendous amounts of speculative interest by retail investors.

  2. A sincere belief “this time was different:” and,

  3. A tragic ending that devastated financial fortunes.

This time is likely no different.

Timing Is Everything

So, yes, a crash is coming.

However, the problem is the “when.”

A crash could come at any time, next month, next year, or another decade.

In the meantime, as noted, sitting in cash or some other asset that vastly underperforms either inflation or the market impedes the progress in achieving your financial goals.

Notably, crashes require an event that changes investor psychology from the “Fear Of Missing Out” to the “Fear Of Being In.” As noted previously,this is where the current lack of liquidity becomes extremely problematic.

The stock market is a function of buyers and sellers agreeing to a transaction at a specific price. Or rather, “for every seller, there must be a buyer.”

Such is an important point. Every transaction in the market requires both a buyer and a seller, with the only differentiating factor being at what PRICE the transaction occurs. When the selling begins in earnest, buyers will vanish, and prices will fall lower. Such is why the correction in March 2020 was so swift. There were indeed people willing to buy from panicking sellers. They were just 35% lower than the previous peak.

What could cause such a shift in psychology?

No one knows. However, historically speaking, crashes have always resulted from just a few issues.

  1. An unexpected, exogencous event that changes economic outlooks (Geopolitical Crisis, War, Pandemic)

  2. A rapid increase in interest rates.

  3. A sudden surge in inflation.

  4. Credit-related events that impact the financial system (Bankruptcies, Real Estate foreclosures, defaults)

  5. Monetary event (currency crisis)

Almost every financial crisis in history boils down ultimately to one of those five factors and mainly a credit-related event. Importantly, the event is always unexpected. Such is what causes the rapid change in sentiment from “greed” to “fear.”

Preparing For The Crash

As investors, we should never discount “risk” under the assumption some force, such as the Fed, has eliminated it.

Every era of speculation brings forth a crop of theories designed to justify the speculation, and the speculative slogans are easily seized upon. The term ‘new era’ was the slogan for the 1927-1929 period. We were in a new era in which old economic laws were suspended.” –Dr. Benjamin Anderson – Economics and the Public Welfare

So, we know two things with certainty:

  1. Robert Kiosaki will be correct about the next crash; and,

  2. We have no idea when it will happen.

Fortunately, we can take certain actions to protect portfolios from a crash without sacrificing financial goals. However, such actions are not “free” of cost.

  1. Properly sizing portfolio positions to mitigate the risk of concentrated positions.

  2. Rebalancing portfolio alllocations

  3. Take profits from extremely overbought and extended positions.

  4. Sell laggards

  5. When you are not sure what to do, do nothing. Cash is a great hedge against risk.

  6. Don’t dismiss the value of bonds in a portfolio.

  7. Look for non-correlated assets to mitigate risk.

As noted, there is a “cost.” Adding any strategy to a portfolio to mitigate or diversify risk will create underperformance relative to an all-equity benchmark index.

However, as investors, our job is not to beat some random benchmark index but to make sure our investments meet just two goals:

  1. Exceed the rate of inflation

  2. Meet the rate of return required to meet our long-term financial goals.

Any objective that exceeds those two goals requires an undertaking of increased risk and ultimately increases losses.

So, if you are afraid of the next crash, click here for a FREE REPORT.

Okay, I don’t actually have one.

However, you can certainly take some actions today to mitigate the risk of catastrophic losses tomorrow.

Tyler Durden Fri, 05/13/2022 - 08:43

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The War Between Knowledge And Stupidity

The War Between Knowledge And Stupidity

Authored by Bert Olivier via The Brownstone Institute,

Bernard Stiegler was, until his premature…

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The War Between Knowledge And Stupidity

Authored by Bert Olivier via The Brownstone Institute,

Bernard Stiegler was, until his premature death, probably the most important philosopher of technology of the present. His work on technology has shown us that, far from being exclusively a danger to human existence, it is a pharmakon – a poison as well as a cure – and that, as long as we approach technology as a means to ‘critical intensification,’ it could assist us in promoting the causes of enlightenment and freedom.

It is no exaggeration to say that making believable information and credible analysis available to citizens at present is probably indispensable for resisting the behemoth of lies and betrayal confronting us. This has never been more necessary than it is today, given that we face what is probably the greatest crisis in the history of humanity, with nothing less than our freedom, let alone our lives, at stake. 

To be able to secure this freedom against the inhuman forces threatening to shackle it today, one could do no better than to take heed of what Stiegler argues in States of Shock: Stupidity and Knowledge in the 21st Century (2015). Considering what he writes here it is hard to believe that it was not written today (p. 15): 

The impression that humanity has fallen under the domination of unreason or madness [déraison] overwhelms our spirit, confronted as we are with systemic collapses, major technological accidents, medical or pharmaceutical scandals, shocking revelations, the unleashing of the drives, and acts of madness of every kind and in every social milieu – not to mention the extreme misery and poverty that now afflict citizens and neighbours both near and far.

While these words are certainly as applicable to our current situation as it was almost 10 years ago, Stiegler was in fact engaged in an interpretive analysis of the role of banks and other institutions – aided and abetted by certain academics – in the establishment of what he terms a ‘literally suicidal financial system’ (p. 1). (Anyone who doubts this can merely view the award-winning documentary film of 2010, Inside Job, by Charles Ferguson, which Stiegler also mentions on p.1.) He explains further as follows (p. 2): 

Western universities are in the grip of a deep malaise, and a number of them have found themselves, through some of their faculty, giving consent to – and sometimes considerably compromised by – the implementation of a financial system that, with the establishment of hyper-consumerist, drive-based and ‘addictogenic’ society, leads to economic and political ruin on a global scale. If this has occurred, it is because their goals, their organizations and their means have been put entirely at the service of the destruction of sovereignty. That is, they have been placed in the service of the destruction of sovereignty as conceived by the philosophers of what we call the Enlightenment…

In short, Stiegler was writing about the way in which the world was being prepared, across the board – including the highest levels of education – for what has become far more conspicuous since the advent of the so-called ‘pandemic’ in 2020, namely an all-out attempt to cause the collapse of civilisation as we knew it, at all levels, with the thinly disguised goal in mind of installing a neo-fascist, technocratic, global regime which would exercise power through AI-controlled regimes of obedience. The latter would centre on ubiquitous facial recognition technology, digital identification, and CBDCs (which would replace money in the usual sense). 

Given the fact that all of this is happening around us, albeit in a disguised fashion, it is astonishing that relatively few people are conscious of the unfolding catastrophe, let alone being critically engaged in disclosing it to others who still inhabit the land where ignorance is bliss. Not that this is easy. Some of my relatives are still resistant to the idea that the ‘democratic carpet’ is about to be pulled from under their feet. Is this merely a matter of ‘stupidity?’ Stiegler writes about stupidity (p.33):

…knowledge cannot be separated from stupidity. But in my view: (1) this is a pharmacological situation; (2) stupidity is the law of the pharmakon; and (3) the pharmakon is the law of knowledge, and hence a pharmacology for our age must think the pharmakon that I am also calling, today, the shadow. 

In my previous post I wrote about the media as pharmaka (plural of pharmakon), showing how, on the one hand, there are (mainstream) media which function as ‘poison,’ while on the other there are (alternative) media that play the role of ‘cure.’ Here, by linking the pharmakon with stupidity, Stiegler alerts one to the (metaphorically speaking) ‘pharmacological’ situation, that knowledge is inseparable from stupidity: where there is knowledge, the possibility of stupidity always asserts itself, and vice versa. Or in terms of what he calls ‘the shadow,’ knowledge always casts a shadow, that of stupidity. 

Anyone who doubts this may only cast their glance at those ‘stupid’ people who still believe that the Covid ‘vaccines’ are ‘safe and effective,’ or that wearing a mask would protect them against infection by ‘the virus.’ Or, more currently, think of those – the vast majority in America – who routinely fall for the Biden administration’s (lack of an) explanation of its reasons for allowing thousands of people to cross the southern – and more recently also the northern – border. Several alternative sources of news and analysis have lifted the veil on this, revealing that the influx is not only a way of destabilising the fabric of society, but possibly a preparation for civil war in the United States. 

There is a different way of explaining this widespread ‘stupidity,’ of course – one that I have used before to explain why most philosophers have failed humanity miserably, by failing to notice the unfolding attempt at a global coup d’etat, or at least, assuming that they did notice it, to speak up against it. These ‘philosophers’ include all the other members of the philosophy department where I work, with the honourable exception of the departmental assistant, who is, to her credit, wide awake to what has been occurring in the world. They also include someone who used to be among my philosophical heroes, to wit, Slavoj Žižek, who fell for the hoax hook, line, and sinker.

In brief, this explanation of philosophers’ stupidity – and by extension that of other people – is twofold. First there is ‘repression’ in the psychoanalytic sense of the term (explained at length in both the papers linked in the previous paragraph), and secondly there is something I did not elaborate on in those papers, namely what is known as ‘cognitive dissonance.’ The latter phenomenon manifests itself in the unease that people exhibit when they are confronted by information and arguments that are not commensurate, or conflict, with what they believe, or which explicitly challenge those beliefs. The usual response is to find standard, or mainstream-approved responses to this disruptive information, brush it under the carpet, and life goes on as usual.

‘Cognitive dissonance’ is actually related to something more fundamental, which is not mentioned in the usual psychological accounts of this unsettling experience. Not many psychologists deign to adduce repression in their explanation of disruptive psychological conditions or problems encountered by their clients these days, and yet it is as relevant as when Freud first employed the concept to account for phenomena such as hysteria or neurosis, recognising, however, that it plays a role in normal psychology too. What is repression? 

In The Language of Psychoanalysis (p. 390), Jean Laplanche and Jean-Bertrand Pontalis describe ‘repression’ as follows: 

Strictly speaking, an operation whereby the subject attempts to repel, or to confine to the unconscious, representations (thoughts, images, memories) which are bound to an instinct. Repression occurs when to satisfy an instinct – though likely to be pleasurable in itself – would incur the risk of provoking unpleasure because of other requirements. 

 …It may be looked upon as a universal mental process to so far as it lies at the root of the constitution of the unconscious as a domain separate from the rest of the psyche. 

In the case of the majority of philosophers, referred to earlier, who have studiously avoided engaging critically with others on the subject of the (non-)‘pandemic’ and related matters, it is more than likely that repression occurred to satisfy the instinct of self-preservation, regarded by Freud as being equally fundamental as the sexual instinct. Here, the representations (linked to self-preservation) that are confined to the unconscious through repression are those of death and suffering associated with the coronavirus that supposedly causes Covid-19, which are repressed because of being intolerable. The repression of (the satisfaction of) an instinct, mentioned in the second sentence of the first quoted paragraph, above, obviously applies to the sexual instinct, which is subject to certain societal prohibitions. Cognitive dissonance is therefore symptomatic of repression, which is primary. 

Returning to Stiegler’s thesis concerning stupidity, it is noteworthy that the manifestations of such inanity are not merely noticeable among the upper echelons of society; worse – there seems to be, by and large, a correlation between those in the upper classes, with college degrees, and stupidity.

In other words, it is not related to intelligence per se. This is apparent, not only in light of the initially surprising phenomenon pertaining to philosophers’ failure to speak up in the face of the evidence, that humanity is under attack, discussed above in terms of repression. 

Dr Reiner Fuellmich, one of the first individuals to realise that this was the case, and subsequently brought together a large group of international lawyers and scientists to testify in the ‘court of public opinion’ (see 29 min. 30 sec. into the video) on various aspects of the currently perpetrated ‘crime against humanity,’ has drawn attention to the difference between the taxi drivers he talks to about the globalists’ brazen attempt to enslave humanity, and his learned legal colleagues as far as awareness of this ongoing attempt is concerned. In contrast with the former, who are wide awake in this respect, the latter – ostensibly more intellectually qualified and ‘informed’ – individuals are blissfully unaware that their freedom is slipping away by the day, probably because of cognitive dissonance, and behind that, repression of this scarcely digestible truth.

This is stupidity, or the ‘shadow’ of knowledge, which is recognisable in the sustained effort by those afflicted with it, when confronted with the shocking truth of what is occurring worldwide, to ‘rationalise’ their denial by repeating spurious assurances issued by agencies such as the CDC, that the Covid ‘vaccines’ are ‘safe and effective,’ and that this is backed up by ‘the science.’ 

Here a lesson from discourse theory is called for. Whether one refers to natural science or to social science in the context of some particular scientific claim – for example, Einstein’s familiar theory of special relativity (e=mc2) under the umbrella of the former, or David Riesman’s sociological theory of ‘inner-’ as opposed to ‘other-directedness’ in social science – one never talks about ‘the science,’ and for good reason. Science is science. The moment one appeals to ‘the science,’ a discourse theorist would smell the proverbial rat.

Why? Because the definite article, ‘the,’ singles out a specific, probably dubious, version of science compared to science as such, which does not need being elevated to special status. In fact, when this is done through the use of ‘the,’ you can bet your bottom dollar it is no longer science in the humble, hard-working, ‘belonging-to-every-person’ sense. If one’s sceptical antennae do not immediately start buzzing when one of the commissars of the CDC starts pontificating about ‘the science,’ one is probably similarly smitten by the stupidity that’s in the air. 

Earlier I mentioned the sociologist David Riesman and his distinction between ‘inner-directed’ and ‘other-directed’ people. It takes no genius to realise that, to navigate one’s course through life relatively unscathed by peddlers of corruption, it is preferable to take one’s bearings from ‘inner direction’ by a set of values which promotes honesty and eschews mendacity, than from the ‘direction by others.’ Under present circumstances such other-directedness applies to the maze of lies and misinformation emanating from various government agencies as well as from certain peer groups, which today mostly comprise the vociferously self-righteous purveyors of the mainstream version of events. Inner-directness in the above sense, when constantly renewed, could be an effective guardian against stupidity. 

Recall that Stiegler warned against the ‘deep malaise’ at contemporary universities in the context of what he called an ‘addictogenic’ society – that is, a society that engenders addictions of various kinds. Judging by the popularity of the video platform TikTok at schools and colleges, its use had already reached addiction levels by 2019, which raises the question, whether it should be appropriated by teachers as a ‘teaching tool,’ or whether it should, as some people think, be outlawed completely in the classroom.

Recall that, as an instance of video technology, TikTok is an exemplary embodiment of the pharmakon, and that, as Stiegler has emphasised, stupidity is the law of the pharmakon, which is, in turn, the law of knowledge. This is a somewhat confusing way of saying that knowledge and stupidity cannot be separated; where knowledge is encountered, its other, stupidity, lurks in the shadows. 

Reflecting on the last sentence, above, it is not difficult to realise that, parallel to Freud’s insight concerning Eros and Thanatos, it is humanly impossible for knowledge to overcome stupidity once and for all. At certain times the one will appear to be dominant, while on different occasions the reverse will apply. Judging by the fight between knowledge and stupidity today, the latter ostensibly still has the upper hand, but as more people are awakening to the titanic struggle between the two, knowledge is in the ascendant. It is up to us to tip the scales in its favour – as long as we realise that it is a never-ending battle. 

Tyler Durden Fri, 03/15/2024 - 23:00

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Government

“I Can’t Even Save”: Americans Are Getting Absolutely Crushed Under Enormous Debt Load

"I Can’t Even Save": Americans Are Getting Absolutely Crushed Under Enormous Debt Load

While Joe Biden insists that Americans are doing great…

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"I Can't Even Save": Americans Are Getting Absolutely Crushed Under Enormous Debt Load

While Joe Biden insists that Americans are doing great - suggesting in his State of the Union Address last week that "our economy is the envy of the world," Americans are being absolutely crushed by inflation (which the Biden admin blames on 'shrinkflation' and 'corporate greed'), and of course - crippling debt.

The signs are obvious. Last week we noted that banks' charge-offs are accelerating, and are now above pre-pandemic levels.

...and leading this increase are credit card loans - with delinquencies that haven't been this high since Q3 2011.

On top of that, while credit cards and nonfarm, nonresidential commercial real estate loans drove the quarterly increase in the noncurrent rate, residential mortgages drove the quarterly increase in the share of loans 30-89 days past due.

And while Biden and crew can spin all they want, an average of polls from RealClear Politics shows that just 40% of people approve of Biden's handling of the economy.

Crushed

On Friday, Bloomberg dug deeper into the effects of Biden's "envious" economy on Americans - specifically, how massive debt loads (credit cards and auto loans especially) are absolutely crushing people.

Two years after the Federal Reserve began hiking interest rates to tame prices, delinquency rates on credit cards and auto loans are the highest in more than a decade. For the first time on record, interest payments on those and other non-mortgage debts are as big a financial burden for US households as mortgage interest payments.

According to the report, this presents a difficult reality for millions of consumers who drive the US economy - "The era of high borrowing costs — however necessary to slow price increases — has a sting of its own that many families may feel for years to come, especially the ones that haven’t locked in cheap home loans."

The Fed, meanwhile, doesn't appear poised to cut rates until later this year.

According to a February paper from IMF and Harvard, the recent high cost of borrowing - something which isn't reflected in inflation figures, is at the heart of lackluster consumer sentiment despite inflation having moderated and a job market which has recovered (thanks to job gains almost entirely enjoyed by immigrants).

In short, the debt burden has made life under President Biden a constant struggle throughout America.

"I’m making the most money I've ever made, and I’m still living paycheck to paycheck," 40-year-old Denver resident Nikki Cimino told Bloomberg. Cimino is carrying a monthly mortgage of $1,650, and has $4,000 in credit card debt following a 2020 divorce.

Nikki CiminoPhotographer: Rachel Woolf/Bloomberg

"There's this wild disconnect between what people are experiencing and what economists are experiencing."

What's more, according to Wells Fargo, families have taken on debt at a comparatively fast rate - no doubt to sustain the same lifestyle as low rates and pandemic-era stimmies provided. In fact, it only took four years for households to set a record new debt level after paying down borrowings in 2021 when interest rates were near zero. 

Meanwhile, that increased debt load is exacerbated by credit card interest rates that have climbed to a record 22%, according to the Fed.

[P]art of the reason some Americans were able to take on a substantial load of non-mortgage debt is because they’d locked in home loans at ultra-low rates, leaving room on their balance sheets for other types of borrowing. The effective rate of interest on US mortgage debt was just 3.8% at the end of last year.

Yet the loans and interest payments can be a significant strain that shapes families’ spending choices. -Bloomberg

And of course, the highest-interest debt (credit cards) is hurting lower-income households the most, as tends to be the case.

The lowest earners also understandably had the biggest increase in credit card delinquencies.

"Many consumers are levered to the hilt — maxed out on debt and barely keeping their heads above water," Allan Schweitzer, a portfolio manager at credit-focused investment firm Beach Point Capital Management told Bloomberg. "They can dog paddle, if you will, but any uptick in unemployment or worsening of the economy could drive a pretty significant spike in defaults."

"We had more money when Trump was president," said Denise Nierzwicki, 69. She and her 72-year-old husband Paul have around $20,000 in debt spread across multiple cards - all of which have interest rates above 20%.

Denise and Paul Nierzwicki blame Biden for what they see as a gloomy economy and plan to vote for the Republican candidate in November.
Photographer: Jon Cherry/Bloomberg

During the pandemic, Denise lost her job and a business deal for a bar they owned in their hometown of Lexington, Kentucky. While they applied for Social Security to ease the pain, Denise is now working 50 hours a week at a restaurant. Despite this, they're barely scraping enough money together to service their debt.

The couple blames Biden for what they see as a gloomy economy and plans to vote for the Republican candidate in November. Denise routinely voted for Democrats up until about 2010, when she grew dissatisfied with Barack Obama’s economic stances, she said. Now, she supports Donald Trump because he lowered taxes and because of his policies on immigration. -Bloomberg

Meanwhile there's student loans - which are not able to be discharged in bankruptcy.

"I can't even save, I don't have a savings account," said 29-year-old in Columbus, Ohio resident Brittany Walling - who has around $80,000 in federal student loans, $20,000 in private debt from her undergraduate and graduate degrees, and $6,000 in credit card debt she accumulated over a six-month stretch in 2022 while she was unemployed.

"I just know that a lot of people are struggling, and things need to change," she told the outlet.

The only silver lining of note, according to Bloomberg, is that broad wage gains resulting in large paychecks has made it easier for people to throw money at credit card bills.

Yet, according to Wells Fargo economist Shannon Grein, "As rates rose in 2023, we avoided a slowdown due to spending that was very much tied to easy access to credit ... Now, credit has become harder to come by and more expensive."

According to Grein, the change has posed "a significant headwind to consumption."

Then there's the election

"Maybe the Fed is done hiking, but as long as rates stay on hold, you still have a passive tightening effect flowing down to the consumer and being exerted on the economy," she continued. "Those household dynamics are going to be a factor in the election this year."

Meanwhile, swing-state voters in a February Bloomberg/Morning Consult poll said they trust Trump more than Biden on interest rates and personal debt.

Reverberations

These 'headwinds' have M3 Partners' Moshin Meghji concerned.

"Any tightening there immediately hits the top line of companies," he said, noting that for heavily indebted companies that took on debt during years of easy borrowing, "there's no easy fix."

Tyler Durden Fri, 03/15/2024 - 18:00

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Spread & Containment

Sylvester researchers, collaborators call for greater investment in bereavement care

MIAMI, FLORIDA (March 15, 2024) – The public health toll from bereavement is well-documented in the medical literature, with bereaved persons at greater…

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MIAMI, FLORIDA (March 15, 2024) – The public health toll from bereavement is well-documented in the medical literature, with bereaved persons at greater risk for many adverse outcomes, including mental health challenges, decreased quality of life, health care neglect, cancer, heart disease, suicide, and death. Now, in a paper published in The Lancet Public Health, researchers sound a clarion call for greater investment, at both the community and institutional level, in establishing support for grief-related suffering.

Credit: Photo courtesy of Memorial Sloan Kettering Comprehensive Cancer Center

MIAMI, FLORIDA (March 15, 2024) – The public health toll from bereavement is well-documented in the medical literature, with bereaved persons at greater risk for many adverse outcomes, including mental health challenges, decreased quality of life, health care neglect, cancer, heart disease, suicide, and death. Now, in a paper published in The Lancet Public Health, researchers sound a clarion call for greater investment, at both the community and institutional level, in establishing support for grief-related suffering.

The authors emphasized that increased mortality worldwide caused by the COVID-19 pandemic, suicide, drug overdose, homicide, armed conflict, and terrorism have accelerated the urgency for national- and global-level frameworks to strengthen the provision of sustainable and accessible bereavement care. Unfortunately, current national and global investment in bereavement support services is woefully inadequate to address this growing public health crisis, said researchers with Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine and collaborating organizations.  

They proposed a model for transitional care that involves firmly establishing bereavement support services within healthcare organizations to ensure continuity of family-centered care while bolstering community-based support through development of “compassionate communities” and a grief-informed workforce. The model highlights the responsibility of the health system to build bridges to the community that can help grievers feel held as they transition.   

The Center for the Advancement of Bereavement Care at Sylvester is advocating for precisely this model of transitional care. Wendy G. Lichtenthal, PhD, FT, FAPOS, who is Founding Director of the new Center and associate professor of public health sciences at the Miller School, noted, “We need a paradigm shift in how healthcare professionals, institutions, and systems view bereavement care. Sylvester is leading the way by investing in the establishment of this Center, which is the first to focus on bringing the transitional bereavement care model to life.”

What further distinguishes the Center is its roots in bereavement science, advancing care approaches that are both grounded in research and community-engaged.  

The authors focused on palliative care, which strives to provide a holistic approach to minimize suffering for seriously ill patients and their families, as one area where improvements are critically needed. They referenced groundbreaking reports of the Lancet Commissions on the value of global access to palliative care and pain relief that highlighted the “undeniable need for improved bereavement care delivery infrastructure.” One of those reports acknowledged that bereavement has been overlooked and called for reprioritizing social determinants of death, dying, and grief.

“Palliative care should culminate with bereavement care, both in theory and in practice,” explained Lichtenthal, who is the article’s corresponding author. “Yet, bereavement care often is under-resourced and beset with access inequities.”

Transitional bereavement care model

So, how do health systems and communities prioritize bereavement services to ensure that no bereaved individual goes without needed support? The transitional bereavement care model offers a roadmap.

“We must reposition bereavement care from an afterthought to a public health priority. Transitional bereavement care is necessary to bridge the gap in offerings between healthcare organizations and community-based bereavement services,” Lichtenthal said. “Our model calls for health systems to shore up the quality and availability of their offerings, but also recognizes that resources for bereavement care within a given healthcare institution are finite, emphasizing the need to help build communities’ capacity to support grievers.”

Key to the model, she added, is the bolstering of community-based support through development of “compassionate communities” and “upskilling” of professional services to assist those with more substantial bereavement-support needs.

The model contains these pillars:

  • Preventive bereavement care –healthcare teams engage in bereavement-conscious practices, and compassionate communities are mindful of the emotional and practical needs of dying patients’ families.
  • Ownership of bereavement care – institutions provide bereavement education for staff, risk screenings for families, outreach and counseling or grief support. Communities establish bereavement centers and “champions” to provide bereavement care at workplaces, schools, places of worship or care facilities.
  • Resource allocation for bereavement care – dedicated personnel offer universal outreach, and bereaved stakeholders provide input to identify community barriers and needed resources.
  • Upskilling of support providers – Bereavement education is integrated into training programs for health professionals, and institutions offer dedicated grief specialists. Communities have trained, accessible bereavement specialists who provide support and are educated in how to best support bereaved individuals, increasing their grief literacy.
  • Evidence-based care – bereavement care is evidence-based and features effective grief assessments, interventions, and training programs. Compassionate communities remain mindful of bereavement care needs.

Lichtenthal said the new Center will strive to materialize these pillars and aims to serve as a global model for other health organizations. She hopes the paper’s recommendations “will cultivate a bereavement-conscious and grief-informed workforce as well as grief-literate, compassionate communities and health systems that prioritize bereavement as a vital part of ethical healthcare.”

“This paper is calling for healthcare institutions to respond to their duty to care for the family beyond patients’ deaths. By investing in the creation of the Center for the Advancement of Bereavement Care, Sylvester is answering this call,” Lichtenthal said.

Follow @SylvesterCancer on X for the latest news on Sylvester’s research and care.

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Article Title: Investing in bereavement care as a public health priority

DOI: 10.1016/S2468-2667(24)00030-6

Authors: The complete list of authors is included in the paper.

Funding: The authors received funding from the National Cancer Institute (P30 CA240139 Nimer) and P30 CA008748 Vickers).

Disclosures: The authors declared no competing interests.

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