Bereavement support for adults

Hudson, 2012Rabow, 2004Shear, 2017

After a patient’s death, bereavement follow-up may include expressing condolences, enquiring about coping following the death, offering and providing support to the family and carer(s) if needed, and liaising with relevant cultural or religious supports.

It may be appropriate for healthcare professionals to attend a patient’s funeral; for example, when they have had a longstanding connection with the patient, family or community. Attendance at a patient’s funeral is not essential practice; it is a personal decision.

While there is limited evidence about best practice in bereavement support, some form of follow-up of the principal carer may be of value, particularly in those at increased risk of prolonged grief disorder. Opinion is divided about whether this should be done in a structured way, or as opportunities arise (eg as part of a general consultation). Review at 3 to 6 weeks after the death, and a follow-up assessment 6 months after the death is recommended, but the circumstances around each death should be considered and managed individually. For features and management of grief and potential complications, see Grief in palliative care.

Family members and carers may be followed up by a general practitioner, a bereavement counsellor or a member of the healthcare team most closely connected with the family; a community nurse, volunteer or other support person may assist. Some bereaved people appreciate ongoing support from a member of the healthcare team who was involved in the care of the patient who died, while others prefer to receive support from someone who has not previously been involved. For support resources, see Grief and bereavement resources.

Follow-up provides an opportunity to review medical care and consider the coping responses and support needs of bereaved people. Risk factors for prolonged grief disorder can be reviewed and the need for closer follow-up or intervention considered. For advice on communicating with bereaved family members and carers, see Communicating with bereaved family members and carers.
Figure 1. Communicating with bereaved family members and carers

When communicating with bereaved family members and carers it may be helpful to:

  • acknowledge their loss and related emotions
  • review the circumstances of the death and history of the relationship with the deceased
  • ask about other current stressors (eg other losses, caregiving responsibilities, financial strain)
  • ask about dominant concerns for themselves or others (eg children)
  • explore current symptoms of grief and coping strategies (including asking about alcohol or other substance use), and past responses to loss
  • provide information and reassurance about normal grief (see Grief in palliative care)
  • offer further contact to review progress over time.

People with developmental disability or significant disability from chronic psychiatric disorders often have unmet bereavement support needs. Tailor communication with them appropriately and coordinate support with other health services or community agencies.

Community-based palliative care services often have counselling and volunteer staff who can assist with bereavement support, if necessary.

For advice on family and carer needs after death, see Family and carer needs after a patient has died.

For additional advice on bereavement support for families whose child has died, see Bereavement support for families whose child has died.

Further information on bereavement support, including tools and resources, is available at the CareSearch website.