Bereavement

Why is it important to share information about dying, grieving and bereavement?

Sharing basic information about dying and grieving can help people to understand their responses to grief. It may also assist older people, family and carers to prepare for a death at home. [14,15] Over time, consider ways to share resources when talking with older people, their family and carers about end of life or grief.

• Consider offering information, such as the Palliative Caring booklet (pdf) from Palliative Care NSW for families and carers about caring at home, which includes information about grief and bereavement.
• See Information for families and carers for examples of other simple resources to offer.

Keep in mind the need to share culturally appropriate information about grief and bereavement. There are also translated resources that are freely available. For instance, Coping with Grief by Griefline is available in English, Arabic, Greek, Spanish, Vietnamese and Chinese.

How should I respond when an older person in my care dies?

It is important to offer proactive support and assistance around the time of a death at home. Support following a death at home can be especially important, as families and carers may not receive other follow up that often happens when a death occurs in a hospital or specialist palliative care unit.

When you have contact with family and carers soon after a death at home, ensure that you:

• Acknowledge the death with thoughtful words or actions. This might be by writing a simple condolence or sympathy card when you have worked with an older person, their family and carers over time.
• Offer practical information about what to do in the weeks and months following a death. For instance, Services Australia provide information about what to do when someone dies, including a list of who to tell when someone dies.
• Where it is within your scope of practice, check in about the coping and support needs of family or carers after a death.

How might I identify people at risk of poor grief and bereavement outcomes?

All care workers and clinicians should be aware of some of the factors that may place older people, family or carers at increased risk of difficulties in grief and bereavement. This includes mental health concerns, such as Prolonged Grief Disorder.

ELDAC Grief and Bereavement: Core Concepts for Care Workers (pdf) and Clinicians (pdf) includes a simple summary of some of risk factors to keep in mind, such as:

• low social support
• high levels of pre-loss grief
• existing mental health concerns
• carer burden
• feeling unprepared for a death
• bereavement overload (many losses close together).

Clinicians working in home care should also use the conversational prompts listed in ELDAC’s Grief and Bereavement: Core Concepts for Clinicians (pdf) to support assessment of grief and bereavement-related risk and protective factors for older people and their family and carers. Consideration of these factors should begin before a death, and factors should be revisited and reviewed over time.

Caring for someone at home through the end of life can be isolating. Some carers may have limited support or have become distanced from other family and friends. This may increase the impacts of grief and bereavement. As you interact with carers while looking after an older person at home:

• Recognise and validate their grief.
• Prompt carers to attend to their own wellbeing.
• Be aware of local or community support services that may be helpful. Share information about these supports as needed.

Adjusting to life after a caring role may also be challenging. Some carers may experience the end of caring as another major loss in their role and identity as a carer. Encourage carers to engage with support, such as trusted friends or their GP, while caring and after a death.

What should I do when someone needs extra support in their grief or bereavement?

Pay attention if someone is experiencing risk factors, such as:

• low mood
• loss of purpose
• intense and painful longing for someone who has died
• difficulty engaging in day-to-day tasks
• withdrawal from others.

You may notice some of these factors over time, as you work with an older person, and their family and carers in the home. This means you may be able to proactively support people in need of extra care to connect with services providing anticipatory grief and bereavement support.

It is important to offer extra support when someone has several risk factors that seem to impact their ongoing coping in negative ways. Suggest counselling or other support services.

You might also discuss any concerns with a manager or supervisor, or offer information about services yourself, depending on your role.

ELDAC’s Grief and Bereavement: Practice Tips for Care Workers (pdf) and Clinicians (pdf) provide simple guidance about identifying complex needs, and assisting people to access additional grief and bereavement support where needed.