Incorporating Bereavement into the Continuum of Care

Medpage | By Charles Bankhead

A new sense of urgency has emerged for healthcare organizations to develop "sustainable and accessible bereavement care" and to cultivate a "bereavement-conscious" workforce to position bereavement as an "inherent element of the duty of care," authors of a recent opinion piece asserted.

Inadequate investment in bereavement care has led to a paucity of integrated services at organizational, national, and global levels. Failure to recognize bereavement as a vital component of continuity of care can leave bereaved families without access to psychosocial support, putting them at risk of illness that exacerbates the substantial public health toll of interpersonal loss.

To develop a framework for compassionate communities requires shifting bereavement care from "an afterthought to a public health priority," wrote Wendy G. Lichtenthal, PhD, of the University of Miami Sylvester Comprehensive Cancer Center, and co-authors in Lancet Public Health.

"We need an investment in the healthcare system and in the community to build up support and grief-literate, compassionate communities," Lichtenthal told MedPage Today. "We need workplaces, schools, all institutions where people are, to be more informed and feel better about supporting grievers."

The public health toll associated with grief has been well documented, she said. Recent events have accelerated the urgency for sustainable and accessible bereavement care -- COVID-19, suicides, drug overdoses, homicides, armed conflicts, and terrorism.

Despite being integral to high-quality, family-centered healthcare, bereavement support often is poorly resourced, even described as the "poor cousin of palliative care." In an ideal setting, bereavement care begins with pre-death grief education, continues through the dying process and end of life, and transitions into community-based support and psychosocial services, as needed.

Recent reports on death, palliative care, and pain relief have highlighted the need for better bereavement care delivery infrastructure, the authors noted in their introduction. Acknowledging that "bereavement has been overlooked," the Lancet Commission on the Value of Death called for reorganizing priorities to address social determinants of death, dying, and grief. Imbalances in health and social care fostered by westernized medicine have "medicalized death and dying processes," resulting in disenfranchisement of family and community involvement throughout illness and end of life, the authors continued…

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