Bereavement support encompasses the experience of family members and friends on a continuum, including the anticipatory, expectant, death and post-death periods. It is an essential element of high-quality end of life care (DHHS, 2016). Austin Health cares for approximately 1400 people per year who die as inpatients. We thank the North and West Palliative Care Consortium for funding this initiative.

We have developed an evidence-based bereavement support model to ensure a systematic approach to identifying and supporting the bereavement of families and carers of Austin Health patients. The model has a focus on sustainable bereavement support utilising existing resources (including community palliative care services when available) and targeting clinical resources to those in most need. The model includes a bereavement risk assessment tool, consumer resources, and the use of the validated Brief Grief Questionnaire (Shear et al., 2005). Consumers were an integral part of the steering committee.

Prior to death, the Bereavement Risk Assessment tool identifies factors contributing to both resilience and risk (based on Neimeyer et al., 2012). At the time of death, the patient’s next of kin is allocated to either ‘universal’ or ‘specialist’ follow-up. Usual psychosocial assessment and care is provided at all times.

All next of kin are sent a bereavement card, hand-written and posted by volunteers, with information on supports available.

The specialist stream adds a telephone call to the next of kin from a trained clinician (most commonly a social or spiritual care worker) at about 12 weeks post death. At this point, the Bereavement Risk Assessment is repeated.

If ongoing risk of complicated grief is identified, a further telephone call is undertaken at 6 months. The Brief Grief Questionnaire is then used to formally screen for complicated grief. Usual psychosocial care is provided at both these time points, but if more support is required then the person is advised to seek external supports as appropriate, for example via their general practitioner.

The model has been implemented on the Palliative Care Unit and is being scaled up across the hospital. It has been well received by staff and bereaved families.

References

1. Department of health and human services (DHHS) ‘Victoria’s End of Life and Palliative Care Framework A guide for high-quality end of life care for all Victorians’; 2016.

2. Shear K, Frank E, Houck PR. Treatment of complicated grief: a randomized control trial. The Journal of the America Medical Association 2005;293(21):2601–2608.

3. Neimeyer RA, Burke LA. Complicated grief and end of life: risk factors and treatment considerations. In counselling clients near the end-of-life. J.L. Worth (ed.), pp.205–224. New York: Springer Science.2012