In the summer of 2020, I wrote a blog on bereavement and predicted then, as we went through the pandemic, that we would experience a “tsunami of grief” that would be different to anything we had seen before. I also thought we would continue to see an increase in psychological stress for staff as they reflected on what they may have experienced and of course, sadly, these have come to fruition. The pandemic has forced a “new normal” in almost everything we do in health and social care, especially around communication. And unfortunately, an increase in caring for dying with the unprecedented increase in excess deaths for which there is no definitive explanation other than as a tragic consequence of COVID-19.
The depth of people’s distress and utter sadness at not being able to touch or be with their loved ones is beyond words, and trying to help them come to terms with this is a major challenge for staff. More people require support in their grief than ever before. How do we quantify that and how do we manage it as a society? How do we help stabilise this chaotic wave of grief that just keeps coming? The complexity of need is immense. Using tools to assess for risk of complex grief such as the Complex Bereavement Assessment Tool (CBRAT) may be helpful. It is also helpful to “triage” any referrals for bereavement support by carefully having a conversation that includes asking some key questions as part of the assessment. This is in line with Chochinovs (2005) Patient Dignity Question (PDQ): What do I need to know about you to provide the best care possible? Most bereaved people simply need the opportunity to talk in a safe space and be listened to. Mannix (2021) advocates a highly sensitive and gentle way of supporting people, guiding them to suggest how we can help them- to be with and alongside them without “doing to” them. This can be applied in bereavement support. To help staff, training in communication skills should be available. Staff can add the models they learn to their toolbox to bring out, adapt and use depending upon the individual situation to facilitate responding in a truly compassionate, person centred manner. Bereavement should be part of all curriculum to prepare staff in Health and Social Care.
Resources must be in place to support staff with these “tender conversations” and to facilitate this increase in demand, if people are to be supported to function again in society whilst they are learning to live with the loss of the person. This can be as basic as creating the space for people to talk about the person such as going for a coffee or facilitating a small group adopting a peer support or compassionate communities approach.
Bereavement care should be viewed as everybody's responsibility! We must adopt a compassionate and caring approach for bereavement and accept we all have a significant role to play in how a bereaved person may cope and as the death rate continues to be 100% and if approximately five people are significantly affected by each death, this is critical care!
Listen to the podcast below which reflects on bereavement and how we may look after ourselves and others:
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