Bereavement

Caring for bereaved families is an important element of hospice and palliative care. Hospice and palliative care clinicians must learn to work with interdisciplinary teams to provide bereavement care, and especially to distinguish between normal grief and more pathological responses to loss. Over the course of the year, fellows learn about bereavement in a variety of ways, including a series of didactic sessions led by two bereavement experts, a psychologist, and a social worker. Fellows also make mentored bereavement calls and participate in weekly and biannual remembrance activities.

This fellowship trains participants in the following Hospice and Palliative Medicine Core Competencies:

  • Provides treatment to the bereaved
  • Provides support to family members at the time of death and immediately after
  • Involves interdisciplinary team members in treating the bereaved
  • Refers family members to bereavement programs
  • Describes the basic science, epidemiology, clinical features, natural course, stages, and management options for normal and pathologic grief
  • Demonstrates knowledge of normal grief and elements of bereavement follow-up, including assessment, treatment, and referral options for bereaved family members
  • Recognizes the risk factors, diagnostic features, epidemiology, and management of depression and prolonged grief disorder
  • Appreciates risk of suicide in the bereaved and carries out initial assessment for suicide risk
  • Demonstrates skill in the following paradigmatic situations with patients or families and documents an informative, sensitive note in the medical record: Writing condolence notes and making bereavement calls

Didactics
Syndrome of imminent death
Bereavement seminar

  • Session 1: The nature of grief
  • Session 2: Condolence guidelines and strategies to help the bereaved
  • Session 3: Risk factors for poor bereavement outcomes
  • Session 4: Reflections about interacting with the bereaved

Experiential learning
Bereavement support group
Mentored bereavement phone calls
Memorial services at the clinical sites
Weekly remembrance at MGH, BWH/DFCI