Bereavement. Strategy Exchange. PCQN Conference Call June 17, 2015

Transcription

1 Bereavement Strategy Exchange PCQN Conference Call June 17, 2015

2 Strategy Exchange PCQN Spring 2015 Conference Grief and Bereavement Team and personal responses Helping families/loved ones Identifying people at risk for complicated grief

3 What do you do to acknowledge a patient s death? Send cards to families Leave on the unit for nurses to sign as well Daily/weekly/monthly review of deaths and reading of names Allow team members to reflect, talk about what went well, what they wish had gone better Debrief of particularly difficult cases Acknowledge patients deaths Place a bow on a wreath, butterfly collage with patients names, bell ringing, quarterly team memorial service, traveling remembrance tree

4 What services/activities do you offer for bereavement? Bereavement group led by social worker Grief workshop on self-care Three day check in by phone to discuss logistics Death certificate, funeral, etc.

5 What do you do individually to acknowledge and deal with death of patients? Attend funerals of patients Reflect on take-away and learning opportunities, then let it go, as part of endof-day debrief Sit with patient in room after family leaves Tension release exercise activity, 3-4x/day

6 What would you like to do that you aren t currently doing? Writing course to help process experience of caring for patients Call bereaved family Annual Day of Remembering for families and staff Allow more time for reflecting/remembering patient Better leverage hospice services and resources Obituary Wall at local shelters

7 Complicated Grief/Prolonged Grief Disorder Intense yearning Difficulty accepting the death Inability to trust others since the death Excessive bitterness Feeling uneasy about moving on Felling emotionally numb, detached, that life is meaningless and the future holds no prospect for fulfillment Symptoms persist for at least 6 months after the loss Occurs in up to 20% of bereaved

8 Risk Factors for Complicated Grief/Prolonged Grief Disorder Circumstances of death Untimely- child Sudden and unexpected, even in the terminally ill Traumatic Stigmatized- suicide Personal vulnerability History of depression Cumulative losses Nature of relationship with the deceased Overly dependent Ambivalent Poor social support

9 Working with people at risk for complicated grief Discuss at team meeting to identify people at risk Chaplain notified and sees family in hospital and refers to outpatient bereavement group Chaplain is also a therapist and does some of this work Refer family members to local hospice agencies Make call to hospice agency with person s name Refer to online resources e.g. young children use Dana Farber website Refer high risk individuals to a community psychologist

10 Treating complicated grief Treat depression with antidepressants Psychotherapy Supportive counseling

11 Where are the most effective places to refer people for support after the death of a loved one? Church/synagogue/mosque/temple support groups Community groups for Limited English Proficient family members Hospice bereavement programs Reach out early Campus cancer center Geripal.org Supportivecarecoalition.org

12 Does your team offer bereavement support? If so, how do you do this? Comfort care basket Hand out bereavement packages Letter with bereavement resources, including hospice bereavement resources Provide translated materials 24-hour chaplain service Chaplain offers 13-month bereavement program Child Life services for children Weekly/monthly support meetings

13 Thank you! Next call: July 22 nd 1-2 pm PT Have something you want to present? Something you have prepared? Chances are if you are interested, we are too! Contact Ashley: