Management model of caregiver's grief in a tertiary oncological center Hospice, from anticipatory mourning to condolence conversation: preliminary observations

BMC Palliat Care. 2024 Dec 20;23(1):289. doi: 10.1186/s12904-024-01620-2.

Abstract

Background: Bereavement is a crucial physiological process in palliative care; grief-processing disorders can be diagnosed at least 6 months after death and can have severe clinical or psychological consequences. This study aims to verify how adequate management of anticipatory mourning and condolence conversations can be protective in the early stages of grief.

Methods: Patients and caregivers are supported by a multidisciplinary team through semi-structured interviews. In condolence conversations within one month of the death, we identify signs of psychological fragility that require support for adequate processing of the loss.

Results: From the condolence conversations, only 2-4% of caregivers who had received psychological support during the hospital stay and showed a good level of acceptance of their relative's end of life exhibited grief problems within 1 month of death; none showed excessive avoidance of memories, difficulties with trust, or feelings of emotional loneliness.

Conclusions: Despite the limitations, the preliminary data of our study clearly suggest the protective potential of multidisciplinary support, particularly in reducing the risk of developing grief processing disorders. These considerations encourage us to implement our model of clinical and psychological support systems and develop pathways dedicated to caregivers experiencing greater difficulty.

Keywords: Anticipatory mourning; Grief; Hospice care; Palliative care; multidisciplinary; Psychological support.

Plain language summary

Bereavement is a crucial psychological process, indeed processing the loss of a relative is a complex and painful experience, which can sometimes become complicated, with the appearance of grief processing disorders. In palliative care and particularly in Hospice a progressive path is possible to protect patients and caregivers, identifying their vulnerabilities. This leads to correct management of anticipatory grief, taking advantage of all the skills of the multidisciplinary team involved in taking charge. Furthermore, scheduling an interview within a month of the death (“condolence conversation”) allows the team to identify those most at risk for complicated grief and suggest strengthening strategies, directing the caregivers most in difficulty towards a dedicated psychological path.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Aged, 80 and over
  • Caregivers* / psychology
  • Communication
  • Female
  • Grief*
  • Hospices / methods
  • Humans
  • Male
  • Middle Aged
  • Qualitative Research
  • Tertiary Care Centers / organization & administration