IE10 and below are not supported.

Contact us for any help on browser support

Discussion 6.2: Grief and Bereavement

10 months ago
CLOSED: This discussion has concluded.

As a society, we are so focused on prolonging life and curing illness that very little thought is given to when we experience the death of someone close to us. The grieving process can often begin while the person is still alive. Individuals who have experienced a death need time to grieve, to remember, and to heal.They also may need help to find information, resources and support.

How can the risk of intense and long-lasting grief best be assessed and treated? Can this be prevented / reduced through early bereavement support?

This consultation is now closed.


  • CFHI_FCASS over 1 year ago
    Patient and family partners/advisors can also inform program planning and service improvement around grief and loss. While there are valid assessment tools available to identify those who may have complicated grief, access to specialized services and supports is a significant gap in our systems of care. Peer based services (volunteers) are one of the most frequent ways of offering grief support. While these services are an important way for communities to care for each other and provide tremendous comfort to many, they are not accessible everywhere and they are not sufficient for those who experience complicated grief. Planning tools like demand and sustainability analysis used to plan health service delivery for many other conditions are needed to design grief care services that can address unmet needs and be sustained into the future. CFHI has provided financial support to Canadian Virtual Hospice to build upon and tailor their award-winning platform to emergency service providers, their families, professional associations and unions. CVH has engaged national and international grief experts, paramedics, professional associations and family members to develop evidence-based tools and resources that are grounded in lived experience and tailored to their unique environment. These resources will support the scale and spread of the Paramedics and Palliative Care: Bringing Vital Services to Canadians ( project.
  • CanadianVirtualHospice over 1 year ago
    Grief is often intense following a significant loss, however the intensity usually eases as people begin to accept and integrate the loss and adjust to their changed lives. However, this natural progression and easing of grief may not occur for some people. Some of the risk factors for complicated grief include: sudden, violent death, poor death notification, loss of a child or spouse, low social support and attachment insecurity. Most evidence-based treatments for complicated grief focus on both the grieving process and the restoration of meaningful activity. Virtual Hospice has developed free online grief resources which include content on early bereavement support. is an online bereavement resource that supports marginalized and diverse grievers. The nine self-directed modules cover a diversity of topics across the bereavement trajectory and include personal narratives of 21 people of diverse age, cultural, and sexual orientation groups normalizing the grieving process, sharing insights and providing hope. The first module "Grieving an expected loss" looks at common problems faced by families approaching the death of a family member or someone close to the family and suggests ways to manage these challenges. KidsGrief includes 3 bilingual modules to support parents caring for children through times of grief. The first module discusses teachable moments and encourages seizing these moments to discuss death with children early. The modules equip parents with tools for having difficult conversations with their children and supporting them in their grief experiences to develop healthy coping strategies and avoid possible mental health issues.
  • afoxrob over 1 year ago
    As an ICU physician I see complex grief frequently. We need to support caregivers better early during critical illness. Complex grief requires engagement of a broader health care team once the patient has either left or died in the ICU setting
  • PallRNKaren over 1 year ago
    The interdisciplinary team requires training on assessing, referring and treating clients/caregivers who are at risk for or suffering intense/long-lasting grief.
  • melmay over 1 year ago
    We need more trained professionals who can identify this. Our community based team can offer resources in the community for bereavement but we are lacking in this area, for sure. I feel it could be reduced if we have developed a relationship with the family, we may be able to identify their coping skills thru the illness and perhaps be able to council them earlier on and then after the death the language of bereave followup wont seem so foreign and un natural between the careteam and the family. We definitely need (more) dedicated SW and Spiritual care leaders as part of the home team.
  • veejay over 1 year ago
    Yes through access to languages-specific chaplaincy services in the community and at home for the families. We only have 1 chaplain in Scarborough and she only speaks English
  • Kjpt11 over 1 year ago
    due to the rural nature of our area, there are very limited resources to assist with this. Our organization does provide bereavement support however our resources to do so are limited as well. Large gap.
  • Sarah over 1 year ago
    Our community's hospice society raises funds to pay the salaries and program costs of 2 full time clinical counsellors to provide professional grief counselling and support groups. We have many volunteers who also make this possible. If we had a wish list, it would include some funding support from the health authority to ensure this remains complimentary to clients.
  • Sunrise over 1 year ago
    I truly believe that grief support is the biggest gap in our service and this has been ongoing. I believe grief is long-lasting (the rest of the griever's life) so I'm not sure I like the wording of this question. However I feel we need resources to ensure support is offered that people can readily access if they need support in dealing with their grief. I believe we do a good job at trying to help families prepare for grief before a death but the support after the death is lacking and funding within the health authority does not recognize the health implications of this. If we identify a person in need of support we have no resources to refer to
  • palliumcanada over 1 year ago
    In all our LEAP courses, we have incorporated modules on grief. We understand that the patient themselves, as well as their family, can/will go through the grieving process and we want to equip health providers with tools and skills on how to differentiate a normal grief response from a complicated grief response and how to support those individuals.Furthermore, anyone connected to the patient will also go through the grieving process: family members, friends and even the health providers themselves. This is one way in which Pallium’s work on Compassionate Communities integrates with our LEAP courses; the community coming together to support those grieving and going through bereavement, shifting the culture around death, dying, grief and bereavement in Canada. We want to provide supports for communities across the country so they can create safe environments for those grieving to open up about the subject matter, an example of this being Death Cafes, where those grieving can share their experiences and reflect on how it has impacted them.
  • Palliative RN almost 2 years ago
    Yes, I do believe that this can be reduced but likely not completely eliminated as we live in a death denying society at this time. I believe that this can be mitigated by placing a greater emphasis on psychosocial bereavement clinicians as part of the essential palliative care team. I currently see, more often than not, people are not given access to these services until much later in their trajectory but they are already experiencing anticipatory grief and mourning the little deaths that occur frequently once someone is diagnosed and beginning their Palliative care journey. The psychosocial bereavement clinicians are often an after thought or thought of much later, their role is crucial in the healthcare team.
    Hide reply (1)
    • Linda Hochstetler over 1 year ago
      The psychosocial clinician needs time to get to know the family before their loved one moves into the active dying phase, so when they are there, the relationship with the psychosocial clinician carries them through it. They need to build trust and confidence. This might only take a couple of visits, but is a critical phase.
  • PallMedDoc almost 2 years ago
    Dedicated psychologist support to palliative care teams are usually not available and not resourced properly. We have advocated for such a position in our program with no success so far. And in fact, dedicated spiritual care services (with training in palliative care) are being decreased as well unfortunately.More evidence based tools on how to proactively identify individuals at risk of complicated grief would be helpful.
    Hide reply (1)
    • Linda Hochstetler over 1 year ago
      Whether it is a psychologist or a social worker assigned to a dying person, they need to be willing to address the family needs, and not just the individual. The capacity of the family to support the dying person is crucial in determining what the dying person's experience is.
  • jcruikshank almost 2 years ago
    CHPCA recognizes that grief is a complex process and that those who are bereaved need adequate time to process and work through their feelings. We recommend that compassionate care benefit (CCB) programs across the country include a 2-week bereavement period for individuals to mourn in the ways most meaningful to them without fear of reprisal of loss of income from their employment. The development of tools and resources that address overall wellbeing, including mental health, can support the grieving process for caregivers and those closest to a patient who has died. A requirement for healthcare providers to routinely assess caregiver quality of life can help identify issues and emotional needs that are part of the grieving process, and provide more opportunities to facilitate the delivery of support services. Support for volunteers is also essential to help ease them through the grieving process, and culturally sensitive, language-appropriate supports can assist the grieving process at the community level.
  • alliedhealthworker almost 2 years ago
    Our program tries to take the approach of palliative care being everyone's responsibility. What that means in day-to-day life is that all team members, regardless of role acknowledge that they may form a relationship with family members and need to be prepared to provide support in the moment. We do refer within the teams to social work or spiritual care for more formal counselling, but if any of our team members hears a concern or senses anticipatory grief, etc., the expectation is that that team member is present in the moment to reassure the family member that they are not alone and that the whole team is there to support them.
  • NurseDar almost 2 years ago
    Yes, grief, anticipatory grief, and bereavement are all important to address and support. Sometimes people are reluctant to receive support but it is usually due to not fully understanding how complex and difficult the experience can be and how various types of support can be helpful.Many people associate spiritual support as purely religious or feel awkward about seeking out professional counselling.If what grief and bereavement support were better explained it might be helpful and more accepted. Also, deaths that are well supported by such counselling enhance the acceptance palliative care as wholistic care and a positive experience.