Better Bereavement and Palliative Care Priorities Are Needed Internationally
Palliative and bereavement care should be a health policy priority, an international team of public health scientists reported (https://doi.org/10.1016/S2468-2667(24)00030-6) in Lancet Public Health. They called for interprofessional health workers, organizations, and systems to “shift bereavement care from an afterthought to a public health priority.”
The authors cited evidence (https://doi.org/10.1016/S2468-2667(24)00030-6) that bereaved individuals are at increased risk for numerous adverse outcomes, including prolonged grief disorder, mood and anxiety disorders, existential distress, decreased work productivity, adverse health behaviors, cancer, heart disease, suicide, and death. They added that the burden is particularly high for vulnerable groups, including those living in communities with limited resources.
Healthcare professionals’ barriers to providing bereavement care are similar to those for palliative care, they said (https://doi.org/10.1016/S2468-2667(24)00030-6), including:
- Limited training
- Lack of time
- Insufficient organizational and community resources
“The situation is even more dire in low-income and middle-income countries,” the scientists wrote (https://doi.org/10.1016/S2468-2667(24)00030-6). “As already-limited institution-based services wane, social support from the community (e.g., family, friends, workplace, or religious institutions) frequently dissipates in parallel, precisely when it is needed most. Furthermore, support that is available might be problematic because of the pervasive lack of grief literacy in many communities.”
The scientists boldly advocated for a solution: a translational model of bereavement care that begins with palliative care. “Offering a holistic approach to alleviate suffering for individuals who are seriously ill and their families, palliative care culminates with bereavement care in both theory and practice guidelines,” they wrote (https://doi.org/10.1016/S2468-2667(24)00030-6).
A translational palliative–bereavement care model involves (https://doi.org/10.1016/S2468-2667(24)00030-6):
- Bereavement-conscious clinical practice (e.g., facilitating discussions, supporting decision-making) and awareness of loved ones’ emotional and practical needs
- Organizational support, including dedicated personnel who apply evidence-based care tailored to individual need
- Community support for successful transition to local resources
- Organizational–community partnerships to improve the quality and availability of resources and build sustainable professional and lay support
“We must bring bereavement care to the forefront in the health and social care discourse and transform the urgent needs surrounding grief and grieving from an afterthought to a public health priority,” the scientists wrote (https://doi.org/10.1016/S2468-2667(24)00030-6). “The time is right to invest research and practice resources in both institutional and community-based models that rehumanize care and, ultimately, create safe and supportive settings for those who grieve.”
Oncology nurses and ONS have long advocated for policy and funding for palliative care (https://www.ons.org/podcasts/episode-289-2023-health-policy-wrap-and-outlook-2024), including the bipartisan Palliative Care and Hospice Education and Training Act (https://voice.ons.org/advocacy/bipartisan-pcheta-legislation-reintroduced-in-us-senate) in both the U.S. House of Representatives and U.S. Congress. Raise your voice for your patients and their loved ones by contacting your policymakers (https://www.votervoice.net/ONS/Home) and asking for their support on bereavement, palliative, and end-of-life care legislation.