Balm for the Broken-Hearted: The Bereavement Program
Jonathan C. Wretlind, M.Div
Chaplain and Bereavement Coordinator, Front Range Hospice
One of the great benefits of hospice care is the emotional support offered by chaplains, social workers, and the bereavement program. A well-organized bereavement program is crucial to providing the best care to hospice families. Hospice is not only about caring for the patient, but realizing that death of a loved-one impacts the entire family-system. Offering each family the opportunity to receive support for 13 months following a death, the bereavement coordinator “follows” family members by mail and phone in order to provide assistance to those who need it and are willing to receive help. It is a free benefit, and one that is often overlooked in presenting the benefits of hospice to family members considering hospice care for a loved-one.
One of the main goals of a bereavement program is to identify those individuals in a family that may need extra support, may experience “complicated grief”, and may need ongoing professional support through a referral to a local therapist or counselor. Complicated grief can be a serious psychological condition, and can mimic symptoms similar to Post-Traumatic Stress Disorder (PTSD), and is a form of secondary trauma itself. It may even lead to fully-developed PTSD, cause permanent brain damage, and even lead to suicide or homicide. Even “normal” grieving itself can result in depression, loss of productivity, or illness. It is because of this potential consequence of grief that Medicare requires the hospice program to provide bereavement services as part of the Conditions of Participation (CoP), even though it is non-reimbursed by Medicare/Medicaid.
The Bereavement Coordinator continually contacts family members who are in the bereavement program to “check-in” with them at predetermined intervals according to a plan-of-care based on an individuals’ risk for complicated grief. This is done through phone-calls, letters, or through support groups in order to continually assess which family members may need extra support in order to prevent complications due to grief. The plan-of-care may need to be altered depending on what is reported to the bereavement coordinator or bereavement program assistants or what other objective risk-factors (such as alcohol abuse, family dysfunction, lack of support system or suicidal ideation) are discovered through interaction with the bereaved individual. There are many factors which plays into an individual’s risk for complicated grief, and the bereavement coordinator along with hospice social-workers and chaplains record what is learned about the bereaved using a document called a Bereavement Assessment. This document is reviewed for each family member in the bereavement program on a regular basis by the psycho-social team, and modified if necessary.
Part of the bereavement program also includes grief counseling services through one-on-one counseling with a qualified counselor, or through group-sessions held throughout the year and conducted by the psycho-social team. Counseling may also be offered prior to the patient’s death if needed for family-members who are having difficulty with coping with “anticipated grief.” These are free benefits through our hospice program, and extremely beneficial to those willing to receive help. When a person is identified with a high-risk for complicated grieving and/or may be experiencing extremely poor coping, a referral may be made to a local counselor or therapist qualified to handle difficult cases of complicated grief. Also, family members who reside out of our service area may be referred to another grief program or counselor in their area.
I am proud to be part of Front Range Hospice’s bereavement program as both a chaplain and the bereavement coordinator, working with a team of top-notch bereavement assistants and volunteers. I have heard many stories and reports from our families of the legendary care that Front Range provides, and honored to be able to help the bereaved in their time of need.