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Nearly all British children are bereaved of someone close to them by the time they turn 16 and, with the Covid-19 pandemic and world humanitarian crises across the news and social media, they are being exposed to more anxiety about death than ever before. Learners need to be taught about grief and death to prepare them to manage bereavement and support others. As it stands, although teaching resources exist and some curriculum guidance documents mention loss or death, there is no statutory requirement for schools anywhere in the UK to cover grief or bereavement and many pupils have no classes about these difficult topics. This article consolidates the case for grief education in schools. We discuss six key questions to examine evidence that children benefit from talking about grief, death and loss;the current provision for grief education in UK schools;the obstacles to teaching these topics and ways to overcome them;and the potential further implications of a policy change. Following the lead of child bereavement charities, research and new national reports on UK bereavement support, we demonstrate the need for mandatory grief education in all four countries of the UK and offer evidence-based recommendations for its implementation. © 2023, Cruse Bereavement Care. All rights reserved.
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Background: The COVID-19 pandemic resulted in rapid and unparalleled changes to the provision of health care globally. New Zealand (NZ) experienced a lower rate of COVID-19 deaths compared with other high-income countries, related to the swift reaction to close borders and implement strict lockdowns, known colloquially as the 'go hard, go early' response. Healthcare workers reduced non-essential contact implemented social-physical distancing and wore personal protective equipment. This influenced the delivery of maternity care and perinatal bereavement support. There is limited information of the impact of the pandemic on parents bereaved by perinatal loss, and none in the NZ context. Our aim is to explore the experiences of NZ parents bereaved by late miscarriage, stillbirth and neonatal death during the COVID-19 pandemic. Method(s): Semi-structured interviews with bereaved parents via video-call technology analysed using qualitative Framework Analysis. Result(s): We interviewed 26 bereaved parents. Their losses comprised 15 stillbirths, 4 late-miscarriages, 1 neonatal death. Four key themes were identified, (1) Distant and impersonal care, (2) Exclusion of partners, (3) Negotiating hospital rules, and (4) Hindered access to social & cultural support. Conclusion(s): This study adds important insights into perinatal bereavement care in NZ during the COVID-19 pandemic, which impacted negatively on parents' already difficult experience of baby loss. The degree of impact was related to periods of greater restriction and institutional responses to the pandemic. The unique context of NZ's model of maternity care, with a known maternity provider and culturally responsive care mitigated some of the difficulties imposed by the pandemic.
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The proceedings contain 47 papers. The topics discussed include: long COVID rehabilitation services, Cardiff and Vale and Cwm Taf Morgannwg University health boards: social return on investment;the clinical meaning of family reported outcome measure (FROM-16) scores: translational research to support holistic clinical practice;patient-centered outcome measure design: the perspectives and preferences of children and young people with life-limiting or life-threatening conditions;co-creation of a patient reported outcome measure for older people with frailty and acute care needs (PROM-OPAC);PROMs: coming of age in lymphoedema services in Wales;ForMi-person-centered planning and outcomes recording app;true colors online mood monitoring in the bipolar disorder research network (BDRN) research program: challenges, benefits and importance of personalization;patient reported outcome measures for rheumatoid arthritis disease activity: using Rasch measurement theory to achieve more meaningful measurement;developing a roadmap towards national collection of electronic patient-reported outcomes for people with chronic kidney disease in the UK;and measuring bereavement support needs in people bereaved during Covid-19;the adaptation and development of a bereavement support needs scale.
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Background/Purpose: Inova Life with Cancer (LWC) is a communityoriented program providing outpatient education and support to families affected by cancer. During the pandemic, psychosocial providers trialed several service models, such as virtual monthly groups and in-person 5-week series, yet experienced low attendance and/or retention rates. To address these challenges, the LWC Grief Circle Program was developed as a one-time peer-based workshop to (1) re-engage youth bereaved by cancer (2) more effectively allocate facilitators' time and resources;and (3) flexibly tailor programming to identified community needs. Method(s): Grief Circles rotated age groups and were held quarterly to allow time to screen families and plan workshops. A rolling interest list identified potential participants and determined the next targeted age range. Eligible participants included children and adolescents who had lost a family member to cancer within the last four years. Referral sources included hospital-based providers, schools, community partners, and individual inquiries. Result(s): Four Grief Circle workshops have occurred since February 2022: two for ages 7-11 (in-person), one for tweens (virtual), and one for teens (in-person). Programming was evaluated by each workshop's referral numbers, attendance rates, and parent feedback. While referrals for each group were consistent, attendance fluctuated due to several barriers (e.g., child illnesses, caregiver forgetfulness). Facilitators adapted accordingly, rescheduling when necessary and updating processes. Benefits were reported, such as participants staying connected after workshop completion. Additional workshops are planned for early 2023 and will be incorporated into results. Conclusions and Implications: After the height of the pandemic, an age-based, one-time workshop model for bereavement support of children and adolescents allowed for improved allocation of facilitator's time and resources. While creative solutions to attendance barriers are still needed, the LWC Grief Circle program provides a potential framework for revitalizing community engagement in cancer-related bereavement support and demonstrates how providers can respond flexibly to changing community needs.
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Introduction At the advent of COVID-19 the bereavement support service in Belfast Hospice had to quickly adapt to new ways of working to ensure continued service provision, with counsellors transitioning to video-link platforms and telephone to facilitate client sessions. However, counsellors reported challenges building a rapport with clients online, and had concerns that the client's grief was compounded by loneliness and social isolation. In response, the Marie Curie walk and walk bereavement support project, in partnership with the National Trust, was proposed as an innovative solution. Taking traditional counselling sessions outdoors meant the counsellors could maintain adherence to COVID-19 guidance, while supporting the mental health and wellbeing of bereaved clients. Furthermore, nature therapy has been shown to enhance both physical and mental health, reducing symptoms of depression. Whilst there are studies that demonstrate the benefit of nature therapy for mental health outcomes, research is limited in bereavement care. Aims Supporting the mental health and wellbeing of bereaved clients. Methods A pilot Walk and Talk bereavement therapy brings together the skilful, compassionate counselling work of Marie Curie staff and volunteers in beautiful, restorative National Trust spaces. We plan to conduct semi-structured interviews with service users to explore their experience of walk and talk therapy. Results To date, the feedback received has been overwhelmingly positive, this is based on informal verbal feedback gathered by counsellors at the end of each session. Conclusions Despite the physical distancing barriers faced during COVID-19, staff and volunteers were able to overcome these challenges through innovation, creativity, and flexibility, to provide person-centred, compassionate bereavement care and support Impact Work is ongoing, but we hope to continue to develop the walk and talk bereavement service with the National Trust, to support the mental and physical health and wellbeing of people affected by dying, death and bereavement.
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Introduction The COVID-19 pandemic has resulted in many people experiencing bereavement in challenging circumstances. In April 2020 at a large London Trust, a "Bereavement Welfare Hub" (BWH) was established to offer support and advice by telephone to relatives and carers of all adults who died as inpatients. Data from these calls has been used to examine and learn from experiences of the bereaved at this time. Methods Data from BWH call records regarding 809 adults who died at the Trust in March - May 2020 were collated and analysed quantitatively. A random selection of 149 call records were examined using thematic analysis. Results 809 adults died at the Trust between March and May 2020. The mean age at death was 76 (SD=14) and 86% of deaths occurred on medical wards (outside intensive care). Bereavement calls were completed in 663 (82%) of cases. From analysis of call records, several themes that influenced the bereavement experience were identified. These included support from family and community, communication and contact with the dying person, support from bereavement services and ability to carry out usual rituals associated with dying. Conclusions Age is a significant risk factor for death from COVID-19 and the majority of deaths have occurred on medical wards. Improving hospital care of dying patients during the pandemic or at any time is relevant to geriatricians and other healthcare professionals working with older people. Our analysis identifies several factors which positively or negatively influenced the experiences of people bereaved during the first wave of COVID-19. From these findings, recommendations have been made which have the potential to improve the bereavement experience, particularly during the pandemic era.
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Introduction There are significant social and healthcare inequalities in the provision and access to bereavement services. With the increase in deaths and experiences of bereavement, the Covid-19 pandemic accelerated the need to address this crucial area of psychological, social and healthcare support. The UKCB was set up to respond to the challenges of the pandemic by hearing about the lived experience of bereavement. Aims The study aimed to draw on UKCB data to analyse the experiences of those bereaved in the last five years to explore how age, gender, ethnicity, and sexual orientation were associated with inequalities relating to access, effectiveness, satisfaction, and delivery of services. Methods An in-depth qualitative thematic secondary analysis was conducted of free text data from 1119 individual and 130 organisational UKCB survey responses. Results Age Those over 50 reported not wanting to cause a fuss, saw seeking help as a weakness and were reluctant to access digital support. Family pressures, lack of time, and perceptions of less support available for younger people were reported in respondents under 50 years. Ethnicity: The value of support was compromised where there were language barriers and a lack of cultural and religious understanding. Sexuality: LBGTQ + respondents valued non-judgemental understanding and a feeling of belonging from support where this is lacking on a wider level. Gender: Men leaned toward a preference for more informal and practical support. In more formal support they found difficulties in talking with those unconnected with family and friends. Conclusions Age, gender, ethnicity, or sexual orientation affected many respondents' access to formal and informal bereavement support as well as the effectiveness, satisfaction, and delivery of services. Impact The study contributed recommendations which add to those of the UKCB, that can help to reduce inequalities in effective bereavement support.
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Introduction Restrictions during the COVID-19 pandemic adversely impacted bereavement as: visiting the dying, funerals, family meetings, access to bereavement services were disrupted. Pandemic work at Public Health England and Test and Trace was unrelenting. Enforced home working enhanced isolation. Many colleagues experienced difficult bereavements with little access to normal support networks. Aims To further understand how a workplace grassroots virtual grief cafe can support the bereaved. Methods A grassroots group of bereaved staff and/or with bereavement expertise, established virtual bereavement cafes in May 2021, run by staff for staff. MS Teams (video teleconferencing, chat, signposting to resources) provided a safe, supportive meeting space. Facilitated Cafes are held fortnightly, with mental health first aiders present. Ground rules emphasised respect, confidentiality, the validity of all types of grief and all deaths (pre or during the pandemic). Chat and emojis offered support. Post cafe email and phone follow-up was offered. Additional themed cafes supported: Grief Awareness Week, the Queen's death, Pregnancy or Infant loss and bespoke sessions run for teams whose colleague had died. A rapid qualitative thematic evaluation to better understand participants experience of grief and how the cafes have helped was carried out in 2022. Results Between 9-34 staff attend with new participants at each session. All types of grief have been experienced: anticipatory, complicated, cumulative and disenfranchised grief - often in combination. Participants' feedback has been thematically grouped related to their experience of the Grief Cafes, specific workplace challenges, and the impact of the pandemic on grief. Conclusions There is a significant level of unresolved and complex grief following the COVID-19 pandemic in workingage people. Impact Virtual cafes provide critical emotional support in geographically dispersed organisations. They work best linking with and driving compassionate workplace policies.
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introduction: There has been a lack of consistency in approaches to bereavement support provision and evaluation. As part of a study which identified outcomes for adult bereavement support services in palliative care, we conducted stakeholder workshops with people from professional and lived experience backgrounds, providing a view on what support interventions should look like. aims: The aims of this first workshop were to gather stakeholder views on the purpose, impacts and outcomes of bereavement service support. In this paper we summarise these findings and consider their relevance to bereavement support during and following the Covid-19 pandemic. Methods: Stakeholders were divided into three groups and asked to consider how support services should help bereaved service users and what good bereavement service support looks like. Key themes were identified from the written and verbal content of the workshop.Findings: Three main themes emerged from the data;informal support and self¬management;the aims and purpose of bereavement service support and the timing, accessibility and quality of support. conclusion: Workshop findings align with public health models of bereavement care and recent service standards, identifying core support functions and aspirations for bereavement services. Finding the best mechanisms and modalities for meeting these, in the context of the late/post-pandemic period, presents both challenges and opportunities. © 2022, Cruse Bereavement Care. All rights reserved.
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Background: Due to its high death toll and measures to curb the pandemic, COVID-19 has affected grieving experiences and may contribute to risk factors for Prolonged Grief Disorder (PGD). Persons at risk for PGD often seek support from grief counselling.Objective: To explore whether pandemic-associated risk factors have become more important topics in counselling in a mixed-method design.Method: German grief counsellors (n = 93) rated whether pre-defined risk factors had become more important in grief counselling and indicated additional important themes in an open format.Results: The counsellors indicated that all pre-defined risk factors had become more important, though differing significantly in their frequency. Most frequently endorsed risk factors were lack of social support, limited possibilities to accompany a dying loved one and absence of traditional grief rituals. Qualitative analysis identified three additional themes: the societal impact of the pandemic, its impact on bereavement support and health care, and a chance for personal growth.Conclusions: The pandemic has affected bereavement experiences and grief counselling. Counsellors should monitor grief processes and specific risk factors to provide the best possible care for bereaved people when needed.
Pandemic-associated risk factors for PGD have become more important topics in grief counselling during COVID-19.Risk factors include especially a lack of social support, limited possibility to accompany a dying significant other and absence of traditional grief rituals.Future research is needed to investigate whether monitoring and addressing these risk factors can improve bereavement care.
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COVID-19 , Preimplantation Diagnosis , Female , Pregnancy , Humans , Pandemics , Prolonged Grief Disorder , Grief , Risk FactorsABSTRACT
The pandemic has had a devastating impact on people in care home communities. At the peak in 2020, deaths in care homes rose by 159% (Healthwatch Suffolk, 2021). The Healthwatch Suffolk report indicates several areas for improvement in the support of bereaved people: 58% of family members related to a person who died in a care home were not present at death and of all people who were bereaved during this period, those bereaved of someone who died in a care home were least likely to be offered bereavement support (14% compared with 63% of those bereaved of someone who died in hospice). As well as people in care homes being less likely to have access to bereavement support, we also know that COVID deaths were often traumatic, potentially leading to a need for greater bereavement support (Spurio, 2021. Psychiatr Danub. 33,S.9:102). This project addresses this inequity, embedding care home support into the hospice's open access bereavement services, in line with the ICS's commitment to ensure that 'people bereaved [should] have the support they need to cope with trauma and loss' (Healthwatch Suffolk, 2021). A multi-disciplinary model has been developed involving psychological services, chaplaincy services, community connectors and hospice neighbours. A targeted range of interventions is being delivered within care homes, focussing on: * People that are the significant others of a person who died. * Bereaved residents including those whose peer has died. * Residents approaching the end of their lives and their significant others. * Care home staff. The initial pilot roll-out covers 3 care homes. Bespoke assessment tools have been developed in order to measure the impact of each of the interventions and the project as a whole. This paper outlines project design, key parameters and pilot data and will show how the reflexivity built into the design enables a continual process of service development.
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eHealth or Digital health is the pioneer project funded by Government of India and Department of Health and Family Welfare, Government of Kerala, designed to provide residents of Kerala with convenient centralized healthcare system. It describes the integration of information technology and electronic communications used for different healthcare processes for people's health and their wellbeing. It has introduced since 1920s as Telemedicine and later it expanded in 2009 as e-Health due to advancement of technology. When the countries healthcare industry was facing tough times, we observed that the e-Health came to the rescue of many times during multiple waves of the pandemic. This study mainly focusses on analysing various digital health initiatives by MHFW and an attempt has been made to know what are telemedicine schemes, web portals and mobile applications and global digital health agenda used for implementation of digital health and how far it benefited in the pandemic days. Copyright © 2022, Anka Publishers. All rights reserved.
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Introduction: Almost half the UK population die in hospital and more than two thirds of these are aged 75 years or more.1 Older people make up an increasing proportion of patients admitted to critical care and often have poorer outcomes, especially in the context of COVID-19.2 Loved ones are an essential support network for older patients but their ability to provide support was compromised by visiting restrictions during COVID-19. Little is known about the experiences of older patients in ICU and there is limited literature on the experiences of bereaved relatives.3 Bereaved relatives may be the only way to access the experiences of patients who do not survive, but there are a number of barriers to including bereaved relatives in research. Researchers may feel inhibited from imposing what might be seen as an additional burden on families during the aftermath of a bereavement. The ongoing ESCAlation of the eLderly (age >65years) to criTical carE with COVID-19) (ESCALATE) study includes semi-structured interviews with bereaved loved ones as well as patients and NoK of survivors in the UK. Objectives: To describe successful involvement of bereaved next of kin in critical care-based research Methods: This qualitative research uses semi-structured interviews and thematic analysis. Patient and public involvement from an intensive-care focused charity and local palliative care team advice was sought in order to develop recruitment strategies such as detailed, sympathetically worded participant information packs.4 In keeping with the literature,5 the window for recruitment and interview was approximately one year following bereavement. Following ethical approval, participants were recruited via postal invitations with follow up telephone calls if no response after a minimum of one week. Results: Recruitment was limited by only 40% of bereaved NoK (next of kin) having postal addresses recorded on the hospital systems. 9 /40 bereaved NoK contacted by letter responded and as well as completing a questionnaire, consented to be interview. A further 5/11 contacted by follow-up telephone call agreed to participate (consistent with response rates for patients and NoK of survivors). All of the interviewed bereaved participants completed the interview according to the interview topic guide, with each interview lasting around 45 minutes. More than half were female, and three quarters were Black, Asian or Minority Ethnic. Bereaved relatives were keen to share their experience and some even volunteered additional information with the interviewers, such as resources they had created for their local community and personal diaries. Participants reported that they were happy to be interviewed if it would help others in a similar position. Conclusion: Bereaved relatives of critical care patients are willing to engage in qualitative research. Recruitment is challenging due to practical constraints, but we suggest could be improved through meticulous documentation of contact details and involvement of bereavement services in research. By seeking the views of bereaved loved ones, we can improve care for critically unwell patients at end of life.
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Background Nottinghamshire Hospice's day therapy unit closed its doors to patients during the COVID-19 pandemic. Government advice was supporting discharge from hospital wherever possible (NHS England and NHS Improvement, 2020). When asked, more than four in five people say they would prefer to die at home (Hoare, Morris, Kelly, et al., 2015). Patients receiving care from specialist palliative care teams tend to do better than those without (Higginson & Evans, 2010). Aims To expedite the discharge of patients at end-of-life from hospital and prevent unnecessary hospital admission for those in the community so that more people achieve their preferred place of death (PPD) with the provision of a dedicated palliative care service. Methods March-May 2020: consultations with fast track continuing care (FTCC), model planning, internal consultation, workforce transformation. May-July 2020: recruitment, service launch. July-March 2021: continuous service provision. We worked closely alongside FTCC to support patients either in hospital that wished to come home but needed a package of care or, patients that were deteriorating at home and required end-of-life care. An initial assessment by a registered nurse from the Hospice Outreach Discharge Support (HODS) team meant more timely referral into extended palliative community services including provision of specialist equipment and access to other hospice services e.g. bereavement support. It also focuses on the completion of EPaCCS and ReSPECT forms identifying PPD. Results Number of patients treated by HODS May 20 - March 21 = 195. 64% (124) died at home. 23% (44) remained well enough to be discharged to domiciliary care agency. 10% (20) admitted to hospital. 3% (6) admitted to nursing home. Average length of stay on HODS = 10 days PPD achieved = 95.87% [4] Conclusion The creation of HODS allows more people at end-of-life to remain in their PPD and with greater access to support services preventing carer burnout and unnecessary admission to hospital.
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In 2019 the hospice was contacted to provide easy-read literature explaining what hospice care is for a person with a learning disability. As an organisation we didn't have this kind of documentation and we couldn't source it from elsewhere. This set us on a journey of collaborative working and service co-design with our local Community Learning Disabilities Team and Learning Disabilities Patient Experience Group (LDPEG). The first draft of the leaflet was utterly 'trashed' by the group;they were particularly critical of the images we had used as none of them were of our hospice building and none of them contained people with a learning disability. As a result, a number of the LDPEG visited the hospice and met with staff. They proved very insightful and challenging in their questioning of the work we do as well as about death and dying. We were in the process of finalising the leaflet, using members of the LDPEG in the photographs as well as piloting a wellbeing group when COVID-19 hit and everything had to be postponed. We are now in a position to re-commence that work. We have an afternoon tea event scheduled for 23 June to celebrate Learning Disability Week and will hopefully be in a position to complete the easyread literature before Hospice UK's conference in November. In talking to professionals and carers we are aware how challenging advance care planning discussions can be, and we hope to pilot a group for people with learning disabilities and their families/carers to introduce hospice care and advance care planning discussions. This will hopefully address some of the shocking inequalities in end-of-life care people with a learning disability can experience. We also plan to provide bereavement support, not only to families and informal carers. but also to paid carers who may have had a longstanding relationship with an individual prior to their death.
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Background Evidence indicates that psycho-educational models of bereavement group support provide greater bereavement support than social models (Marotta;Drake, 2021), due to the dual process of peer support and information sharing. At Mary Ann Evans Hospice, the bereavement support group ('Jigsaw') previously followed a social model facilitated by volunteers where bereavement was discussed in an open, unstructured way. The impact of staff changes, combined with low uptake of new group members, led to a qualitative review in February 2020 being undertaken. Clients felt unable to discuss their bereavement freely fearing dominant group members, negatively comparing their grief to others and feeling dissatisfied with the unstructured format. Aims Improve client experience by enhancing bereavement support provision, including bereavement education to understand grief and encouraging peer support. Methods A qualitative evaluation/thematic analysis of the current model was undertaken. Current client and volunteer feedback, combined with evidence (Näppä, Lundgren, Axelsson, 2016;de Willoughby, 2013/14;Belmont, 2017), led to a new group structure and programme being created and delivered by an experienced psycho-educational group counsellor. Three new groups started using this model from August 2020. Results The COVID-19 pandemic changed bereavement and a new structured programme was able to address this directly. Clients discussed, and shared, a new sense of disenfranchised grief (Albuquerque, Teixeira, Rocha, 2021).•75% increase in new group members since August 2020.•Increase in male group members.•A more time efficient model utilising the skills of one, highly trained staff member as the facilitator rather than a number of volunteers.•Feedback is positive, with clients feeling they understand their grief more and gained new coping strategies with the benefit from peer support. Conclusion The psycho-educational model enhances bereavement support by allowing the structured education of bereavement, gaining of coping strategies, establishment of peer support and a normalisation of grief that comes from sharing similar experiences. The use of skilled professionals enabled group dynamics to be better managed and facilitation to be more effective.
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The proceedings contain 245 papers. The topics discussed include: application of the lantern model to stories from the pandemic: its use in enhancing MDT working;hidden work and hidden workers in hospice care;carrying the torch for physician associates (PAS) working in UK hospices;'going against the grain of all we do': hospice staff experiences of moral distress during COVID-19;transformation of death and bereavement support processes across children and adult hospice services;development of a journal club to improve care in a hospice through evidence based practice;no barriers here! advance care planning and people with intellectual disabilities;online community of practice development - palliative care and homelessness;enhancing bereavement group support - changing from a social to a psycho-educational model;and hospice heritage stories: making every memory matter.
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Background and Aims People of African and Caribbean descent experienced the highest mortality rates during the pandemic, yet often have the poorest access to palliative care. This study aims to identify how palliative care services can better meet the needs of people of African and Caribbean descent, by exploring patients' (by proxy), families' and health, social care and community workers' experiences of end-of-life-care during the pandemic. Methods Bereaved relatives, and professionals were recruited using social media, community networks and direct advertising to over 100 organisations. Semi-structured interviews explored experiences of end-of-life-care using a topic guide, developed with patient and public involvement partners. Participants' suggestions for care improvement were foregrounded throughout. The theoretical framework combined Critical Race Theory and Saurman's model of access. Thematic analysis was used. Results Over 40 participants were recruited. Results indicate that people of African and Caribbean descent are poorly served by current services. Interviewees identified distinct differences between the culture of care, and that of the patent. Participants reported institutional racism. Processes were insensitive to diversity in family and community support structures in different cultures. Themes describing end of life care services included: Unavailable: spiritual support, paid carers, specialist care, visitation and choice Inadequate: advertisement of services, cultural diversity and the appreciation of the importance of extended families Unacceptable: communication surrounding death and bereavement (upstream/proactive early discussions would improve engagement) and mental health and bereavement support. Conclusions People of African and Caribbean descent are often termed a 'hard to reach' group. Yet our study suggests that current configuration mean it is services that are hard to reach. Prioritisation of person-centred, culturally competent spiritual, psychological and social interventions remains an aspiration for palliative care. A focus on cultural sensitivity and communication may be a good start to enhance palliative and end of life care for all.
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Background The COVID-19 pandemic has had a detrimental impact on millions of people's experiences of bereavement. Traumatic end-of-life experiences and disruptions to support networks increase chances of poor bereavement outcomes. Aim To examine grief and support needs, and identify associated risk factors. Methods Mixed-methods survey of people bereaved in the UK from March 2020-January 2021, disseminated via media, social media, national associations, community/charitable organisations. Practical and emotional support needs were assessed in 13 domains, and grief intensity using the Adult Attitude to Grief (AAG) scale, which calculates an overall index of vulnerability (IOV) (range 0-36). Results 711 participants, mean age 49.5 (SD 12.9);88.6% female;95.3% white. Mean age of deceased 72.2 (SD 16.1);58% died in hospital;44% from COVID-19. Mean IOV was 20.41 (95% CI = 20.06 to 20.77), i.e. high vulnerability in grief overall. 28.2% exhibited extreme levels of vulnerability (i.e., IOV ≥ 24). In six support domains, all relating to psycho- emotional support, 50% to 60% of respondents reported high/fairly high levels of need. Increased levels of perceived support from health professionals led to significantly (P < 0.001) lower levels of grief and support need (small/medium effect, P < 0.001). Bereaved participants who were socially isolated/lonely experienced higher levels of grief and support needs than those who were not (P < 0.001). Grief and support needs were much higher for close family members compared with other groups (P < 0.05). Levels of grief and support needs were slightly higher for COVID deaths compared with non-COVID (P < 0.01), although this was not significant in a mixed model. Conclusions People bereaved during the pandemic experience high levels of grief and emotional support needs, with social isolation/loneliness and death of a close family member particular risk factors. Healthcare professionals' support is associated with better bereavement experiences.
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The proceedings contain 154 papers. The topics discussed include: cordotomy improves pain in palliative cancer patients receiving care from a specialist center, and continues to rebuild following temporary closure due to the COVID-19 pandemic;the impact on staff of providing non-invasive advanced respiratory support during the COVID-19 pandemic' a qualitative study in an acute hospital;levels of grief, support needs and risk factors among people bereaved during the COVID-19 pandemic: baseline results from a longitudinal UK online survey;the palliative care needs of patients with multiple sclerosis, Parkinson's related diseases and motor neuron disease: a secondary analysis of the optcare neuro trial data;a co-speciality cross-boundary model of supportive care: an innovative approach to caring for the palliative care needs of heart failure patients;creating equity of community palliative care in Manchester in a pandemic. does the 'Midhurst model' of care work?;palliative medicine specialist training: designing and implementing an oncology placement fit for the future;managing dying: multimedia end of life care simulation training for medical undergraduates;and use of a novel trigger tool for the identification and referral of patients in the last year of life pallitrigger.