Practice Practice Pointer

Supporting patients who are bereaved

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j2854 (Published 06 July 2017) Cite this as: BMJ 2017;358:j2854
  1. M Katherine Shear, internist and psychiatrist1,
  2. Stephanie Muldberg, bereaved mother dedicated to helping bereaved people by disseminating information to professionals and the lay public2,
  3. Vyjeyanthi Periyakoil, internist, geriatrician, and palliative care physician3
  1. 1Center for Complicated Grief, Columbia University School of Social Work, New York, USA
  2. 2New York, USA
  3. 3Palliative Care Education and Training, Stanford Hospice and Palliative Medicine Fellowship Program, Stanford Ethnogeriatrics and Successful Aging Portal, Stanford University, Stanford, California, USA; and Palliative Care Services, Veterans Affairs Palo Alto Health Care System
  1. Correspondence to M K Shear ks2394{at}columbia.edu

What you need to know

  • Acute grief is distinct from depression and other psychiatric disorders

  • Symptoms of grief include prominent yearning and longing that is focused on the deceased person, and a strong desire to be around other people

  • Bereaved patients should have the opportunity to talk about their loved one, their loss, and how they have been coping

  • Answer patient questions or concerns about medical care that their loved one received, or about the last days of life

  • Encourage the patient to confront loss and reminders, and at the same time begin to create a new life

A doctor consults with a 69 year old patient and notes that she seems distant and sad. It is three months since her partner died. When the doctor asks how she is managing she says the house feels empty without him and she feels low. She no longer sees any reason to cook and struggles to clean. She longs for companionship but refuses invitations from her friends because being with them makes her miss her partner. Her grandchildren are a pleasure but they ask about grandpa, so she doesn’t want to see them. Tearfully, she talks of dreading her future.

A woman presents with sleep disturbance and severe headaches a month after her son died by suicide. She believes that a good mother would have saved him and she is plagued by guilty self-recrimination. She seems irritable and has been fighting with her husband. She has been finding it very hard to care for her two living children.

Loss of a loved one can be very painful. When seeking support, some people turn to their doctor. Because of their pivotal role in the community, physicians can provide excellent support for bereaved people and can often direct them to additional resources.1 Medical professionals who see bereaved patients …

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