QL-18 * CLOSING THE GAP: BEREAVEMENT SUPPORT FOR FAMILIES, CAREGIVERS, AND MEDICAL STAFF

Abstract

The National Comprehensive Cancer Network (NCCN) Guidelines® “are the first to include death as an expected outcome and after-death care for the family as an essential part of the continuum of cancer care”. NCCN Guidelines® also include recommendations for bereavement support of health care providers themselves. Despite this, there is little consensus regarding the role of primary oncology practitioners in families' after-death bereavement care, and little attention is given to providers' own grief and bereavement needs. For patients' families, the neuro-oncology team is formalizing an approach to after-death care to include (a) an expression of condolence (e.g. sympathy card signed by clinic staff and primary oncologist), (b) referral to bereavement services (e.g. support group), (c) intermittent telephone calls over a one-year period, and (d) optional debriefing meetings. We are also proposing a “Service of Remembrance” to be held during the month of May to coincide with “Brain Tumor Awareness Month”. This will be a time for reflection and remembrance to honor those who have died, not only for families and caretakers) but also for staff who were involved in the care of their loved ones. For healthcare providers, participation in monthly “Schwartz Center Rounds®” is encouraged. The Schwartz Center Rounds® are part of a national program which utilizes an open forum to discuss difficult social and emotional issues related to patient care. Current challenges to implementation of a comprehensive after-death bereavement program for families and staff include lack of time, ambiguity as to which individuals are performing proposed family follow up, and a paucity of research to guide intervention implementation. Future directions include survey of the bereavement needs and preferences of our population, a process to identify at risk health professionals for complicated bereavement, moral distress or compassion fatigue, and a systematic approach to address these issues.