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Grief and Bereavement

People who have a serious illness and their loved ones can face complex emotions when the patient chooses to receive hospice care. Even before a patient dies, their family may begin to experience feelings of grief. Understanding grief and bereavement can help all members of the hospice interdisciplinary group (IDG) guide patients and families through the experience while providing the highest quality care.

The Experience of Grief

Grief is a natural part of life but affects everyone differently. People commonly experience grief as feelings of anger, guilt, emptiness, numbness or as a state of shock, especially if the loss was sudden and unexpected.

Many people also describe physical manifestations of grief, such as changes in appetite and sleep pattern, upset stomach, difficulty concentrating or difficulty making important decisions. It is also common to question spiritual beliefs and lose interest in visiting with others or engaging in activities that used to be enjoyable.

Types of Grief

Anticipatory grief, or anticipatory mourning, involves processing feelings of loss before the loss occurs. Many take this time to attend to unfinished business, express feelings towards a loved one and gain closure.

Intense, pervasive and long lasting grief symptoms may be an indication of complicated grief, and professional help is available for those experiencing significant impairment in functioning or suicidal feelings.


Bereavement is the time of grief and mourning after a death. It is a normal process and varies by social, cultural or religious norms. Hospice, religious and community organizations provide bereavement services and support groups. For families with a loved one in hospice care, they can expect to be contacted by a bereavement counselor, who will offer an individualized assessment and a personalized plan of care which may include individual counseling, support groups, workshops on loss and transition and many more interventions, for a period of up to 13 months following the loss of a loved one.

Many will recover from a loss on their own over time, especially if they have a strong support system. However, members of the hospice IDG may notice patients or loved ones struggling with grief and can connect them with support. There are also resources available online, such as CaringInfo.org, a program of the National Hospice and Palliative Care Organization.

Axxess Hospice, a cloud-based hospice software, features a Bereavement Center that enables users to manage all bereavement activities, tasks and contacts in one convenient location.

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