In a recent article in the Journal of the American Medical Association, Yale researchers present an illustrative case and offer strategies for communication and caring for patients who have lost a loved one.
Medical training offers little guidance to physicians for caring for the grieving patient despite the fact that bereavement is associated with declines in health, inappropriate health service use and increased risk of death. In their article, Holly G. Prigerson, associate professor of psychiatry and in the Department of Epidemiology and Public Health at Yale School of Medicine, and Selby C. Jacobs, M.D., professor of psychiatry and director of the Connecticut Mental Health Center, examine the experience of a woman widowed for two years to illustrate distinctions between symptoms and outcomes of uncomplicated and complicated grief.
The article authors also recommend various approaches to physician interactions with bereaved patients and offer guidelines for professional intervention when necessary.
Their strategies include a list of appropriate things to say and not to say to a bereaved patient and reasons why. Among things to say are: “Do you have any questions about the final illness and treatment?” because, the authors write, “Most bereaved are extremely interested to know about the events leading up to the death and many have unanswered questions that have bothered them. Providing a response may help to provide closure.”
Things not to say include: “You should work toward getting over this by now,” because “Bereaved people never ‘get over’ their loss, but learn to live with it. Putting pressure on them to ‘move on’ is, in a sense, blaming them for their continued grief, may instill guilt and add to their concerns. If grief is prolonged, it may be time for a referral for expert help.”
According to the authors, detection and treatment of psychiatric complications related to bereavement can prevent significant and costly health problems and enhance a physician’s professional life.
