Bereavement support services
A natural continuity ought to exist between support for the grieving process among patients and their carers during palliative care and its maintenance for the bereaved after the death. Health care organizations caring for the dying have an invaluable opportunity to deliver such seamless continuity of care and thus minimize the rates of morbid consequence arising in the bereaved (Wilkes 1993). The configuration of bereavement support services is the practical manner in which this ideal is achieved.
Nurses at the coalface of clinical care are intimately involved with not only the dying but also their loved ones and carers – those family members and friends who subsequently become the bereaved. Moreover, knowledge of and familiarity with these people enables nurses to sustain a supportive role during that peak of emotional distress, the early phase of bereavement. Their contribution to any programme of bereavement support is crucial to its success (Foliart et al. 2001).
The nature of grief and the mourning process has been described (see Chapter 22) as has the care of the newly bereaved person present at the moment of death (see Chapter 23). The district nurse's perspective on bereavement support is also covered in Chapter 26. Here the focus is on the formal and informal support services provided by hospices and specialist palliative care services, with particular attention being paid to the nurse's role given the principles, stated above, of continuity of care and the nurse's intimate, prior connection with those who become bereaved.
The goal of these programmes is to deliver relevant and effective support to the bereaved in a manner that is both clinically appropriate and costeffective. A targeted response is necessary to reach certain groups whose