ABSTRACT
Caregivers who have multiple stresses, high illness-related burdens, and limited informational and practical support are at increased risk of adverse bereavement outcomes. Palliative care situations enable families to be forewarned about an impending death, and some investigations have shown that the bereaved who have had an opportunity for anticipatory grief adjust better to their loss. The bereaved's preexisting physical health condition, history of substance abuse, and/or premorbid mental illness can contribute to adverse bereavement outcomes. Five broad principles of bereavement support can be readily applied in palliative care situations: view the patient and family as one unit of care; enable open discussion of illness and death-related concerns; provide emotional support; facilitate practical assistance; and respect cultural, ethnic, and religious practices. However, palliative care settings provide the opportunity to initiate preventive interventions in advance of the death with those individuals identified as being at high risk for adverse bereavement outcomes.
