The Virulence of Grief in the Pandemic: Bereavement Overload During COVID

Author(s):  
Antonio Gabriel De Leon Corona ◽  
Jessica Chin ◽  
Paul No ◽  
Jennifer Tom

The COVID-19 pandemic brought about bereavement overload as a risk factor for complicated grief. Bereavement overload (BO) describes individuals’ reactions to losses transpiring in a quick succession, without the time and opportunity for coping [9]. It can occur during catastrophic events and impact everyone experiencing the loss. With the high death toll from COVID-19, many people have lost multiple loved ones followed by an abbreviated grieving process due to the nature of the pandemic. This can have psychosocial impact on survivors for years. One of the evolving roles of Palliative Care within and after the pandemic should be to recognize those suffering from BO. Obtaining loss histories may identify those at risk of pathologic grief to provide preventive bereavement care. We present three cases encountered in our health system during the COVID-19 pandemic amongst a family member, a patient, and a healthcare provider. In each case the Palliative Care Team worked closely with these individuals to identify COVID-associated BO and helped them reconcile their unresolved grief to be able to move forward. These cases reflect only a fraction of those who experienced loss during the pandemic, but they illustrate how grief can be complicated by the pandemic for everyone involved. Palliative Care will have a crucial role moving forward, in treating the pandemic of complicated grief within the pandemic to adapt to the needs of all survivors, as we realize the effects of COVID will last long after its virulence has waned.

Author(s):  
William S. Breitbart

Bereavement care is an integral dimension of palliative care. Identifying risk factors for complicated grief and routine assessment of the bereaved allow the psycho-oncologist to proactively intervene and reduce unnecessary morbidity. This chapter provides a comprehensive overview of definitions regarding grief and bereavement, the features of normal grief, anticipatory grief, inhibited or delayed grief, chronic grief, traumatic grief, and complicated grief, as well as a review of interventions used to support the bereaved.


2021 ◽  
pp. 082585972110143
Author(s):  
Silvio A. Ñamendys-Silva ◽  
Adán R. López-Zamora ◽  
Bertha M. Córdova-Sánchez ◽  
Luis A. Sánchez-Hurtado ◽  
Francisco J. García-Guillén ◽  
...  

Objective: To determine the outcomes of hospitalized cancer patients requiring intensive care unit (ICU) intervention and receiving palliative care. Materials and Methods: An observational retrospective study was completed at a single academic critical care unit in Mexico City. All hospitalized cancer patients who were evaluated by the intensive care team to assess need for ICU were included between January and December 2018. Results: During the study period, the ICU group made 408 assessments of critically ill cancer patients in noncritical hospitalized areas. In total, 24.2% (99/408) of the patients in this population were consulted by the palliative care team. Of the patients evaluated, 46.5% (190/408) had advanced stage, but only 28.4% were receiving care by the palliative care team. The only risk factor for hospital mortality in the multivariate analysis was the quick Sequential Organ Failure Assessment (qSOFA) score at the time of the consultation by the ICU group (HR = 2.10, 95% CI = 1.34-3.29, p = 0.001). The median time between palliative care consultation and death was 3 days (IQR = 2-22). A total of 63% (37/58) of patients who were discharged from the hospital died during follow-up. The median follow-up time was 55 days (95% CI = 26.9-83.0). The overall mortality rate for the entire group during hospitalization and after hospital discharge was 80.8% (80/99). Conclusion: Fewer than 3 out of 10 hospitalized cancer patients requiring admission to the ICU were evaluated by the palliative care team despite having incurable cancer. The qSOFA score of patients at the time of the ICU consultation was the only risk factor for mortality during hospitalization. Future research efforts in Mexico should focus on earlier integration of palliation care with usual oncology care in incurable cancer patients.


2015 ◽  
Vol 10 (2) ◽  
pp. 901-905
Author(s):  
Hiroyuki Watanabe ◽  
Miwako Eto ◽  
Keiichi Yamasaki

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
In Gyu Song ◽  
Seung Yeon Kwon ◽  
Yoon Jung Chang ◽  
Min Sun Kim ◽  
Sung Hoon Jeong ◽  
...  

Abstract Background Although the importance of palliative care in pediatric patients has been emphasized, many health care providers have difficulty determining when patients should be referred to the palliative care team. The Paediatric Palliative Screening Scale (PaPaS) was developed as a tool for screening pediatric patients for palliative care needs. The study aimed to evaluate the PaPaS as a reliable tool for primary care clinicians unfamiliar with palliative care. Methods This was a retrospective cohort study of patients referred to the pediatric palliative care teams in two tertiary hospitals in the Republic of Korea between July 2018 and October 2019. Results The primary clinical and pediatric palliative care teams assessed the PaPaS scores of 109 patients, and both teams reported a good agreement for the sum of the PaPaS score. Furthermore, the PaPaS scores correlated with those obtained using the Lansky performance scale. Although the mean PaPaS score was higher in the pediatric palliative care team, the scores were higher than the cut-off score for referral in both groups. Conclusion The PaPaS can be a useful tool for primary care clinicians to assess the palliative care needs of patients and their families.


NeoReviews ◽  
2014 ◽  
Vol 15 (10) ◽  
pp. e422-e425 ◽  
Author(s):  
B. Dean ◽  
K. McDonald

2006 ◽  
Vol 9 (4) ◽  
pp. 903-911 ◽  
Author(s):  
Erik K. Fromme ◽  
Paul B. Bascom ◽  
M.D. Smith ◽  
Susan W. Tolle ◽  
Lissi Hanson ◽  
...  

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