For GPs and other primary health care clinicians

The aim of this collection of resources is to assist primary care providers to develop their professional knowledge and skills in bereavement care. GPs and other primary health care professionals often play an important role in providing end-of-life care for people with life-limiting illnesses.

When this care extends to include the immediate family or carers of a dying person, the clinician is well placed to monitor and support mental health, both before and after death. Most people will require no intervention but may still benefit from:

• Information on what to expect when someone is dying
• Acknowledgement of the death once it takes place and follow-up over appointments
• Advice on self-care strategies
• Normalisation of expected grief symptoms and reassurance that grief will soften over time.

For an estimated 5-10% of bereaved people, however, grief can become prolonged and may have a debilitating impact on biopsychosocial wellbeing.¹ Parents and people bereaved through a sudden, unexpected, or violent death are particularly susceptible to this form of ‘complicated,’ ‘complex,’ or ‘prolonged’ grief².

The GP will often be the first health professional those with unresolved grief turn to for help. Where GPs have a strong, established therapeutic relationship with the bereaved, they might pre-empt difficulties by being aware of known risk factors such as a lack of social support, dysfunctional family dynamics, previous losses in a short timeframe, existing mental health issues, or extreme dependence on the deceased.

GPs might begin to manage prolonged grief by:

• Conducting a brief assessment using a validated bereavement screening tool
• Creating a Mental Health Treatment Plan
• Providing a referral to a psychologist/psychiatrist with experience in bereavement therapy.

Useful resources for patients

The free MyGrief App can support clinical care by providing the bereaved with tailored grief strategies based on their responses to a series of questions. Developed by the Australian Centre for Grief and Bereavement and available for use on Apple and Android mobile devices.

A range of other face-to-face, online and information resources are provided on the For the bereaved webpage.

The GP bereavement literature

• Prolonged grief: Applying the evidence in the primary care setting (PDF 728KB)
• General practitioners’ experiences of bereavement care and their educational support needs: A qualitative study
• Understanding grief and bereavement
• Grief loss and the COVID-19 pandemic
• Supporting families in end-of-life care and bereavement in the COVID-19 era
• Experiences of support from primary care and perceived needs of parents bereaved by suicide: a qualitative study

Recommending a mental health professional

The GP Mental Health Treatment Plan, will allow people to claim a Medicare rebate for up to 10 psychological sessions per calendar year. (Note: Currently extended to 20 sessions until 30 June 2022 as part of the Government’s pandemic support initiative.)

If you don’t have your own list of preferred mental health providers, you or your patient can identify someone using the Find a Psychologist online directory (Australian Psychological Society). Search by type of issue, area of practice and geographic area. Information provided includes:

• Contact details
• A profile of each therapist including their therapeutic approaches
• Fees and/or Medicare rebate eligibility
• Telehealth availability.

A bereaved family may be eligible for bereavement services through a palliative care service, if their loved one was registered with that service.

Online information and resources

General

• Bereavement and grief (Clinical Evidence)
• Following up the bereaved

Bereaved by suicide

• Square: Suicide Questions Answers Resources
• Postvention Australia guidelines
• Supporting general practitioner and practice staff after a patient suicide: a proposal for the development of a guideline for general practice
• After suicide: A resource for GPs (PDF 972KB)
  

Bereaved parents

• Sands Australian principles of bereavement care: Miscarriage, stillbirth and newborn death (PDF 896KB)

Special populations

• Working with Aboriginal or Torres Strait Islander Grief and Bereavement: A Resource for Workers (PDF 4MB)

Bereavement during COVID-19

• Palliative care and COVID-19: Grief, bereavement and mental health, December 2020 (PDF 210KB)
• Bereavement and the COVID-19 pandemic: ANZSPM (PDF 252KB)

References

¹Shear M. K. (2012). Grief and mourning gone awry: pathway and course of complicated grief. Dialogues in clinical neuroscience, 14(2), 119–128. https://doi.org/10.31887/DCNS.2012.14.2/mshear

²Burke LA, Neimeyer RA. Prospective risk factors for complicated grief: A review of the empirical literature. In: Stroebe M, Schut H, van den Bout J, editors. Complicated grief: Scientific foundations for health care professionals. London: Routledge, 2013. p. 145-161.