Death in homes: bereavement needs of residents, relatives and staff.

This article reports findings from a study in the UK, which investigated the case for applying the principles and practices of palliative care to caring for older people dying in residential and nursing homes. It focuses on the emotional and practical consequences of a death occurring in these settings. It outlines the bereavement needs of residents, relatives and staff as well as obstacles to providing adequate support. Homes differed in policies and practices in relation to providing bereavement support for relatives. Most managers felt some responsibility for relatives of deceased residents, but rarely felt capable of providing what they perceived as appropriate bereavement support. They recognized the need for practical as well as emotional support for staff and other residents after a death but felt that they lacked the skills and time to provide this. Certain types of home prioritized bereavement support, but many homes operated under considerable resource and staffing constraints. Even where support needs were recognized it was often difficult to put the requisite help into operation. This study identified a lack of training in communication skills and in particular little access to training in bereavement care. This area needs to be addressed if residents, relatives and home staff in these settings are to have their bereavement needs met.