Communicating with bereaved patients Systematic literature review

Context. Bereavement is associated with an increased incidence of cardiovascular and psychological diseases. The bereavement process has been described since Freud. Bereaved patients expect contact from their GP, but in consultation, bereavement is explored by a minority of them. Objective. The objective of this work was to identify tools facilitating the bereavement process that can be used by the bereaved and by caregivers. Methods. Systematic review of the literature on the Medline (R) database over 10 years, on normal bereavement in adult patients. Results. From 436 articles identified, 31 were included. A caregiver attitude to facilitate the bereavement process was identified. This attitude combined availability, compassion and involvement through caregiver's participation in funerals or commemorations, through a letter or phone call. Honest information had to be delivered before and after the death, possibly via media such as comics. Helpful tools for the bereaved included seeing the person before and after death, talking about the deceased (storytelling: e.g. journaling) and talking to the deceased (transcorporeal communication model). Experiences of continuous presence helped to maintain the deceased's social position, to talk about past and present events, and even to say goodbye. Conclusion. These different tools are found in different recommendations. Caregivers can adopt an attitude of empathetic information without stigma, combining availability, compassion and involvement. They can legitimize the existence of tools described by the bereaved in consultation. A second study could be carried out to analyze these tools. Further action research could question their feasibility and validity.