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Primary Care for the Elderly Bereaved: Recommendations for Medical Education

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Abstract

The aim of this study was to explore the current practices of primary care physicians (PCPs) in providing bereavement care to elderly patients, with implications for medical education. A total of 63 PCPs answered a brief online survey about their typical practices, barriers, comfort level with bereavement, and confidence in their ability to diagnose prolonged grief disorder (PGD). They were recruited through an online newsletter and contacts of one of the authors. The results found that two-thirds of the PCPs do not routinely screen their elderly patients for recent losses, nor do they refer to mental health clinicians when loss is identified. Barriers included not learning of the deaths in patients’ lives and lack of time during clinic visits. Those PCPs who had experienced their own losses were significantly more comfortable in speaking to patients about recent losses and more confident in their ability to diagnose PGD. We recommend bereavement education be incorporated into the medical school curriculum from the outset, utilizing the psychological principle of graded exposure to bereaved individuals.

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Acknowledgements

The authors would like to thank the American College of Physicians for running the survey in their e-newsletter and to the physicians who participated in the study, which was conducted by Dr. Morris in partial fulfillment of her Doctorate degree at William James College, Newton, MA. The authors would also like to thank Dr. Laurel Wainwright for her help with analyzing the data and Dr. Shyamala Venkataraman for her guidance throughout the study.

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Authors and Affiliations

  1. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston Children’s Hospital and Brigham and Women’s Hospital, Harvard Medical School, 450 Brookline Avenue, DA 2016A, Boston, MA, 02215, USA

    Sue Morris

  2. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Kristen Schaefer

  3. William James College, Newton, MA, USA

    Erlene Rosowsky

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  1. Sue Morris
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Correspondence to Sue Morris.

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Conflict of interest

Sue Morris, Kristen Schaefer, and Erlene Rosowsky declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Morris, S., Schaefer, K. & Rosowsky, E. Primary Care for the Elderly Bereaved: Recommendations for Medical Education. J Clin Psychol Med Settings 25, 463–470 (2018). https://doi.org/10.1007/s10880-018-9556-9

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  • DOI: https://doi.org/10.1007/s10880-018-9556-9

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