Does good care equal good grief? A recent review suggests otherwise

An article written by Dr Priyanka Vandersman, Senior Research Fellow, ELDAC Project

Grief and bereavement are universal but deeply personal experiences that impact anyone who loses a loved one or faces major life changes. While we know that dying is an inevitable part of ageing, we do not always consider what it means for families when someone dies in residential aged care. Family caregivers play a pivotal role in supporting older individuals in these settings. As primary providers of care and emotional support, understanding their grief and bereavement processes is essential.

Our recent study reviewed 35 papers examining the grief, loss, and bereavement experiences of family caregivers of those entering, living, and dying in residential aged care, as well as related interventions. [1] Our findings reveal that while good quality care for a dying person can lead to a positive grief experience, it is only one piece of a larger puzzle. The quality of care provided to the resident and the support available to family caregivers before, during, and after the resident’s death were crucial to the family's bereavement experience. Involving families in the older person’s care, having open conversations about their loved one’s health decline and deterioration, care options and choices, and helping them prepare for death were key elements influencing family caregivers’ grief.

Despite evidence showing the rapid growth of the aging population and increasing demands on aged care services [2], particularly in Australia where 86% of people entering residential aged care will spend their final days [3], our review found very little exploratory evidence and few interventions focusing on the grief, loss, and bereavement experiences of family caregivers in these settings.

Our work highlights the need for a greater focus from the residential aged care sector, government agencies, and research entities to develop and implement a comprehensive approach to grief, loss, and bereavement care. This includes service policies, staff training and support, and family resources to support everyday care practices. Recognising the emotional experiences and support needs of families and carers can enhance our understanding of the ageing, caring, dying, and grieving pathway for older people and their families. Our hope is that by highlighting the support needs and the complexities involved in decision-making and transitions in residential aged care facilities, families and their loved ones are provided with holistic care that is effectively funded by the government and supported by the aged care and research sectors.

This review is part of a series of studies exploring the grief, loss, and bereavement experiences of families of those in residential aged care. The work was supported by the South Australian Government for Health and Wellbeing under the Palliative Care 2020 Grants Program.
 

Author

Dr Priyanka Vandersman

Senior Research Fellow

ELDAC Project

Reference

1. Vandersman P, Chakraborty A, Rowley G, Tieman J. The matter of grief, loss and bereavement in families of those living and dying in residential aged care setting: A systematic review. Arch Gerontol Geriatr. 2024 May 6;124:105473.
2. Kalánková D, Stolt M, Scott PA, Papastavrou E, Suhonen R. Unmet care needs of older people: A scoping review. Nurs Ethics. 2021 Mar;28(2):149-178.
3. Australian Institute of Health and Welfare. People leaving aged care [Internet]. Canberra: AIHW; 2023 [cited 2024 May 28]. Available from: https://www.gen-agedcaredata.gov.au/Topics/People-leaving-aged-care.