Bradford VTS Online Resources:
- Current Learning in Palliative Care – A comprehensive set of 15 minute tutorials.
- NW London’s Cancer in Primary Care Communication Toolkit – a set of videos and workbook to help you diagnose, refer and communicate better.
- Cancer in Primary Care – a communication toolkit
- The Other Side is a book by Kate Granger – buy it here: http://theothersidestory.co.uk/
This questionnaire can be used to help highlight those relatives who are at high risk of an abnormal bereavement reaction. A score higher than 18 is of HIGH risk. When trying to complete this questionnaire, please try not to lose the narrative of what the person you are talking to is telling you. Please click on this link if you would like to see more Notes for Doctors and Nurses Making Telephone Calls to Bereaved Relatives.
|1.||Person’s relationship to the patient:||7.||is the main carer inclined to consume alcohol or drugs (incl. tranquillisers, antideps etc)|
|None or a little|
|Child under 15|
Dependent adult child
Parents of adult child
|Alcoholic or Drug addict||10|
Available support. Does the main carer lack a caring family or does their family/friends inhibit the expression of grief?
|9.||Is the main carer facing a concurrent life crisis eg other losses, moving house, financial difficulties, redundancy etc?|
|Is the main carer unusually dependent? Dependant clinging, insecure or sensitive to separation?|
|4.||Unusually angry or bitter?||10.||Is the main carer suffering from:|
|Some||3||Minor nervous problems||5|
|Much||5||Major nervous problems|
Minor heart disease
Unusually self reproachful or guilty?
|Major heart disease or stroke|
Threat of suicide in the past
Serious risk of/or attempted suicide in the past
Is the family unable to share feelings or reluctant to face patient’s illness?
|11.||Is the main carer in need of bereavement support’?|
Total ______ Low Risk/High Risk
(if score is above 18 – at High Risk)
Before telephoning the relative, read these three lists in order.
HERE ARE SOME NORMAL GRIEF REACTIONS YOU SHOULD BE AWARE OF
- Preoccupation with thoughts of the dead person leading to tearfulness and to insomnia.
- Visual phenomena Illusions of seeing the dead person and pseudo hallucination visual, auditory and physical.
- Poor concentration
- Indecision and Restlessness. There may be periods of being able to concentrate and perform quite well amongst periods of haziness and indecision.
- Searching – knowing that the person is dead but going hopefully to places where the would have been.
THESE FACTORS INCREASE THE RISK OF A DIFFICULT GRIEF
- A sudden or unexpected death
- An painful/stormy/horrible death
- Multiple losses
- Over dependance on lost relative
- Lack of support
- Other life crises e.g. financial, job loss, house being taken over etc.
- Existing mental illness, especially depression.
- Carer not present at death
CHECK LIST WHEN TELEPHONING BEREAVED RELATIVES
2 Appetite (+ or -)
3 General health
4 Going out
5 Keeping in touch with family and friends
6 Feelings of excessive anger or guilt – do they need to be explored?