Condolences in the age of corona: new study shows a doctor’s words matter

A new study finds that the COVID-19 pandemic is upending traditional bereavement rituals, for example in terms of the comforting words that grieving survivors hear.

The types of condolences that doctors use can make a huge difference. This is especially in terms of showing empathy, and identifying who needs help most.

The study appeared on November 17, 2020, in the journal Annals of Internal Medicine.

Comforting words in times of crisis: what to say, and when

The study offers doctors and other medical staff a list of comforting words and sayings that they can use to deal with the often overwhelming situations that they have frequently been encountering during the pandemic. The paper also offers guidance on when and how they should refer grieving survivors who may face mental health issues.

The authors, from Memorial Sloan Kettering Cancer Center and Cornell, took into account that these are not normal times. Communicating condolences during a pandemic, they write, is challenging for many reasons.

Examples include “the sheer volume of deaths, barriers to communication imposed by social distancing, time pressures, compassion fatigue, and mental and physical exhaustion.”

Express empathy, and get the names right

Doctors speaking with family immediately after the death of a patient should start by expressing how sorry they are for their loss. Ideally, they should use the deceased patient’s first name to personalize the experience.

The researchers say they have learned that what grieving family members most appreciate is empathy. In this case, that means a willingness to feel the survivors’ grief and pain, and acknowledge their loss and sorrow.

“Family members want to know that their loved one mattered,” the study says.

The research paper offers several scripts, with sample dialogues that doctors can use. “I can’t imagine how hard this must be for you and your family” is one example. Another is”I appreciate having the chance to speak with you and share how sorry I am.”

Doctors might then take a minute to ask whether the family members have any questions about the patient’s final days or moments.

Likewise, doctors can show their empathy by asking how the family is coping, and waiting for a response. “Some family members may seem numb, angry, or in shock,” the authors write. But “this should not be interpreted as a lack of appreciation for the physician’s effort.”

Showing compassion and empathy, even when doing so is difficult, “is a way to show respect for the deceased patient and the bereaved family member, reduce feelings of abandonment by the medical team, and promote a sense of support, concern, and care.”

Beyond comforting words: identifying people in need of mental health services

Bereavement can actually represent a risk of serious physical illness. Examples include takotsubo cardiomyopathy, a heart condition caused by too much stress, also known as “broken heart syndrome.”

Other examples are increases in substance abuse, and mental health issues such as depression and posttraumatic stress disorder. In fact, “prolonged grief disorder” is a newly-recognized psychiatric illness that’s now included in the DSM-5.

Corona-related factors that can increase bereavement risk include sudden death and not having an opportunity to say goodbye. To check whether a family member is at risk. doctors can ask a few simple questions.

Examples include asking whether they’re feeling so overwhelmed by grief that they’re having trouble coping, or “finding it hard just to get through the day.”

This question should be followed up by asking whether that person has support, in the form of “someone to help you out or to talk to.”

Based on the answers they hear, doctors can distinguish between people in immediate need, and “those who can be provided with referrals and resources to use in the future should they need them.”

It’s important for doctors to let family members who are having difficulty know that someone will be following up with them.

In sum, the authors write, medical professionals are “well-positioned to comfort and create a critical link to bereavement services for those who may need it. “

Study: “Bereavement Care in the Wake of COVID-19: Offering Condolences and Referrals”
Authors: Wendy G. Lichtenthal, Kailey E. Roberts, and Holly G. Prigerson
Published in: Annals of Internal Medicine
Publication date: November 17, 2020
DOI: https://doi.org/10.7326/M20-2526
Photo: by Ben White on Unsplash

Originally published at https://www.psychnewsdaily.com on March 15, 2021.