The assessment of need for bereavement follow-up in palliative and hospice care.

This paper describes a postal survey of palliative care services and teams which were identified in the 1992 Directory of Hospice Services in the UK and Ireland. Its aims were to investigate how units assess the need for bereavement follow-up, and to determine the nature and extent of services provided for bereaved adults. We sent out 397 questionnaires, of which 187 were returned, a response rate of 47%. Results indicate that 156 respondents (84%) provided follow-up and a further 13 (7%) were planning bereavement services. Only 48 (25%) units undertook formal standardized risk assessment procedures to allocate appropriate services; in 41 units (85%) this was done by a nurse. Of the remaining 125 units, 58 (46%) reported basing their decisions on clinical impressions. Content analysis of the formal assessment instruments revealed 39 subcategories, which were broadly grouped into three areas: circumstantial factors at or near to the time of death, personal factors and social factors. Recommendations are made for further study.