A survey of grief and bereavement in nursing homes: the importance of hospice grief and bereavement for the end-stage Alzheimer's disease patient and family.

OBJECTIVES: To determine the prevalence of grief and bereavement services in nursing homes. To highlight the importance of grief and bereavement as provided in the Medicare hospice benefit for the end-stage Alzheimer's Disease (AD) patient and family residing in long-term care facilities.
DESIGN: Telephone survey of nursing homes. PARTICIPANTS: One hundred twenty-one nursing homes in the Lower Peninsula of the state of Michigan. MEASUREMENTS: The facilities were asked questions about on-site grief and bereavement services, services routinely offered by licensed hospice agencies.
RESULTS: Fifty-five percent of the homes sent sympathy cards after the patients death. Ninety-nine percent of the facilities surveyed did not provide materials to the family or primary caregiver on the grieving process or bereavement after the death. None of the facilities sent a letter after the patients death informing them of local, community or on-site bereavement support group meetings. Seventy-six percent of the homes were not able to offer a referral to a counseling or psychiatric professional when bereavement intervention was deemed appropriate. Fifty-four percent of the homes usually went to the funeral home or the funeral of a patient who died it their facility. Ninety-eight percent of the nursing homes neither visited, made phone calls, nor provided written communication (i.e., bereavement newsletter) to the family members after the patients death.
CONCLUSION: The study demonstrated few grief and bereavement services for families of patients residing in long-term care facilities. Because grief and bereavement is part of the career of most Alzheimer's caregivers, access to the Medicare hospice benefit should be encouraged for families of patients with end-stage Alzheimer's Disease residing in nursing facilities.