Life after Death: A Practical Approach to Grief and Bereavement

Life after Death: A Practical Approach to Grief and Bereavement

David Casarett, MD, MA;
Jean S. Kutner, MD;
Janet Abrahm, MD; and
for the End-of-Life Care Consensus Panel*

From the Philadelphia Veterans Affairs Medical Center and Institute on Aging and Center for Bioethics, University of Pennsylvania, Philadelphia, Pennsylvania; and University of Colorado Health Sciences Center, Denver, Colorado.

Abstract

This consensus paper describes the essential skills that clinicians need to help persons who are experiencing grief after the death of a loved one. Four aspects of the grieving process are reviewed: anticipatory grief, acute grief, normal grief reactions, and complicated grief. Techniques for assessment and recommendations about interventions and indications for referral are provided for each aspect.

Article and Author Information

*This paper was authored by David Casarett, MD, MA; Janet Abrahm, MD; and Jean S. Kutner, MD, for the ACP–ASIM End-of-Life Care Consensus Panel. Members of the ACP–ASIM End-of-Life Care Consensus Panel were Bernard Lo, MD (Chair); Janet Abrahm, MD; Susan Block, MD; William Breitbart, MD; Ira R. Byock, MD; Kathy Faber-Langendoen, MD; Lloyd W. Kitchens Jr., MD; Paul Lanken, MD; Joanne Lynn, MD; Diane Meier, MD; Timothy E. Quill, MD; George Thibault, MD; and James Tulsky, MD. Primary staff to the Panel were Lois Snyder, JD (Project Director); Jason Karlawish, MD; and David Casarett, MD, MA.
This paper was reviewed and approved by the Ethics and Human Rights Committee, although it does not represent official College policy. Members of the Ethics and Human Rights Committee were Risa Lavizzo-Mourey, MD (Chair); Susan Dorr Goold, MD; Joanne Lynn, MD; David A. Fleming, MD; Bernard Rosof, MD; Daniel P. Sulmasy, OFM, MD, PhD; James A. Tulsky, MD; S.Y. Tan, MD; Vincent Herrin, MD; and Lee J. Dunn Jr., JD, LLM.
Acknowledgment: The End-of-Life Care Consensus Panel thanks the Greenwall Foundation for its support in the development of this paper.
Grant Support: By the Greenwall Foundation.
Requests for Single Reprints: Lois Snyder, JD, Center for Ethics and Professionalism, American College of Physicians–American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106.
Current Author Addresses: Dr. Casarett: University of Pennsylvania, Institute on Aging, 3615 Chestnut Street, Philadelphia, PA 19104.
Dr. Kutner: University of Colorado Health Sciences Center, Box B180, 4200 East Ninth Avenue, Denver, CO 80262.
Dr. Abrahm: University of Pennsylvania Medical School, 514 Maloney, Hospital of the University of Pennsylvania, 3600 Spruce Street, Philadelphia, PA 19104.