About this course
This course teaches grief, loss and bereavement to hospice aides, nurses, social workers, chaplains, volunteers and schedulers. Its subject is the family - their grief before the death and their bereavement afterwards - and the obligation the hospice carries for a year once the patient has died. Part one distinguishes grief, mourning and bereavement, sets out the CMS definition of bereavement counseling as support provided before and after the death, and names the grief models honestly: the Kubler-Ross five stages as a description of dying patients with limited empirical support, the Bowlby and Parkes phases, and the two models that are actually usable at a bedside - Worden's four tasks of mourning and the Stroebe and Schut dual process model of loss-oriented and restoration-oriented coping with oscillation between them. Part two covers anticipatory grief in the family, including the five fallacies about it, and the family suffering that occurs before the death: ambiguous loss in dementia, caregiver exhaustion, the guilt of relief, and unfinished business. Part three covers what normal grief looks like, including grief bursts and hallucinations of the deceased, the DSM-5 distinctions between grief and major depression, and prolonged grief disorder as added to DSM-5-TR in March 2022. Part four covers the regulation: 418.64(d)(1) and tag L596, the one-year duration, the requirement for a qualified supervisor, and the bereavement plan of care that begins with the initial bereavement assessment required at 418.54(c)(7). Part five covers children and grief by developmental stage and cultural variation in mourning. Part six covers the hours around a death, the funeral and follow-up, the CAHPS Hospice Survey item on emotional support after the death, and the cumulative grief carried by hospice staff themselves. Suitable for new-hire orientation, annual refresher training, hospice aide in-service hours, and survey readiness.