Among the many challenges a caregiver will face in his or her career is the loss of patients. Patient death is common in many healthcare settings, but is particularly prevalent in hospice care as well as in long-term care facilities like nursing homes and assisted living facilities (ALFs). Unfortunately, the grieving process of caregivers is poorly managed, and may result in unforeseen risks to the health and welfare of healthcare personnel as well as their patients. As a risk management approach that includes nursing home insurance or other healthcare liability insurance solutions, facility managers must understand the factors that influence the grieving process and to provide support for caregivers who have experienced patient loss in the workplace.
Patient Loss: Challenges for Caregivers
In long-term care facilities, caregivers often form powerful bonds with their patients. These compassionate individuals are often the closest people to those patients, taking the place of family members and all too aware of the patient’s specific needs for support. Providing care, especially end-of-life care, can be emotionally and physically demanding for facility staff members. Although the patient may be comfortable and at peace with their care even to the end, caregivers shoulder a heavy burden once the patient passes away and even long after the loss. When a patient dies, caregivers are faced with the loss of a sense of worth, often leading to depression and anxiety. They may even feel guilt, even though deaths are a regular and expected experience in long-term care facilities.
The healthcare industry is plagued by high rates of caregiver burnout, or the phenomenon where they reach a critical level of physical and mental fatigue. The loss of a patient can exacerbate burnout in nursing homes, leaving caregivers feeling unable to cope. Burnout has been implicated as a risk factor to other staff members and patients alike – with caregivers making mistakes or ultimately neglecting their duties to the detriment of facility residents.
The Grieving Process: A Research Study
In the February 2015 issue of Journal of Pain Symptom Management, a study conducted by medical researchers, was published. The study investigated how caregivers experience patient deaths and the extent to which caregivers were prepared for the experience of patient loss.
A selection of direct-care staff members in nursing homes and home healthcare settings were assessed. The study pointed to several troubling factors, including:
- Caregivers reporting a lack of preparedness for the death of patients.
- An inability to process or to accept the loss, which is a part of the natural grieving process but can take an emotional toll.
- Grief symptoms very similar to those experienced by family members, particularly when they had formed close bonds with their patients.
- Evidence that facility managers do not often have mechanisms in place for helping caregivers cope with patient loss, including grief reporting systems and post-loss support.
Supporting Caregivers in the Grieving Process
Long-term care facilities experience many challenges as they provide care to elderly and at-risk residents. Understaffing in many facilities means that caregivers are expected to do more with less, often resulting in exhausting patient workloads. When a patient dies, either as expected or unexpectedly, the symptoms of grief can be overwhelming to an already-stressed staff member. They may experience far more dangerous effects than grief, potentially leading to unhealthy coping mechanisms like alcohol use or overeating, which puts the health of those caregivers at risk. If not supported, caregivers often reach a level of burnout that cannot be managed by time off or vacations.
Facility managers must implement risk management practices that protect the health and safety of caregivers during the grieving process. Like nursing home insurance, these risk management practices are designed to help minimize the risk exposures facilities face as they continue to deliver compassionate care. To provide adequate support for caregivers who experience patient loss, facilities can and should:
- Establish health and wellness programs for caregivers, including exercise, healthy eating, and yoga components.
- Ensure that caregivers are given time to process their grief.
- Provide training on the grief process, including the stages of grief and how they are experienced.
- Implement reporting mechanisms to allow caregivers to voice their concerns with facility managers and fellow staff members.
- Provide grief counseling services for caregivers who have experienced a recent patient loss. Counseling services are widely available and have been shown to substantially improve outlooks for caregivers, allowing them to continue caring for others.
It is important for facility managers to understand that the grieving process varies between individuals, and that some individuals are more able to cope with grief than others. By implementing grief support processes and services, managers can help to ensure that the caregiver risks associated with patient loss are minimized.
About Caitlin Morgan
Caitlin Morgan specializes in insuring assisted living facilities and nursing homes and can assist you in providing insurance and risk management services for this niche market. Give us a call to learn more about our programs at 877.226.1027.