Grief Coach: Feasibility and acceptability of a text message program for bereavement support among grievers in the United Kingdom

To address gaps in bereavement services in the UK, a national charity offered free access to Grief Coach, a 12-month text message-based grief support program. To assess the feasibility and acceptability of the approach, this study examined program reach, retention, and user satisfaction. Over 4000 grievers enrolled in the program over 13.5 months; 6- and 12-month retention rates were 87.8% and 83.2%. Among individuals responding to a satisfaction survey (response rate = 55.9%), 94.8% rated the program as moderately or very helpful and 95.4% said it contributed to their sense of being supported in their grief. Common themes emerging from a qualitative analysis of the written comments were how the program helped with coping with the pain of grief and user appreciation of the program. Grief Coach may be a promising component of high-quality grief support to meet the needs of grieving people in the UK.

Supporting bereaved people: a qualitative study on the experience of informal support providers, before and during the pandemic scenario

The COVID-19 outbreak has further highlighted the need to strengthen support networks to sustain grieving people. However, we know very little about the experience of those who, because of their emotional connection with the bereaved person or of their social function, find themselves supporting people in grief. The current study aimed to analyze the experience of grievers' informal support providers (relatives and friends, teachers, religious leaders, funeral providers, pharmacists, volunteers, and social service workers). 162 in-depth interviews were collected (meanage = 42.3, SD = 14.9; women = 63.6%). Findings highlight two different ways of talking about one's experience and two different ways of offering support. Such dissimilarities do not relate to the period in which support was offered (before or during the pandemic). The results will be discussed in order to highlight emerging training needs to support bereaved people in their difficult transition.

Grief Coach, a Text-Based Grief Support Intervention: Acceptability Among Hospice Family Members

U.S. Medicare-certified hospices must provide bereavement care to family members for 13 months following a patient's death. This manuscript describes Grief Coach, a text message program that delivers expert grief support and can assist hospices in meeting the bereavement care mandate. It also describes the first 350 Grief Coach subscribers from hospice and the results of a survey of active subscribers (n = 154) to learn whether and how they found the program helpful. The 13-month program retention rate was 86%. Among survey respondents (n = 100, response rate = 65%), 73% rated the program as very helpful, and 74% rated it as contributing to their sense of being supported in their grief. Grievers aged 65+ and males gave the highest ratings. Respondents' comments identify key intervention content that they found helpful. These findings suggest that Grief Coach may be a promising component of hospice grief support programming to meet the needs of grieving family members.

Do Healthy People Engage With Education About Death, Dying and Advance Care Planning? An Early Evaluation of the Omega Course

Background: Death can be difficult to address personally, to discuss and to plan for. Since 2016 The Omega Course (Omega) has educated local people in Kenilworth, UK, about death and dying; broaching these issues and teaching communication skills whilst enabling social interaction. It aspires to produce practical outcomes with positive implications for end of life (EoL) planning and future neighbourhood care within the town. Aim: To investigate the impact of Omega on the attitudes and actions of participants. Method: Anonymous questionnaires, distributed by Qualtrics, or by post if preferred, were sent to 62 participants of Omega aged 22-94 two and a half years post course institution. Thematic analysis and inferential statistics were used. Results: 23 replies (37%) scored changes across 4 areas; barriers to discussion, ease discussing death, fears about death and future planning capability. All showed a significant beneficial change using a Paired Sample t-test (P< .01). Respondents noted common fears of death and dying, barriers to discussing the topic and planning for it. The course helped to allay fear, enabled discussion and encouraged planning for death and EoL. Respondents rated the course as 9.1/10 for achieving its aims. They appreciated discussing death and dying in a supportive environment and found the approach effective in developing their skills and changing attitudes. Conclusion: Omega has the potential to change attitudes towards death; promoting discussion, planning, and tackling misconceptions.

Advance Care Planning for African American Caregivers of Relatives With Dementias: Cluster Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

African-American family caregivers may have insufficient knowledge to make informed end-of-life (EOL) decisions for relatives with dementias. Advance Care Treatment Plan (ACT-Plan) is a community-based education intervention to enhance knowledge of dementia and associated EOL medical treatments, self-efficacy, intentions, and behavior (written EOL care plan). This study evaluated efficacy of the intervention compared to attention control.

RESEARCH DESIGN AND METHODS

In a theoretically based, 2-group, cluster randomized controlled trial, 4 similar Midwestern urban megachurches were randomized to experimental or control conditions. Each church recruited African-American caregivers, enrolling concurrent waves of 5 to 9 participants in 4 weekly 1-hour sessions (358 total: ACT-Plan n = 173, control n = 185). Dementia, cardiopulmonary resuscitation (CPR), mechanical ventilation (MV), and tube feeding (TF) treatments were discussed in ACT-Plan classes. Participants completed assessments before the initial class, after the final class (week 4), and at week 20. Repeated measures models were used to test the intervention effect on changes in outcomes across time, adjusting for covariates as needed.

RESULTS

Knowledge of CPR, MV, TF, and self-efficacy to make EOL treatment decisions increased significantly more in the ACT-Plan group at weeks 4 and 20. Knowledge of dementia also increased more in the ACT-Plan group at both points, reaching statistical significance only at week 20. Intentions to make EOL treatment decisions and actually an advance care plan were similar between treatment arms.

DISCUSSION AND IMPLICATIONS

Findings demonstrate promise for ACT-Plan to increase informed EOL treatment decisions for African American caregivers of individuals with dementias.

Grief literacy: A call to action for compassionate communities

The compassionate communities movement challenges the notion that death and dying should be housed within clinical and institutional contexts, and works to normalize conversations about death and dying by promoting death literacy and dialogue in public spaces. Community-based practices and conversations about grief remain marginal in this agenda. We aimed to theorize how grief could be better conceptualized and operationalized within the compassionate communities movement. We develop the concept of Grief Literacy and present vignettes to illustrate a grief literate society. Grief literacy augments the concept of death literacy, thereby further enhancing the potential of the compassionate communities approach.

Towards a Guiding Framework for Prison Palliative Care Nursing Ethics

The number of people aging and dying behind bars is growing, bringing greater attention to the need for prison palliative care. While this trend has rightly led to increased scholarship, a focus on understanding the most effective way to deliver prison palliative care has overshadowed thinking about why the need itself has arisen, as well as deeper ethical thinking about how the nursing profession should respond. This article interweaves 4 strands of analysis-contextual, relational, social, and political-to produce a framework to guide ethical action in prison palliative care nursing, relevant to practice, research, policy, and education.

Sickle cell disease: an opportunity for palliative care across the life span

Sickle cell disease is a chronic illness that affects patients physically and emotionally and can do so at an early age. An ecological model of palliative care that involves improved communication among the health care team, patients, and their families can be beneficial. Open and honest communication regarding advance care planning, disease management, relief of pain and other symptoms, and bereavement and grief are all important for the patient, family, and health care team. Given the multiple acute and chronic complications of sickle cell disease, an approach to care that is holistic and comprehensive may help to improve a patient's biologic function and the perceived health, functional status, and quality of life of the patient and family.