
Long-term care (LTC) homes play a critical role in supporting the aging population, often accompanying residents and their families through the end-of-life journey. Yet, grief support for LTC staff, who bear significant emotional burdens, remains underprioritized. Addressing grief in these settings is fraught with challenges that demand organizational commitment, cultural change, and structured interventions. Below, we explore the primary obstacles to providing grief support in LTC homes.
Organizational Policy and Practice
Lack of Prioritization: Grief and mental health support are often overlooked in LTC organizational policies. Limited access to palliative skills training and formal education hampers the ability of staff to manage grief effectively.
Underfunding and Resource Constraints: Chronic underfunding in LTC homes leads to understaffing, unsustainable initiatives, and the revocation of vital policies and programs designed to address grief and mental health needs.
Dismissive Supervisory Responses: A culture of silence around death is perpetuated by dismissive attitudes from administrators and supervisors, discouraging open conversations about grief.
Workplace-Based Support
Inconsistent Support: Workplace-based grief support—including peer mentoring programs, in-services, workshops, and debriefings—varies widely in availability and quality. Without consistent support mechanisms, staff are left to navigate their grief in isolation.
High Workload and Burnout: The demanding nature of LTC work leaves staff with little time to participate in optional support offerings, such as memorials or healing groups, further exacerbating feelings of grief and burnout.
Cultural Attitudes Toward Death and Support-Seeking
Denial of Death: Despite being a daily reality in LTC, the institutionalization of death fosters psychological distancing, which inhibits meaningful engagement with grief.
Cultural and Social Contexts: Cultural factors and social norms often hinder open discussions about grief. These contexts shape individual and collective attitudes toward death and support-seeking behaviors, creating additional barriers to effective grief management.
Informal Peer-Support and Relationships
Reliance on Informal Support: LTC staff frequently rely on informal peer-support to cope with grief. While valuable, this form of support is often insufficient to address deeper emotional needs.
Lack of Formalized Support Systems: The absence of structured and formalized grief support systems leaves a significant gap in the emotional care provided to LTC staff.
Individual Beliefs and Self-Care Practices
Personal Coping Strategies: Staff often build familial type relationships with residents and family in the course of their duties and as a result care aides must navigate emotional attachment and detachment to residents through personal coping strategies, often without adequate organizational support. This balancing act can take a toll on their mental health.
Time Constraints: The multiple caregiving roles that LTC staff juggle at work and at home make self-care seem like an unattainable luxury.
Barriers to Implementation
Policy and Regulatory Challenges: Inconsistent policies and a lack of regulatory guidance create significant obstacles to implementing effective grief support services in LTC settings.
Sustainability of Initiatives: High staff turnover and burnout further challenge the sustainability of grief support programs, as these issues create a cycle of unmet needs and emotional strain.
A Path Forward: Addressing Grief in LTC Homes
To address these challenges, a multifaceted approach is necessary. Organizational policies must prioritize grief and mental health support, ensuring that staff have access to palliative skills training and consistent support mechanisms. Cultural change is also critical—fostering open discussions about death and grief can help normalize support-seeking behaviors.
Additionally, structured and formalized support systems should complement informal peer-support networks. Addressing time constraints and offering flexible options for grief support, such as on-site counseling or virtual support groups, can help staff manage their emotional well-being amidst demanding schedules.
Finally, ensuring the sustainability of grief support initiatives requires long-term investment in staff well-being, adequate funding, and regulatory guidance. By addressing these systemic barriers, LTC homes can create a compassionate environment that supports not only residents but also the dedicated staff who care for them.
Source: Adapted from The Key Challenges in Providing Grief Support in Long-Term Care (LTC) Homes. © All rights reserved. Randa-Beaulieu, C. (2023). Grief and bereavement support for staff in long-term care homes: A scoping review [Master's project, Simon Fraser University]. Simon Fraser University Institutional Repository.
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