Research Institute on Aging Studies Bereavement among Health Care Workers

”She was alone. I made her my friend, she made me her friend. We were friends, not just worker and resident.” - Certified Nursing Assistant, remarking on a death of a client

“I wanted to tell someone about [client,] what she was like.” – Home Health Aide

As the remarks above show, nursing staff may feel grief, when an elder patient passes away. Yet while the death of an elderly patient is a sad inevitability, the impact of a patient’s death on direct care workers has not been studied in depth. Until now.

With an eye towards helping staff cope with death among patients, Jewish Home Lifecare’s Research Institute on Aging is conducting a study of bereavement among direct care workers.

In this study funded by the National Institute on Aging (1 R03 AG034076), as well as private donors, the goal is to identify how direct care workers respond to the death of a patient, and what kind of support they may need. This knowledge has important implications for delivery and quality of care provided in elder care, as well as for employment satisfaction and stability among direct care workers in nursing home and home care settings.

Organizations that serve elders typically provide little support, structure, or ritual to help staff cope with death and dying among patients. Researchers surmise that this may also contribute to the extremely high turnover rate in this population.

A preliminary review of the data collected so far shows that the staff members interviewed had close ties with their patients and that the death of these patients was a significant loss for them, which affected how they felt about their job and about being assigned to a new patient.

Many of the certified nursing assistants and home health aides interviewed thus far have expressed gratitude to the researchers for acknowledging their loss and for giving them an opportunity to talk about their experience.

“When I first started working here, I had a situation where a resident died; it hit a part here [gestured to her heart]. I wish I had, away from workers, someone else to talk to; it would be better. I get attached easily. As a CNA, I love what I’m doing. When I leave every day at 3:30, I know I’ve done everything for the patient. They’re like my mom.” – Certified Nursing Assistant

“I think the study is a good idea and I think it is great that you care for people like us.” – Home Health Aide

When completed, researchers will have conducted 220 in-person interviews, which will include standardized grief measures, qualitative data on loss and information on employment specific factors. The goal of this groundbreaking study is to both identify staff needs for support after the death of a patient and to develop support interventions (e.g., rituals, support groups) that successfully address this need. On a practical basis it is hoped that these interventions will also improve staff opinion, engagement and retention metrics.

Source: Boerner, K. Bereavement in Direct Care Workers: Quality of Care and Workforce Issues
Jewish Home Lifecare is one of the few non-profit geriatric healthcare systems to have established a research institute. The Jewish Home Lifecare Research Institute on Aging makes significant contributions to the fields of geriatrics and gerontology with a focus on aging and vision; culture change within nursing homes; dementia and cognition; identification and treatment of depression; family caregiving and support needs; long-term care workforce issues; palliative and end of life care, and transitions in care settings.

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