TY - JOUR
T1 - Primary Care Consultations for Grief in Older People–a Missed Opportunity for Mental Health Support
AU - Gerber, Katrin
AU - Hjorth, Larissa
AU - Bryant, Christina
AU - Lock, Kayla
AU - Chong, Terence W.H.
AU - Engel, Lidia
AU - Hills, Danny
AU - Loi, Samantha M.
AU - White, Primrose
AU - Shimoinaba, Kaori
AU - Brijnath, Bianca
PY - 2024/3/5
Y1 - 2024/3/5
N2 - Objectives: Bereaved older adults often experience health complications, yet receive limited support in primary care settings. This research explored general practice staff’s exposure to older patients’ grief and identified barriers/enablers to bereavement support. Methods: We examined 15 in-depth interviews with general practitioners and practice nurses across Australia. Data were analyzed thematically and via poetic narrative analysis, an innovative arts-based method to meaningfully translate participant’s lived experience and emotions. Results: Exposure to older people’s grief and bereavement informed primary care staff assumptions about older people’s grief, their ability to identify signs of grief, their understanding of how culture, gender, and grief intersected, and how grief could be managed in general practice (e.g. mobilizing nurses to provide support). Barriers/enablers to bereavement support included: Communication, access to support, time to discuss concerns, and knowledge/awareness of grief complications. Conclusions: Older adults require access to tailored support that addresses their experiences of repeated exposure to grief and loss. Primary care is a key conduit to specialist services but to make such referrals more training is needed on ageism and stigmas surrounding mental health. Arts-based methods can open a dialogue about grief and destigmatize help-seeking among older adults. Clinical implications: Clear documentation of grief in patients’ medical records; Destigmatizing mental health support among older patients; and Training primary care staff on grief, age-, culture- and gender-specific needs, and available resources can overcome some of the identified barriers to bereavement support. Primary care providers can use consultations with older patients to enquire about potential recent bereavements and mental health support needs, going beyond the mere assessments of physical symptoms. Timely assessment and documentation of grief in older patients can facilitate appropriate referrals and access to support services; this is a key task for general practitioners, who are gatekeepers to the healthcare system.
AB - Objectives: Bereaved older adults often experience health complications, yet receive limited support in primary care settings. This research explored general practice staff’s exposure to older patients’ grief and identified barriers/enablers to bereavement support. Methods: We examined 15 in-depth interviews with general practitioners and practice nurses across Australia. Data were analyzed thematically and via poetic narrative analysis, an innovative arts-based method to meaningfully translate participant’s lived experience and emotions. Results: Exposure to older people’s grief and bereavement informed primary care staff assumptions about older people’s grief, their ability to identify signs of grief, their understanding of how culture, gender, and grief intersected, and how grief could be managed in general practice (e.g. mobilizing nurses to provide support). Barriers/enablers to bereavement support included: Communication, access to support, time to discuss concerns, and knowledge/awareness of grief complications. Conclusions: Older adults require access to tailored support that addresses their experiences of repeated exposure to grief and loss. Primary care is a key conduit to specialist services but to make such referrals more training is needed on ageism and stigmas surrounding mental health. Arts-based methods can open a dialogue about grief and destigmatize help-seeking among older adults. Clinical implications: Clear documentation of grief in patients’ medical records; Destigmatizing mental health support among older patients; and Training primary care staff on grief, age-, culture- and gender-specific needs, and available resources can overcome some of the identified barriers to bereavement support. Primary care providers can use consultations with older patients to enquire about potential recent bereavements and mental health support needs, going beyond the mere assessments of physical symptoms. Timely assessment and documentation of grief in older patients can facilitate appropriate referrals and access to support services; this is a key task for general practitioners, who are gatekeepers to the healthcare system.
KW - Ageing
KW - bereavement
KW - general practice
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=85186928275&partnerID=8YFLogxK
U2 - 10.1080/07317115.2024.2321341
DO - 10.1080/07317115.2024.2321341
M3 - Article
AN - SCOPUS:85186928275
SN - 0731-7115
JO - Clinical Gerontologist
JF - Clinical Gerontologist
ER -