The Bereavement Care Crisis in Hospice Facilities

Bereavement care is an essential part of the hospice experience, designed to support those coping with loss. Bereavement care is not just a compassionate gesture; it is a critical component of the hospice care continuum. So why is it so underserved in the U.S.? 

When a loved one dies, the emotional toll on families and friends can be immense. Without adequate support, they can experience long-term psychological and physical health issues, including anxiety and depression. People experiencing bereavement are also at higher risk for hypertension and other heart-related problems. The emotional toll doesn’t just show up in their personal lives: Employees exhibit higher rates of absenteeism in the year following a loss and are more likely to quit their jobs or change careers.

Hospice facilities across the U.S. work to appropriately support these grieving families, but find themselves under-resourced, understaffed, and facing vague regulatory guidance from The Centers for Medicare & Medicaid Services (CMS). Not only has this situation stopped them from providing the high-quality care their team is trained to deliver, but also opens hospices to negative consumer reviews that impact referrals, audits, and substantial fines for non-compliance, further destabilizing their organization and its ability to operate effectively. 

Instead of pushing harder on hospice providers to find more ways to deliver comprehensive bereavement care with less, it’s key to address the systemic forces hampering their ability to deliver quality care at the scale required and address these challenges. 

Resolving gaps in modern bereavement care

While statutory guidelines exist, quality measures are necessary to standardize bereavement care across the board. Proposed federal legislation could promote the development of an evidence-based definition of “high-quality” bereavement care. The Centers for Medicare & Medicaid Services (CMS) should develop more specific standards for bereavement services and implement quality measures to assess their effectiveness. This would not only aid hospices in delivering consistent care but also shield them from penalties associated with non-compliance.

Hospice care should be looked at as an area of investment for future healthcare and healthtech innovators. With our population aging at a rate of 10,000 people turning 65 per day, integrating hospice care into every individual’s health continuum is an opportunity for innovation and new personalized support solutions. Innovators must not only think about patient care; thinking about better ways to support their families in advance of a loss and through the bereavement process will become increasingly important as the U.S. faces one of the biggest generational shifts in recent history. 

CMS should reimburse for bereavement services in line with proposed quality guidelines. Hospice receives a per diem payment for each enrolled patient from admission through the end of life, but this payment does not sufficiently cover the essential bereavement period that follows. This financial strain forces many hospices to limit their bereavement programs, even though the need for such services is clear and pressing.

With the injection of innovation, more guidance and more resources to ensure consistent and high quality care across the nation, hospice centers will be better equipped and incentivized to further center bereavement care services in recognition of the benefit it provides. 

Bereavement care is facing a crisis of under-resourcing on a national scale. Without attention paid to the very real benefits — and very real cost — of bereavement care done well, the U.S. healthcare system will be ill-prepared for decades to come. 

Photo: Kimberly Knoefel / 500px, Getty Images

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