We write to describe the establishment and initial outcomes of a bereavement service within our palliative care unit (PCU). This is prompted by the limited availability of guidance regarding service development despite bereavement support being a core component of palliative care. While most bereaved individuals eventually adapt to their new situation, a minority will experience bereavement which becomes maladaptive. Recognition of this is important as complicated bereavement is associated with physical and psychiatric sequelae and increased mortality. The challenges for bereavement services include risk stratification for complicated bereavement and appropriate targeting of grief interventions. Bereavement risk assessment typically involves clinical judgement, risk factor analysis and the use of bereavement risk assessment tools such as the Bereavement Risk Index (BRI). Completed using information from multidisciplinary discussions, a modified four-item version of this index has been demonstrated to have acceptable reliability and validity.
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