Bereavement Professional

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Grief Assessments

  • 1.  Grief Assessments

    Posted 11-24-2014 03:06 PM
    This message has been cross posted to the following eGroups: Social Worker and Bereavement Professional .
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    I have been doing research on Grief Assessments and am having a very hard time finding something that fits our bereaved population and is not too long.  I wondering if anyone would be willing to share what assessments for grief work after the death you are using?

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    Camille Evans, LMSW, ACHP-SW
    Executive Director/ Social Worker
    Heart 'n Home Hospice and Palliative Care, LLC
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  • 2.  RE: Grief Assessments

    Posted 11-25-2014 09:02 AM
    Camille, There was an excellent discussion stream on this topic awhile back.  If you go back into the digest records, I think you could find it.  Not that it's not worth discussing, but there were many ideas shared in that "stream."

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    Merrie MacHose, MA
    Bereavement Coordinator
    Heartland Home Health Care and Hospice
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  • 3.  RE: Grief Assessments

    Posted 11-25-2014 09:21 AM
    I checked back and cannot find the discussion!  Does anyone else remember this?  Anyway, Camille, we must use our company's Comprehensive Bereavement Assessment on admission, if that is the assessment you are speaking of.  I am not allowed to share it, but it assesses Emotions, Relationships, Spiritual Needs, Physical condition, Financial issues, and any risk factors such as a conflicted relationship with the patient, multiple losses, and a variety of other things.  Risk is judged based on grief reactions and impairment in functioning.  Then there is a discussion section at the bottom.  This is all on one page (one side).  I find that when it is completed well, it is a useful tool.  I'm sorry I can't share it, but I imagine if conforms to NHPCO guidelines.

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    Merrie MacHose, MA
    Bereavement Coordinator
    Heartland Home Health Care and Hospice
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  • 4.  RE: Grief Assessments

    Posted 11-28-2014 02:21 PM

    Hi -

    If you type in bereavement assessment, you will find some old discussion threads. The topic does come up from time to time and we did have a chat on it a few years ago.  I know that several Electronic Medical Record software programs come with bereavement assessments.  We have Suncoast as our EMR, but have modified the assessment.  Allscripts has one too as do others.

    NHPCO's Guidelines for Bereavement in Hospice Care includes guidelines for assessments - areas to address - physical, emotional, social, spiritual, economic and intrapersonal. You may find it helpful in developing your own assessment. Many agencies are unable to share their tools or forms.

    Best,

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    Diane Snyder Cowan, MA, MT-BC, CHPCA
    Director of Bereavement Center
    Hospice of the Western Reserve, Inc
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  • 5.  RE: Grief Assessments

    Posted 12-01-2014 09:16 AM

    Thank you Diane.

    We offer a bereavement assessment as well. 

     

    But the problem we're seeing is that *surveyors are rejecting bereavement assessment tools if the tool doesn't "automatically" score the risk level. But I'm unable to determine why that built-in scoring mechanism is required or even necessary.

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    Charles Kleinheksel, LMSW
    Support Spec
    Consolo Services Group
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  • 6.  RE: Grief Assessments

    Posted 12-02-2014 10:38 AM
    Does anyone know if Allscripts is able to automatically generate a risk score based on information in the bereavement risk assessment?

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    Caitlin Mason
    Bereavement Coordinator
    Tabitha Hospice
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  • 7.  RE: Grief Assessments

    Posted 12-03-2014 02:40 PM

    Hi Caitlin,

     

    I would say having using it for a few years that Allscripts cannot automatically generate a risk score (1, 2 or 3) based on use of the assessment tools found there. The assignment of 1 low, 2 moderate or 3 high has always fallen on the hospice social worker's clinical judgment and comprehensive assessment of situation along with input from the hospice team.

    In Allscripts there are a variety of caregiver-related screens that can be completed including primary caregiver issues and coping, and a separate screen for Bereavement/Grief Risk Factors for up to 3 family members total (including PCG). Valuable information can be documented here, however the screens are not very comprehensive.  For example if the family member is dealing with serious illness themselves which might significantly affect their grief coping after the death, this is not a Grief Risk Factor offered on the screen. (Comments about such factors can be added in a box). For these and other reasons related to missing variables, I'm glad that the program does not generate a score automatically but that we rely on the IDT input and assessments. Note also that it only covers 3 family members in assessment screens; any number of family and friends can be added to pt's chart.

    Our recent survey resulted in surveyor insisting on use of above screens in documenting rationale for score, their limitations notwithstanding.

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    Dairine Pearson
    Bereavement Counselor, MSW
    Visiting Nurse & Hospice Care of Santa Barbara
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  • 8.  RE: Grief Assessments

    Posted 12-04-2014 05:28 PM
    I concur, it does not to the best of my knowledge. Also admonished my surveyors to develop a scoring system, we did, but it is not automatically generated.

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    Karen Monts, MS, LBSW
    Director Grief Support Services
    Hospice of Michigan
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  • 9.  RE: Grief Assessments

    Posted 12-03-2014 04:22 PM
    We currently use AllScripts for our charting and as far as I know there is no automatic risk scoring feature. ------------------------------ Becca Frohardt Hospice of the Twin Cities ------------------------------


  • 10.  RE: Grief Assessments

    Posted 12-02-2014 01:58 PM

    Hi Charles;

    When the surveyors came to us in March, they asked about the "scoring."  We no longer score. I shared our protocol, including how we assess continuously, update the plan of care, etc... and they seemed okay with that.  I showed them all our documentation, etc. and again, they seemed okay with that and the explanation.  There are no regulations that I am aware of that require scoring.

    Hope that helps a little.

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    Diane Snyder Cowan, MA, MT-BC, CHPCA
    Director of Bereavement Center
    Hospice of the Western Reserve, Inc
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  • 11.  RE: Grief Assessments

    Posted 12-02-2014 02:23 PM

    During our recent JC survey, we also were questioned about our assessment process and determining risk level.  We use MYSIS as well and although the program has the ability to "score", we chose not to engage this feature as we have an interdisciplinary process to complete the berv assessment post death that involves more than just the "risk factor scale" piece.  Once we described our assessment process of determining Low, Moderate, and High-risk, they were satisfied.  The most common critique of data systems like MYSIS is that they do not "score" or balance strengths against the risk factors.

    Overall,  I think HOW your program determines the risk for complicated grief may be what surveyors are most interested in vs. a numbered "score".   

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    Brenda Kenyon, LCSW
    Grief Specialist/Bereavement Coordinator
    St.Vincent Hospice
    Indianapolis, Indiana
    bekenyon@st.vincent.org
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  • 12.  RE: Grief Assessments

    Posted 12-04-2014 10:11 AM
    Thank you all very much for sharing your experiences and ideas. This is very helpful and much appreciated.

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    Charles Kleinheksel, LMSW
    Support Spec
    Consolo Services Group
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  • 13.  RE: Grief Assessments

    Posted 12-04-2014 05:05 PM

    This more narrative, case by case ongoing assessment seems to fit with the most recent research that questions the benefit of assigning a risk level.

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    Lea Grubbs, LCSW, ACHP-SW
    Hospice Social Worker
    Davis Hospice
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  • 14.  RE: Grief Assessments

    Posted 11-25-2014 10:28 AM
    I have been investigating the BRAT tool developed by Victoria Hospice; does anyone in the group utilize that?

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    Jessica Bohndorf, LMSW
    Bereavement Coordinator
    Hospice and Palliative Care of Chenango County
    Norwich, NY
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  • 15.  RE: Grief Assessments

    Posted 11-26-2014 11:25 AM
    Our Hospice uses the BRAT and find it very simple!  The risk, i.e. high, moderate, etc. is automatic.  There are check boxes for what applies and a space for short explaniations of why any box is checked.  There is an option to override the automatic risk assessment.  Great tool!  We use it at initial death of patient, and again if Bereavement Coordinator disagrees with initial assessment or there are changes in 2-3 weeks.


  • 16.  RE: Grief Assessments

    Posted 11-28-2014 10:07 AM

    Thanks for sharing that Betty.

     

    I'm wondering if this, or any other grief assessment for that matter, has been empirically validated, and for which populations? I'm not criticizing this tool specifically - I'm not familiar with it. This is just a general question I have in the area of bereavement assessments. 

     A concern I have is that if the assessment tool isn't statistically reliable for the population its used with, that the automatic scoring can lead to poor or inconsistent assessment results.

    I often hear that surveyors want hospices to use an assessment tool that 'automatically' scores the survivor's risk level. However, the automatic scoring mechanism doesn't mean much if the tool itself isn't valid. 

    However, there are so many target populations, that it seems like it would be quite a challenge to find a globally useful bereavement assessment.

     

    Thoughts?

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    Charles Kleinheksel, LMSW
    Support Spec
    Consolo Services Group
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  • 17.  RE: Grief Assessments

    Posted 11-29-2014 12:12 PM
    Is this program something you can share or is it what your company uses ? ------------------------------ Susan Herndon LLBSW Hospice of the Sunrise Shore ------------------------------