Working with carer grief in community palliative care nursing.

Background: Community nurses (CN), both generalist and palliative care-specific, are key to supporting the carer with their experience of grief.

Aim: To identify the grief-related needs of carers and the capacity of CNs to provide for those needs.

Methods: A convergent parallel mixed-methods study which employed i) a needs questionnaire among carers of palliative care patients who had recently died; ii) a qualitative interview study among carers and iii) a questionnaire among CNs which canvassed their confidence and skills in working with carer grief.

Findings: In the carer survey, just one-third of carers reported engagement with CNs regarding prolonged and anticipatory grief. In the CN survey, low confidence and skill regarding supporting carers with their grief was reported. CNs with palliative care training were more confident and knowledgeable than generalist CNs.

Conclusions: Despite offering high ratings for CN compassion and overall quality of support during the dying process, grief support was reported by carers to be missing from their experience of CN care. The role of CNs in providing for the grief-related needs of carers is yet to be established.