Bereavement support is not an option

Professionally I have been involved in the work of bereavement for most of my adult life, both teaching and writing about the experience, not least for those who struggle to express their thoughts and feelings. In some senses I am at ease talking about death and dying, about the pain of loss and the emptiness which the absence of love leaves. You could say it has been my particular field of professional and academic interest.

At a personal level like so many I have had times when I have lost those close to me. I have been forced to do the hard work of grief on too many occasions and for too many moments. In those times I have struggled to find a path through and a sense of balance when the waves of absence overwhelm.

Bereavement is the sense of feeling robbed and bereft. For no matter how expected or anticipated a death or loss is, its ache is still sore, its pain still raw, its touch a cold beyond description.

This sense of lost-ness is beautifully conveyed in the original word for ‘bereavement’ from the Old English- ‘bereafian’ which denotes a sense of deprivation, of being robbed by someone, of being seized or grabbed out of living and life.

One of the reasons I wanted to write about bereavement is that at Scottish Care we have decided to make it a focus for some of our work this year. We have held useful and creative discussions with organisations like Cruse Scotland and colleagues in health and social care.

But in wider discussions on bereavement I am sadly detecting a resistance or a certain degree of apathy. It’s almost as if it’s okay to talk about palliative care and end of life, to develop a framework and priorities for those, but somehow bereavement is considered to be the concern and the preserve of the individual.

There seems to be an attitude that bereavement is a grief work which is not deserving of resourcing or strategic priority. I think this is both sad, mistaken and damaging.

We have loads of evidence to show that as a society in Scotland we have lost the cultural and societal ability to deal with dying and have misplaced our skills at working through loss in bereavement.

It is for that and many other reasons that we have solid research which shows that many doctors are struggling to cope with death and dying and are needing support to grieve and to do the work of bereavement.

For social care the Scottish Care report ‘The Trees that Bend in the wind’ last year spoke movingly of the way in which care staff whether in care homes or in the community in homecare services felt poorly equipped to deal with the continual losses they have to experience.

Bereavement support should be a central and critical priority for all who commission care and for all those who make strategic policy and practice decisions. To do other is to fail to support clinicians and carers at their point of real vulnerability and pain.

No matter how skilled and experienced you are we all need to be supported and upheld through our grieving, we all need to find a solace that comforts us in our weakness and binds us up when we feel broken.

When we have a sense of futility and despair, both personally and professionally, we need there to be space to open up and pour out our feelings; we need there to be people who have time and capacity simply to be present and there for us.

Good bereavement support is no optional extra, it is rather fundamental to a society basing its character on dignity and human rights. Good bereavement support renews and restores, it can give a sense of purpose and direction, for many it’s what has literally saved their lives.

I fear that if as a society in Scotland we fail to enable and resource those who do the work of care to grieve properly and to enrich them through good bereavement support then we are sowing the seeds of a harvest of regret and despair.

Dr Donald Macaskill

@DrDMacaskill