The continual pressure on acute general hospital units can easily lead to neglect of the bereaved, unless the unit leader routinely seeks feedback on bereavement follow-up at multidisciplinary meetings. Fleeting contact with several care providers does not easily permit relationships to become established between staff and patients' relatives. Clearly, continuity of care established with relatives before death could facilitate ease of support following the patient's death. This model utilises each member of the multidisciplinary team and reaches out to involve the general practitioner. It promotes continuity of care and takes medical practice beyond the usual patient-centred approach to include the wider community.
Bereavement support is indeed a broad community responsibility.
5 Careful inquiry from a practitioner adopting a family-centred model of care can help to determine whether particular family members are at high risk. The manner of death, including death by suicide or homicide, may be associated with stigma, the horror of violence, and a pressing need for relatives to understand the sequence of events leading up to the death. In such instances, it is vital that GPs meet with family members to address these issues and that they continue to support the family, referring individuals to psychological or family therapy services if appropriate. Untimely and unexpected death occurs not only in the ED, but also regularly within coronary and intensive care units, and occasionally in obstetric and surgical settings, where the emphasis is on repair and rehabilitation. Any relationships between staff and relatives are likely to be brief and tentative.