A public health approach to bereavement support services in palliative care.

Objective: Most Australian palliative care services offer bereavement support services and typically this is regardless of risk or need. Palliative care services need to know how to use their limited resources to deliver best bereavement care and support. Approach: The relevance of a public health model of bereavement support to palliative care services is presented. We draw on the National Institute for Clinical Excellence (NICE) guidelines in the United Kingdom as well as the results from an audit of bereavement support provided to carers in a UK hospice. Conclusion: The provision of professional bereavement counselling for all carers and families of patients in receipt of palliative care is both unsustainable and inappropriate. The application of a public health perspective to bereavement in palliative care provides a systematic and evidence-based way of meeting the needs of bereaved family carers while reducing economic and staffing constraints on palliative care services. Implications: A public health approach to bereavement in palliative care would meet the needs of bereaved family members without additional economic and staffing resources, draws upon existing community resources, encourages the development of further community capacity, and should reduce use of health services. Additionally, the development of community partnerships means that a further strength of the model is its application to bereavement beyond palliative care settings.