A comprehensive approach to bereavement

Bereavement is associated with significant mental and physical health consequences, and risk factors for illness associated with bereavement have been demonstrated. Although bereavement cannot be eliminated as a health risk, primary care providers can screen for it, facilitate the normal grief process, and mitigate risks for bereavement complications and health deterioration. Considering the time constraints in today's fast-paced health care environment, this article offers a clear and comprehensive framework for primary care of grieving people. The framework presented here includes (1) empirically shown risk factors for health deterioration in bereavement; (2) an assessment and screening patient history format suitable for primary bereavement care; (3) primary care guidelines for differential diagnosis of bereavement; and (4) principles of primary care for the bereaved. This article also addresses primary care for bereaved children, parents, and other specific bereaved populations, and discusses pharmacotherapy and multicultural considerations in bereavement.