Confronting Grief: Homecare Aides and Loss

How do you support someone who’s grieving? Maybe you give them a sympathy card to show you’re thinking of them, or you sit and talk with them about how they’re coping. If you’re their manager, you may have given them bereavement from work to properly process their grief.  

But what happens when someone is grieving, and no one around them recognizes it? This isn’t an unusual experience for professional caregivers. When a patient passes away, caregivers aren’t just losing a client, but a person they’ve spent countless hours talking to, looking after, and forming a close bond with. The fact that it’s their job to be a caregiver doesn’t change that the loss may feel like that of a close friend or relative.  

Not properly addressing the emotional toll loss can have on caregivers can quickly lead to job stress, burnout, and feelings of dissatisfaction. Here we explore the many sides of grief that caregivers can experience, and the ways providers can better support their employees during these challenging times.  

Types of Grief 

Anticipatory Grief 

Sometimes grief occurs before a death. According to the National Hospice and Palliative Care Organization, anticipatory grief is when a person is aware of the inevitable loss and begins to anticipate how they will react and cope when the person they care for passes. This type of grief is completely normal, and quite common in situations where someone has a prolonged illness. 

Complicated Grief 

According to the American Psychological Association (APA), complicated grief is a response to death that deviates significantly from normal expectations. Someone may be experiencing complicated grief if their immediate reaction to the loss is particularly devastating, and their pain is not lessened by the passage of time. 

Traumatic Grief 

The APA considers traumatic grief a severe form of separation distress that usually occurs following the sudden and unexpected death of a loved one. This can result in the person feeling numb or feeling like life is meaningless. 

Disenfranchised Grief 

According to the APA, disenfranchised grief (also called hidden grief) is a type of grief that society limits, does not expect, or may not allow a person to express. Examples include the grief of parents for stillborn babies, of teachers for the death of students, and of nurses for the death of patients. This is the type of grief that caregivers often experience.Disenfranchised grief may result in the person becoming isolated and misunderstood, which can prevent them from recovering from their grief. 

Caregiver Loss and Burnout 

Since the COVID-19 pandemic, there has been more focus on the mental health of healthcare workers. People are starting to recognize that the nurses, doctors, and nursing assistants who have been on the frontline and seen a tremendous amount of loss need emotional support and resources. But there has yet to be much attention paid to the grief homecare workers feel.  

Because caregivers work with an older population, it’s not unusual for them to experience the loss of a client. These losses feel especially significant for caregivers because of the nature of their jobs. Unlike nurses or doctors, caregivers often only have one or two clients they see for months (or even years) at a time. They get incredibly close to these clients — sometimes even spending more time with them than their own families. So, why is it that their grief is often ignored? 

Many people may believe that because client deaths are not unusual, caregivers must be “used” to it, and that homecare workers will simply move onto the next client. But by ignoring their grief, and not addressing their feelings, caregivers can start to feel isolated and overwhelmed, and without an emotional outlet, these unresolved feelings wind up being a one-way ticket to burnout.  

According to the Maslach Burnout Inventory (MBI), which has been recognized for more than a decade as the leading measure of burnout, the condition can be divided into three main components: 

1. Feelings of energy depletion or exhaustion 
2. Increased mental distance from one’s job, or feelings of negativism or cynicism related to the job 
3. Reduced professional efficacy, or feeling as if they’re not accomplishing anything at work 

While there are many ways to prevent caregiver burnout, supporting the mental and emotional health of caregivers is a crucial first step. 

How toSupport Grieving Caregivers 

There are multiple ways homecare agencies can support caregivers as they deal with loss.  

1. Acknowledge Grief: This may seem obvious, but it’s important that leadership acknowledge their caregivers’ grief. One of the reasons for disenfranchised grief is that caregivers feel they cannot publicly mourn because society doesn’t recognize patient death as a significant loss. Acknowledging their grief can help alleviate these feelings. This can be as simple as offering them your condolences and sympathy and asking how they’re holding up. This small act of kindness can go a long way towards making your caregivers feel seen and showing them that it’s okay to experience their feelings. 
2. Promote Self-care: Encourage employees to take a PTO day after they have experienced a loss. Small gestures like gift cards for activities they enjoy can help them take some time for themselves, prevent feelings of burnout, and show that you care about their well-being. 
3. Offer Grief Training: Consider providing caregivers with grief training that not only educates them on how to help their clients and clients’ family members navigate grief but gives them helpful tools they can use to better cope with these difficult emotions. 
4. Use an Employee Assistance Program: As part of their benefits package, some providers supply caregivers with an employee assistance program (EAP). These programs often include counseling services. By informing caregivers of the availability of these services, they can know where to turn to for professional support. 

Caregivers who feel respected, valued, and supported by their agency may choose to stay with that agency for many years instead of moving to a new job or changing industries. Not only will understanding and supporting your caregivers when they experience grief help prevent burnout, but it will also show them that their employer cares about their mental health and wants to create a great workplace environment.  

For more tips on caregiver retention, check out our Ultimate Guide to Caregiver Retention.