“After doing this for 20 + years, I've lost many residents. It never gets easier to deal with. You're human and it hurts to lose someone you cared for!

I try to attend any funeral services for my residents.” Quote from a Certified Nursing Assistant

One of the things we believe is that by honoring the humanity of the worker and empathizing with the difficulties of their job that we are able to inspire those workers to find empathy within themselves and for the people they work with. But in some areas, we as a society are failing to support caregivers and to be empathetic about what their needs are. 

Caregivers are out there on the frontline. They show up to work and form deep bonds with the residents they care for. They are the ones spending all day with them. We want them to bring empathy to work but we don't pay attention to what that means for them. If they truly become empathetic and then that patient dies it can be devasating to the caregiver. Often the beds are filled almost immediately giving the caregiver very little time to grieve. Caregivers provide care but we rarely pay attention to the effects of death on their lives. Both in the institutional setting as well as in home care, bereavement support services for staff are widely lacking. In fact, it has been noted that issues around resident death and dying tend to be avoided in residential elder care settings.

72% of long-term care staff reported experiencing at least one grief related symptom in the past month. Grief symptoms affect not only the staff members themselves but residents as well. Thirty six percent of staff members stated that the death of a resident impacted their relationships with other residents. Furthermore, complicated grief (i.e. debilitating feelings of loss that do not improve over time) among Certified Nursing Assistants (CNAs) has been found to be significantly related to depersonalization of residents including more emotional hardening and impersonal feelings towards residents

Involvement in post-mortem care, in the most positive case, can be an appreciated opportunity to be there for the resident and to say goodbye. However, the less positive and more frequent scenario was an apparent lack of guidance and rituals around the post-mortem care, which left some CNAs with the sense of a rather overwhelming experience and the perception that common practices are lacking in respect and dignity for all involved. 

Better training, preparation, guidance and support in the context of post-mortem care and body removal would be important especially early in a CNAs work experience as initial patient deaths can be formative and have an impact on future responses to death.