Can Common Sense Be Written Down?
The Adult Bereavement Care Pyramid
In the previous post Why Should We Research Grief I laid out the reason for why I believe research into to grief and bereavement is an important area to study. I followed it up with a post that broke down a research paper on parental grief How a Landmark Study Sheds Light on Parental Grief. In this post I am going to review a framework called the Adult Bereavement Care Pyramid (ABCP). This has been developed by the Irish Hospice Foundation.
The ABCP
A framework is a structured model that provides guidance and a shared understanding for addressing a complex issue such as grief and bereavement. In the absence of a national policy, The Irish Hospice Foundation facilitated national collaboration to create this framework. Over the last 6 months I have had several meetings with academics who have referred to the ABCP. This suggests that it is gaining recognition and a certain level of acceptance as a useful tool in applying what we know about grief.
Upon first inspection the framework may not appear to be a radical document. If anything, one could claim it is full of common sense. As one of the oldest cliché comments claims “Common sense is not always common”. What the framework is trying to do is to take accumulated knowledge, experience, research and best practice in a form that can be applied to a population through multiple organisations. Institutions often have inspiring mission statements, but in reality, their priorities don't always align with their stated goals. Internal policies and procedures can sometimes overshadow their core purpose.
Imagine someone struggling after the loss of a loved one. They're forced to navigate a maze of organisations, each with its own priorities, just to find the support they desperately need. The Adult Bereavement Care Pyramid has been designed to be a tool for understanding and supporting those who are grieving. It has a structured approach, with tiered levels of need, that helps caregivers assess and respond to the varying levels of support required. This ensures that individuals receive the appropriate help, whether it's basic comfort and information or more specialised grief therapy.
The pyramid is an attempt to create a shared understanding of bereavement amongst healthcare professionals, social workers, volunteers, and families. This common language encourages collaborative working and a consistent approach to care. By recognising the complex nature of grief, the pyramid promotes a holistic approach, considering emotional, social and practical needs. Ultimately, it is trying to enable compassionate and effective support for bereaved individuals.
What's more, this shared understanding has the potential to move beyond the support services to the large institutions and organisations that we all must interact with. In Australia, this could include health funds and super funds (Australia’s equivalent to a pension or 401(k) plan) which provide most of the health, income protection and life insurance to Australian workers. How they view and assess grief, and bereavement will go some way to improving outcomes for their policyholders. Finally, federal and state governments, who determine statutory bereavement leave, can play a crucial role. Well-designed leave entitlements can significantly alleviate the burden on those most deeply affected by grief. I have summarised some of basic ideas from the ABCP below along the actual graphic.
Summary of the ABCP
This graphic above is a summary of the ABCP. This framework provides a clear structure for categorising different levels of grieving “needs” and suggests appropriate support strategies.
At the base of the pyramid, we find the universal needs of all bereaved individuals: compassion, acknowledgement of loss, and basic information. As we move up the pyramid, the level of need increases. Some individuals may require additional support outside their immediate network, such as peer support groups or contact with a GP. Others may need more intensive support, like counselling or therapy. A smaller number may require specialised grief support from mental health professionals. As you can see from the diagram it is not expected that many people would find themselves at the top of the pyramid. That said it is not too hard to imagine if you have lost a child, sibling or spouse (at a young age) that you would find that you grief would manifest itself to in such a way that would place you nearer the top of the pyramid in the days and months after your loss.
Conclusion
The ABCP is an excellent foundation to start to address how society views and assists grieving individuals and families. Death is a difficult subject to face but most of us will all lose someone precious to us before we finally slip off this mortal coil. We all have skin in this game and would all benefit from a grief and bereavement support system that would be able to be a positive force in the most arduous of human experiences.