Working in long-term care means facing the reality of death and grief. It's a workplace hazard that can't be avoided because providing end-of-life care is essential to the job. While this care is deeply compassionate and important, it also exposes staff to the inevitability of loss.

It's crucial to remember that everyone grieves differently. There's no single "right way" to feel, and grief isn't always visible. We need to create a space where people feel comfortable expressing their grief without judgment or stigma. This includes recognizing that grief extends beyond the death of a resident. Significant changes in a resident's condition or their departure from the facility can also trigger feelings of loss.

Grief is a normal and expected part of working in long-term care. We can't expect staff to be immune to these feelings, nor should we want them to be. Ignoring or dismissing grief can have serious consequences for their well-being. It's essential to acknowledge, support, and validate the grief experiences of staff members.

Grief is the emotional, psychological and physical reaction to death or loss.

• Loss can also include significant changes in a resident’s well-being or because they move away from the long-term care home.
• Loss can also be associated with losing relationships with a resident’s family or loved ones.

Grief can cause a range of emotions

• Anger
• Sadness
• Depression
• Loneliness
• Hopelessness
• Numbness

Care aides are the backbone of long-term care, providing the most direct care to residents and forming close relationships with them. They are also on the front lines of a growing trend: long-term care is predicted to become the most common place of death for older adults. With approximately a quarter of all deaths already occurring in these facilities, care aides are constantly facing the reality of death and grief.

This constant exposure takes a toll. Grief is a psychological hazard in long-term care, impacting both physical and mental well-being and contributing to burnout. Expecting staff to become immune to these feelings is unrealistic, especially when they've developed close bonds with residents. The very nature of their role – building meaningful relationships to provide quality care – makes them more vulnerable to experiencing grief and loss.

It's crucial to recognize that grief in the workplace is not unprofessional. Staff will naturally have reactions to the death or loss of a resident, and these feelings should be acknowledged and supported. Just as they care for residents, they must also care for themselves and their colleagues. This means fostering a culture where grief is recognized, validated, and processed in healthy ways, ensuring the well-being of everyone in the long-term care environment.

Strategies

Acknowledging and recognizing grief as a psychological hazard enhances a workplace's psychological health and safety by acknowledging grief as a psychological demand of the work and promoting workers' psychological and social support (these are psych factors).  

• Acknowledge that your feelings are valid.
• Hold space for and acknowledge that other people’s feelings are valid, regardless of what they may look like to you or how you feel.
• Take time to reflect on your work's value and positive impact on people’s lives.
  • The honour of providing end-of-life care to someone
  • Creating a close bond with a resident that is like family
  • Feeling appreciated
  • Making a difference
  • Provide care and company to a resident so they are not alone
  • Providing good care
• Implement practices in the workplace to recognize the passing of a resident. This could include formal or informal debriefings, peer support gatherings, memorial rituals or services.
• Implement grief support for staff.
• Offer staff education and training on matters related to death and dying, and grief.
• Ensure staff are aware of resources available to them that can support them (i.e. Employee Assistance Program)
• Practice self-care at home and work.