Grief Map

This is an introduction to a triage tool which is currently being piloted. As the findings emerge, the tool and its indications for practice will be reviewed. When the study is completed, a final version of the Grief Map will be included on the Resources page for wider practice use.

The Grief Map. There is a growing impetus in the bereavement care sector to distinguish different levels of grief in order to deliver appropriately targeted care. The Grief Map is a measure which identifies a person’s grief, in the span from resilient to vulnerable, and locates that diversity in a tiered model of need to determine a suitable level of support. 

Background. The two-dimensional Range of Response to Loss model1,2 which identifies core grief reactions and vulnerable to resilient coping responses, all shaped by past and present psychosocial influences, has previously been used for developing a 14 item Bereavement Needs Assessment scale (BNA 20103). This was followed by a study to gauge its effectiveness (20144). The BNA was used to provide both a quantitative score and elicit a qualitative profile of individual coping responses. Together these two functions enabled a targeted, needs-based intervention to be offered.  

Rationale. To respond to the growing practice focus on matching needs and interventions, the Grief Map is designed as a shorter version of the BNA. It is also based on the Range of Response to Loss model and uses the same principle of paired resilient and vulnerable statements to capture the dimensions in which a person’s grief might be difficult and the areas of positive coping capacity.   

Design of the Grief Map. The Range of Response to Loss domains – core grief reactions, coping responses, psychosocial influences – form the basis of the Grief Map which consists of:

  • Paired resilient and vulnerable statements
  • A five-point scale to indicate the closest point of fit to experience
  • Grief map responses (both quantitative and qualitative) can be used to locate need and proposed support within the tiered structure of needs-based bereavement care model
  • The preface to the scale for bereaved service users:

Grief has many different distressing and confusing faces – from the range of emotions, like sadness, fear, regret, anger etc., to intense thoughts, about the past, the death of ………… and the future without them, to all the social and practical changes which must be made after a death. The ‘Grief Map’ is a way to help untangle these many aspects of grief by looking at them separately. Hopefully this will help you to understand the ways in which ………… ‘s death is affecting you. It will also help us to see what kind of support might be most appropriate for you.

Using the Grief Map to identify tiered levels of need and matching support:

Emerging Results

The Grief Map pilot is still in progress but early indications are:

  • It is well received by practitioners and bereaved people
  • It sets out pertinent grief domains
  • The focus on strengths as well as challenges is welcomed
  • It permits a matching of need with an appropriate level of intervention

Thanks to participants in the pilot

Sue Ryder Care, UK; St Joseph’s Hospice, Hackney, London; Helen and Douglas House, Children’s Hospice, Oxford; LauraLynn Ireland’s Children’s Hospice, Dublin.

References

  1. Machin, L. (2001) Exploring a framework for understanding the range of response to loss; a study of clients receiving bereavement counselling. Unpublished PhD thesis: Keele University, UK.
  2. Machin, L. (2009/ 2014) Working with Loss and Grief. London: Sage.
  3. Relf, M., Machin, L. and Archer, N. (2010) Guidance for Bereavement Needs Assessment in Palliative Care. (2nd Edition) London, Help the Hospices.
  4. Brocklehurst, T., Hearnshaw, C. and Machin, L. (2014) Bereavement needs Assessment – piloting a process. Progress in Palliative Care Vol 22 Issue 3, p. 143- 149.