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Perspectives on Care at the Close of Life: CODA
February 20, 2002

Caring for Bereaved Patients: "All the Doctors Just Suddenly Go"

JAMA. 2002;287(7):882. doi:10.1001/jama.287.7.882

On September 19, 2001,1 Holly G. Prigerson, PhD, and Selby Jacobs, MD, MPH, introduced Mrs A, a 77-year-old widow of 2 years whose husband, a well-respected public figure, died of renal failure after a protracted course of diabetes and heart disease. Exploring Mrs A's trajectory of grief and the reconstitution of her life through community involvement, her continuing personal relationships, and political activism, they distinguished normal from complicated—ie, pathological—grief reactions and recommended approaches for physician interactions and communication with bereaved patients. The authors reviewed the evidence of benefit for social support, skill building, active daily routines, and narrative disclosure by bereaved patients. Finally, Drs Prigerson and Jacobs offered suggestions for professional intervention with bereaved patients and guidelines for psychiatric referral of complicated cases.