Providing more than the minimum for the primary bereaved

Published on Sep 20, 2021

Where hospice care ends, often the greatest struggles are just beginning for those who are left behind to pick up the pieces after their loss. While hospice bereavement teams provide grief support based on Medicare requirements and the individual agency’s capacity for bereavement care, the assistance needed in the days, weeks, months, and years following the death of a loved one can be complex and diverse. Empathy can help hospices support grievers after the patient has died through those areas that pose the greatest difficulty in the grief journey. 

Hospice support after the death of a loved one

Hospice agencies around the country provide bereavement care to the primary bereaved family member of each patient for no less than thirteen months after the patient’s death. Medicare’s Conditions of Participation (COPs) require this support in order for a hospice to receive reimbursement for the hospice care provided to the patient. While this requirement is therefore standard across the board for all hospices that receive reimbursement through Medicare, the quality and depth of bereavement support offered varies greatly from hospice agency to hospice agency.

Medicare’s COPs provide a general outline for bereavement teams in regard to the baseline care that must be provided to the primary bereaved individual, but each hospice agency must then decide what level of support services is within its capacity. This makes grief support dependent on what the hospice can offer, rather than what the bereaved individual needs, and grievers often feel unsupported in the way their specific grief requires.

Care provided through hospice agencies can be as simple as a single standard letter mailed out to the primary bereaved—and for some, that is enough. Individuals who require little to no grief support following the death of a family member are considered to hold “No Grief Risk.” However, the No Grief Risk category is relatively small; all other grievers fall into Low, Moderate, or High Grief Risk categories. All of these require more care than a letter, but their needs are highly varied, and it can be difficult for a hospice agency to accommodate so many different kinds of grief.

Providing this varied level of care depends greatly on each hospice agency’s capacity to bring in qualified staff who have the training and ability to support individuals in grief. While grief is a universal experience, the death of a loved one can bring up very individual feelings of loss and despair that require support and education to work through. 

In addition to deep feelings of grief, those experiencing the death of a loved one are also often faced with managing the affairs of their deceased family member, a responsibility that many individuals struggle to navigate without guided support. In particular, the person named executor of the estate has a huge list of tasks that must be navigated within a designated amount of time. Many times, an executor is taking on this role for the first time, and there is no straightforward roadmap to assist them.

According to, “It typically takes an executor over 500 hours of effort on average to settle an estate. In general, the more valuable the estate, the more effort required, although the data indicates an unexpected spike of effort in the $50-$250K range. Roughly 80% of estates are settled with <800 hours of executor effort.”

From obtaining death certificates to dealing with the Social Security Administration, bereaved individuals often feel lost as they sift through the many items on the “death to-do list.” This role can be overwhelming and stressful, especially for an individual who is also grieving.

“In most cases, if you are named as executor of someone’s estate, they are a family member or close friend. So, in addition to taking on the role, you’ll also likely be dealing with grief,” writes an author on ”Grief not only makes us sad, but also can make us irritable, anxious and unable to concentrate.”

Providing customized grief support with Empathy

There is no question that if each individual hospice agency had unlimited resources at its disposal, customized grief support would be offered nationwide. The inability to provide custom care does not come from an unwillingness to provide it—individuals who work for a hospice agency generally do so because they believe in the work deeply—but rather limited capacity in terms of budget and staff availability.

In response to the rising and varied needs of the grieving community, the Empathy app offers a tailored, supportive approach that walks individuals through the many aspects of grief, from the pragmatic to-do list to the emotional support that is especially needed once the bulk of that to-do list is finished. Empathy meets the bereaved where they are, both emotionally and practically, by providing them with support, guidance, and information, giving families the assistance they need most at the moment, in a simple, easy-to-use application.

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