Below, you can find answers to questions commonly asked about when a loved one is near the end of their life or has recently died.
Grief and Mourning
What is grief?
Grief is one's emotional reaction to the loss of someone or something meaningful to you. A meaningful loss may include a person, animal, place, a way of life, or good health.
Grieving is the process of emotional adjustment a person goes through after experiencing a loss. Grieving a loved one who has passed is also known as bereavement.
What is mourning?
The expression of deep sorrow for someone who has passed away is known as mourning. Mourning is also used to describe the cultural behaviors in which loved ones of the person who has died participate, or are expected to participate, in, such as wearing black clothes or not cooking for a certain length of time.
Support and Resources
What is palliative care?
Palliative care is specialized medical care for people with serious illness. Palliative care is not hospice and can start at any stage of illness. Palliative care is holistic care that incorporates the person’s spiritual, emotional, and psychosocial needs, as well as their loved ones. It focuses on relieving symptoms of pain and other physical symptoms, to improve the patient and family's quality of life.
Palliative care is often used with other medical treatments and is provided by an interdisciplinary team that includes physicians, nurse practitioners, social workers, chaplains, and other supportive areas.
What is hospice?
Hospice is a philosophy of care that provides comfort and relief of pain and other symptoms for patients with a terminal illness, with a prognosis of six months or less as determined by the patient’s primary care provider and /or specialists who care for the patient.
Hospice focuses on helping patients and their families live the best quality of life that they can, spend quality time together, and manage the patients' symptoms. Hospice also provides emotional, spiritual, and psychosocial support to patients and their families. Hospice services can be provided in the home, nursing facility, hospital, or in a designated hospice house.
Medicare Part A, Medicaid, and most private insurance plans cover hospice care. However, it is always best to speak with your loved one’s physician or care team to discuss further.
How do I find a support group?
If you are searching for a support group to attend after experiencing a loss, speak directly with your physician or social worker to get information about possible local resources and support groups in your area.
Keep in mind that some support groups are specific to a certain type of loss (such as the death of a child), while others may be more generalized to different types of grief— it’s important to consider what may feel best for you.
Funerals
When my loved one is dying, how do I make arrangements?
If your loved one is dying and is a patient at Boston Medical Center, you can ask for help with this process from the social worker or case manager on the inpatient unit where your loved one is located. You can also begin contacting funeral homes who will speak with you about funeral arrangements and suggest the next steps that you should take.
If your loved one is at home with hospice or in another facility, you can ask the professionals working with your loved one for assistance with preparation for a funeral or suitable memorial.
How much does a funeral cost?
Funeral costs vary widely. Many families turn to a funeral home when planning a funeral. If you have not chosen a funeral home ahead of time, the Massachusetts Funeral Directors' Association can give you information on funeral homes in your area. They can be reached at 781.335.2031. A friend, family member or a member of the clergy may also provide you with a reference to a local funeral home.
Families interested in offsetting costs may seek out local memorial societies, which are membership groups that can help with planning and support, and may offer low-cost alternatives. You can also ask any funeral home whether they offer “sliding-scale” services for those with financial limitations. Some insurance companies also assist with funds toward funerals and burials. Please call your loved one's insurance provider directly to see if this is a possibility.
Making Medical Decisions
What is an advanced care directive?
An advanced care directive involves designating a health care proxy and determining a patient or family's "code status choice" as it reflects that patient's care goals and ultimate goals of care. In short, it lays out a person’s wishes if they can’t make medical decisions for themselves and tells the care team who should make decisions in that case.
Ideally, an advanced care directive is created before a patient needs intensive medical care so that their wishes regarding end-of-life decisions, autonomy, and resuscitation methods can be honored.
What is a health care proxy?
A health care proxy is an individual (often a family member or close friend) who the patient designates as their surrogate medical decision maker. A health care proxy should have had previous discussions with the patient or know the patient well enough to represent the patient's wishes.
The health care proxy is activated when the patient is deemed to be unable to make their own medical decisions. This can be in cases where the patient is too sick or their providers are concerned that the patient lacks capacity to make informed medical decisions. The best decisions a health care proxy can make are the ones that best reflect what the patient would choose for themselves if they were able to do so.