Finding Support After a Cancer Death

This page is for people grieving someone who died of cancer. It covers the bereavement help already available to you, what normal grief looks like, help for children, and the paperwork that follows.

If hospice was involved, bereavement support is part of what Medicare requires of the hospice. Medicare rules require a hospice to do three things:

1. Run an organized bereavement program under the supervision of a qualified professional.
2. Write a bereavement plan of care setting out what will be offered and how often.
3. Make those services available to the family, and to others in that plan, for up to one year following the death.

Ask the hospice whether any cost applies to the family.

That year is easy to lose. You may be numb in the first weeks and busy with paperwork. If you did not answer early contact, ask the hospice whether you can still use its services.

Ask for the bereavement coordinator by name. Ask what is actually on offer. It might include:

• Individual counseling
• A group for spouses or for adult children
• Memorial services
• A program for grandchildren
• Phone check-ins

Ask whether they serve people whose relative did not die with that hospice.

Many people die in the hospital, or at home without hospice. Some die after treatment stopped working faster than anyone expected.

Ask the palliative care team, the oncology social worker, or the cancer center's supportive care department what bereavement follow-up they run. Some cancer centers may have their own programs. It may also be worth calling a local hospice, even if your person was never their patient, to ask what it offers the community.

NCI's summary is useful precisely because it refuses to be tidy. There is no typical grief response. For most people, symptoms lessen somewhere between about six months and two years.

Grief is not a staircase. Waves come back on birthdays. At the smell of a hospital corridor. When a song plays in a supermarket.

What warrants an assessment is not intensity. It is persistence, and loss of function. NCI describes complicated grief as symptoms that do not improve, last a long time, cause extreme distress and affect several areas of life.

In practice, ask yourself whether you are eating, sleeping, working and speaking to anyone. Then ask whether that has been true for months rather than weeks. NCI says lack of social support raises the chance of problems coping with a loss. It also says people who feel life cannot be controlled are more likely to have complicated grief after an unexpected loss.

Treatment exists. NCI describes a study in which people treated with cognitive behavioral therapy (a talking therapy that works on thoughts and habits) improved more than people in a counseling group. For depression that comes with grief, NCI says antidepressants give less relief and take longer to work, and that therapy alongside them can ease depression and the intensity of grief.

Is anyone in the family thinking about not wanting to be here? Call or text 988 for the Suicide and Crisis Lifeline, which is free and open 24 hours a day. Call 911 in an emergency. That is not an overreaction.

The American Cancer Society says children of all ages go through grief, sadness and despair after losing a loved one. Ask the hospice, the cancer center's social worker or your child's doctor about grief support for children and teens. It can also help to tell school counselors what happened.

The American Cancer Society says support can come from family, friends, support groups and community organizations. It says grief counseling gives people a safe place to share and work through emotions, and that being with others who have lost someone can help you feel less alone.

• Ask the hospice, palliative care team or oncology social worker about local groups and counselors.
• Call or text 988 for the Suicide and Crisis Lifeline if anyone is in crisis.
• Dialing 211 can connect you to local help; check what your area offers.

Grief and administration arrive together, which is its own cruelty.

Ask the hospital for an itemized bill and check it before paying.

If bills or collection letters become a problem, ask the hospital's billing office or social worker about financial help and who can review the bills.

Consider asking one person you trust to handle mail and phone calls for a few weeks.

• Centers for Medicare & Medicaid Services — Medicare Benefit Policy Manual, Chapter 9: Coverage of Hospice Services
• National Cancer Institute — Grief, Bereavement, and Loss (PDQ), Patient Version
• Code of Federal Regulations, 42 CFR 418.64 (hospice bereavement services)
• American Cancer Society — Coping With the Loss of a Loved One
• 988 Suicide and Crisis Lifeline