The period of bereavement is a stressful life event for anyone. Each person will experience bereavement in different ways and reactions to bereavement are strongly influenced by culture and ethnicity. Most bereaved people are able to overcome their grief, but in about 10% of cases grief is prolonged or complicated.


Symptoms of complicated grief include preoccupation with thoughts of the deceased, crying, disbelief and feeling stunned by the death. Sometimes, complicated grief can be present with delayed grief or absence of grief. Such symptoms are present for at least six months. With prolonged grief, a sense of hopelessness will also develop. Somatic symptoms such as a headache, chest pain or palpitations may also be features of complicated grief. In elderly it will take even more time to recover from the grief. Hence, whenever elderly patients present with multiple somatic complaints following a loss, it is important to recognize the possibility of underlying depression.

Grieving elderly tend to find it difficult to ask for help, even from close family members. There is also a tendency for family members to dismiss these psychological symptoms and underestimate the severity of the distress. It is therefore important for primary care person to be proactive and to regularly check on the elderly bereaved person's condition after the death of a family member.

They need to be prepared and develop ways to identify those at risk of bereavement-related problems, especially psychological morbidities such as depression. Family physician plays a crucial role in identifying risk factors for abnormal grief. Among the risk factors that contribute to complicated grief and which need to be recognized early are old age, caregiver stress, low socioeconomic status and poor social support. Assessment should include identifying the needs of family members, either in the form of bereavement support or counseling. The use of bereavement protocol may also be beneficial in the high-risk groups such as the elderly.

If you wish to discuss a particular case or have a question in this regard, please call Ms Mona/ Ms Lakshmi at +91 99800 67000 or +91 80 2258 6700 or drop a note to her at We will be happy to help!