Core Concepts for Grief-Sensitive Care

Grief can affect cognitive functioning in a range of ways. 

Changes in memory, concentration, and decision-making can occur during grief, sometimes described as a sense of “brain fog.” Because these cognitive responses are not always expected, individuals may worry that something is wrong or that they are not coping “well enough,” which can contribute to confusion, self-doubt, or increased distress.

While unsettling, these cognitive changes are generally understood as a common and expected responses to loss. 

Research suggests that grief is associated with changes in brain activity, particularly in regions involved in emotion and memory. Neuroimaging studies suggest that grief is associated with changes in brain activity and cognitive processes, including altered activation in regions involved in emotional processing, memory, and attachment. These changes are understood as part of the brain’s response to loss. 

Emotional and psychological distress in serious illness has been associated with difficulty understanding and recalling medical information, which can affect communication and participation in shared decision-making. These changes may be important for healthcare professionals to recognize when supporting patients and supporters.

Practices such as using the teach-back method to check understanding and including family members or other supporters in communication, particularly in serious illness or end-of-life contexts, can help build shared understanding and align care with the person’s values and experience. 

These approaches reflect well-established principles of patient-centered care. In the context of grief, applying these principles can be especially important.