Grief-Sensitive Communication: Patients, Families, and Care Partners
Be Mindful of Assumptions and Biases
Compassionate care begins with curiosity rather than assumption. In healthcare settings, as in life, interactions are shaped by personal experiences, cultural contexts, and identities. When assumptions and biases go unexamined, they can influence communication and care.
In the context of grief-sensitive care, this can affect how grief is recognized, understood, and supported, potentially limiting opportunities to fully understand what a patient, family member, or other care partner may be experiencing and what support may be most helpful.
“It’s just understanding that it's a unique experience and not going with any assumptions… you have to remain curious to understand what it is for that person.
In these videos, healthcare professionals Paola Ayora and Thejal Srikumar discuss the importance of recognizing individual, cultural, and contextual differences in grief experiences and how these differences can influence the ways people express, understand, and respond to loss.
Common Grief-Related Assumptions to Watch For
While there is no limit to the assumptions that may arise about another person's experience, it is important to recognize that every relationship, loss, and grief experience is unique.
The meaning of a loss and its impact are shaped by personal, relational, cultural, and situational factors that may not be visible to others.
The following examples highlight common assumptions that can unintentionally shape how grief is interpreted and supported, particularly in healthcare settings.
Relationship-Based Assumptions
Society often assigns value to loss based on biological or legal bonds. Depth of grief may be assumed for socially recognized relationships, such as an immediate family member or spouse, but minimized when the relationship is a friend or extended family member. Conversely, negative experiences linked to biological or legal connections may be overlooked.
Behavior-Based Assumptions
People have different ways of relating, managing stress, and grief styles. When someone appears composed, returns to work quickly, or remains high functioning, it can be easy to assume they are coping well or have “moved on.” However, grief is expressed in many ways. Someone who cries is not grieving more, and someone who stays busy is not grieving less. They are grieving differently.
Some people cope with grief in action-oriented ways. Instrumental grievers may immerse themselves in work by taking on additional shifts, roles, or responsibilities. In settings that equate productivity with wellness, this can be misinterpreted as “being over it.” Whether you're supporting a patient, colleague, or friend, remember that just as tears can express pain, so can action. Avoid assuming that productivity reflects an absence of grief.
Assumptions and Biases Can Be Insidious
Assumptions and biases can influence how grief is understood and responded to. They may shape expectations about how people should feel, behave, or relate to a loss, often reflecting personal experiences as well as broader social, cultural, and systemic influences.
When left unexamined, these assumptions can affect communication and care, contributing to experiences such as disenfranchised grief, when a loss is unacknowledged or unsupported, or suffocated grief, when expressions of grief are discouraged or punished.
Assumptions and biases may also influence how grief is interpreted across differences in identity, culture, age, or developmental stage. Reflecting on these influences can help healthcare professionals provide more responsive, grief-sensitive care.
Age-Based Assumptions and Biases
Children’s grief is often unintentionally minimized due to assumptions that they are too young to be affected by loss. In reality, children experience grief deeply, though it may be expressed through behavior changes, regression, emotional outbursts, or physical complaints rather than words.
Cultural-Based Assumptions and Biases
Grief expressed through culturally specific behaviors, such as loud crying, silence, or collective mourning, may be misunderstood or judged in clinical settings. Implicit bias can influence whether these expressions are viewed as appropriate, disruptive, or pathological.
Ability-Based Assumptions and Biases
Grief among people with disabilities is often overlooked due to assumptions that they do not understand loss or should be protected from emotional pain. But people with disabilities are fully capable of experiencing grief, though they may express it in diverse ways.
Education-Based Assumptions and Biases
Educational attainment can influence health, access to resources, and opportunities. While there is limited research on education-based bias in grief care, assumptions about a person's level of education may influence how their needs are perceived. Healthcare professionals may unintentionally assume that individuals with higher levels of formal education will understand medical information more easily or cope more effectively with loss.
Socioeconomic-Based Assumptions and Biases
Socioeconomic circumstances can shape how grief is experienced and expressed, but assumptions about financial status or social position may influence how people’s needs are perceived. Individuals facing economic strain may encounter additional stressors such as housing instability, job loss, or limited access to resources after a loss. Recognizing these structural pressures can help healthcare professionals respond with greater awareness and support.
Mentalization Can Help
Mentalization Can Support Culturally Responsive Care
Assumptions and biases can be especially problematic in interactions that cross cultural lines.
Because grief is shaped by cultural values, lived experiences, and individual meaning-making, responses to loss may not align with dominant expectations or clinical norms.
Healthcare professionals are not expected to know the grief norms and practices of every culture. Not only is that not possible, there are also many individual differences within any culture, group, or population. Instead, cultural humility offers a guiding framework.
Cultural humility is the ongoing practice of self-reflection, curiosity, and respect for others’ lived experiences and cultural identities. It involves recognizing one’s own assumptions and biases, actively seeking to understand others’ perspectives, and adapting care accordingly.
Cultural humility involves a willingness to learn directly from patients and their supporters and to consult colleagues, chaplains, or trusted resources when needed. In practice, grief-sensitive care demonstrates a curious, collaborative, and critically conscious approach that sees unique value in what patients have to offer, resisting assumptions and, instead, asking open-ended, respectful questions:
Can you share what this loss means for you and your family?
Are there cultural, spiritual, or family practices that are important for us to know about right now?
How is grief usually expressed or supported in your family or community?
What would feel most helpful or respectful during this time?
Who else should be involved in supporting you?
Approaching each interaction with openness and curiosity can help healthcare professionals better understand individual experiences and provide more responsive, culturally attuned support.
From Assumptions to Curiosity
Assumptions and biases are a natural part of human thinking, but when left unexamined they can influence how grief is interpreted and responded to in clinical settings. What matters is noticing these patterns and reflecting on how they may shape communication and care.
By pausing, reflecting, and approaching interactions with curiosity and openness, healthcare professionals create space for patients, families, and supporters to define their own grief. This can help foster respect, trust, and safety while supporting more responsive and equitable care.