The Desirable Approach to Sending Letters and Cards and Holding Memorial Services: Recommendations for Bereavement Care in Hospice and Palliative Care Unit Settings

BackgroundBereavement care in hospice and palliative care settings commonly includes sending letters or cards to bereaved family members and holding memorial services; however, this practice varies widely across facilities and has not been explored in past research in the Japanese context.ObjectiveThis study examines the current practices and bereaved family members' evaluations of letters, cards, and memorial services in hospice and palliative care units in Japan.MethodsA nationwide retrospective survey was conducted as part of the J-HOPE4 study using self-administered questionnaires mailed to the bereaved family members of patients who died in participating palliative care units.ResultsAmong the 563 respondents, 59.9% had received letters and cards. The most positively evaluated content included expressions of appreciation for care during hospitalization, concern for the family's life after discharge, and messages reflecting the patient's personality. The actual and preferred sending times were largely aligned. Only 9% attended memorial services; the key reasons included the desire to meet or talk with clinicians and expectations of emotional comfort. Respondents preferred services that involved opportunities to interact with staff and events that offered emotional support.ConclusionBereaved family members value individualized letters and cards that acknowledge the patient and family context. Although participation in memorial services was low, attendees sought emotional processing and reconnection from clinicians. These findings highlight the importance of individualized relationship-based bereavement support in palliative care.