Louise Montgomery, Denton, Maryland: I work with Palliative Patients at my center, most of which are elderly, I have a difficult time with people I have grown attached to. Please tell me how to help myself as well as other staff with grieving.

Answer: We have tried to address caregiver suffering in several ways at the Children's Center. We initiated educational forums in order for staff to build their knowledge, skills and comfort level in providing palliative care. We also offer bereavement debriefing sessions after the death of each patient in order for staff to express their personal and professional responses to the death, and to review ways to support themselves and each other. We also offer opportunities for meaning-making which can be healing: an Annual Tribute service to honor patients and a candle lighting service for staff. Some people find it helps to develop their own personal rituals, or rituals for a particular unit, such as holding a moment of silence at a staff meeting or making a donation in memory of the patient. Health care professionals face multiple losses and everyone responds to grief in their own way. Offering a variety of opportunities seems to be an effective way to provide support.

Scott Jay Regner, Nottingham, Maryland: Very good article, very beautiful and very human. My question is, are there courses of study and a career path for those who wish to work in the field of caring for the terminally ill?

Answer: There are many meaningful ways to provide care for the terminally ill. Health care professionals can specialize in palliative or hospice medicine. Counseling programs for social workers, counselors and chaplains would offer courses related to end-of-life care and grief. If you have a particular interest in working with pediatric patients, child life specialists focus specifically on children's development and supporting patients and families through illness or traumatic injury. Some of the websites listed as resources in the article have excellent educational materials through their sites.