Introduction      One of the most meaningful acts you can do for a mourner is to write a let­ter of condolence. The words of sympathy and memory can be comforting to the bereaved.  More importantly, mourners may appreciate that you took the time to sit and com­pose a personal message and/or share a memory of the deceased. For professionals who work with dying patients, writing a condolence letter is an opportunity to reflect on both the pain and the rewards of our work.  When we pause to appreciate the privilege, it is to bear witness to the courage, kindness, and dignity that our patients and their families exhibit under duress, we may find our work to be more sustainable and rewarding.

Writing a good condolence letter:  A condolence letter should have two goals: to offer tribute to the deceased and to be a source of comfort to the survivors. The best letters are like conversations, as if you were talking during a visit. Most often, they are written to the bereaved person to whom you feel closest, although it could be a general letter to all family and friends. It should be written and sent promptly, generally within two weeks after the death. Additionally, some care teams have sent condolence letters on the anniversary date of the patient’s death which have been positively received by families. Use any standard stationery and write it by hand. Here are some guidelines for writing a good condolence letter:

• Acknowledge the loss and name the deceased. This sets the purpose and tone of the letter.  Let the bereaved know how you learned of the death and how you felt upon hearing the news.  Using the name of the deceased can be a comforting tribute for mourners. 
• Express your sympathy. Use words of sym­pathy that remind the bereaved that they are not alone in their feelings of sadness and loss. 
• Note special qualities of the deceased. Acknowledge those characteristics that you cherished most about the person who has died. These might be qualities of personality (courage, sensitivity), or attributes (funny, affable), or ways the person related to the world (religious, devoted to community welfare).
• Recall a memory about the deceased. Talk about how the deceased touched your life. Try to capture what it was about the person that you remembered, appreciated, or respected. You may use humor – the funny stories are often appreciated by the bereaved.
• Remind the bereaved of their personal strengths you have witnessed. Bereavement often brings with it self-doubt and anxiety about one’s own personal worth. Qualities to mention might be patience, optimism, religious belief, resilience, and competence. If you can recall something the deceased used to say about the mourner in this regard, you will really be giving the bereaved a gift.  An example: “I was (impressed, inspired, awed, strengthened) by the devotion you and your family evidenced during the period of Mort’s illness. Your presence (concern, care, attentiveness) was only one indication of your love for him.” 
• If you are going to offer help, be sincere and specific. “If there is anything I can do, please call” can put a burden on those in grief who may be totally at a loss about what needs to be done. A definite offer of help is more appreciated. Whatever you offer, do it – don’t make an offer you cannot fulfill.
• End with a word or phrase of sympathy. Somehow, “sincerely,” “love,” or “fondly,” don’t quite make it. Try one of these: “You are in my thoughts and prayers.” Or “My fond respects to you and yours.”

Sympathy notes:  If you can’t write a formal condolence letter, you may prefer to send a sympa­thy note. These are shorter communications that can be written on personal stationery, team stationery, or added to a commercially available card.  Many care teams have implemented bereavement rounds where individual members of the interdisciplinary team each sign and leave short messages to the same sympathy card to convey the condolences of all the clinicians involved in the deceased’s care.  As with a formal condolence letter, the major goal is to tribute the deceased and comfort to the bereaved.

Reference

1. Wolfson, R. A Time to Mourn, A Time to Comfort. Woodstock, VT: Jewish Lights Publishing; 1993: pp 223-226.
2. Goebel S, Mai SS, et al.  Family members of deceased palliative care patients receiving bereavement anniversary cards: a survey on the recipients reactions and opinions. BMC Palliat Care 2017; 16:26.
3. Takaoka A, Vanstone M, et al.  Family and clinician experiences of sympathy cards in the 3 Wishes Project.  American Journal of Critical Care 2020; 29(6):422-428.

Version History:  This Fast Fact was originally edited by David E Weissman MD.  2^nd Edition published July 2005; 3^rd Edition May 2015. 4^th Edition December 2023.