Jan 11, 2024 | Advocacy, Federal Government
Evermore Submits Comments to AHRQ on Interventions to Improve Care of Bereaved Persons
Bereavement’s long-standing absence from public policy debates and national health priorities, along with its newfound urgency, requires sound leadership and an aggressive agenda to address the substantial challenges confronting our nation’s grieving population. Today, America lacks a comprehensive, coordinated, and evidence-based bereavement care system that is protective and mitigates bereavement’s harmful effects across time and place. As a result, bereavement has major spillover effects at every stage of the life course, especially in the first two decades of life (for children and youth) and in mid-life (when family formation, child-rearing, and employment peak).
However, bereavement as a public concern is in its nascent stages and thus offers an unparalleled opportunity to leverage existing public and private healthcare initiatives to go “upstream” by delivering effective preventive services to stem the onset of chronic or debilitating health conditions associated with bereavement.
For example, in one 2020 register-based study examining the entire Norwegian population from 1986 to 2014, researchers found evidence of elevated alcohol-induced mortality among bereaved parents. Based on this evidence, healthcare providers should invoke existing quality alcohol misuse screening tools for bereaved parents to stem the short- and long-term ramifications of alcohol misuse following the death of a child. According to the U.S. Preventive Services Task Force (USPSTF), unhealthy alcohol use screening among adults aged 18 presently receives a B rating. Healthcare providers attending to newly bereaved parents can identify the patient’s risk for developing alcohol misuse while also preventing the onset of addiction and reducing premature mortality. Evidence-based tools for grief and bereavement may be lacking, but alcohol misuse evidence-based resources are not.
Read the full letter..
Dec 10, 2023 | Advocacy, Data Collection, Federal Government
Federal Government Requests Comments on Interventions to Improve Care of Bereaved Persons
In 2023, and as a result of your hard work, Congress directed The Agency for Healthcare Research and Quality (AHRQ) to establish an evidence base for what constitutes high-quality bereavement and grief care. This systematic review will inform an independent subject matter expert panel that will assess the feasibility of developing consensus-based quality standards for high-quality bereavement and grief care.
AHRQ is seeking comments from the public for a limited time. Outlined below are AHRQ’s initial findings and how you may submit your comments directly. The deadline for public comment is January 11, 2024!
Background & Objectives
Bereavement – the state of having lost someone – and grief – the emotional response to the loss – are fundamental aspects of the life course and most individuals will experience the loss of someone during their lifetime.1 In recent years, a growing number of individuals report experiencing grief and bereavement, due to both better identification of grief and grief-related needs, as well as a large aging population, the COVID-19 pandemic, and more frequent mass trauma events. Emotions related to grief can include feelings of deep sadness, longing, and shock.2 There are a range of interventions to support individuals through their grieving process, ranging from informal supports (e.g., online resources, pamphlets, bereavement support groups) to formal supports such as individual and group therapy. Most individuals experience acute grief without formal intervention, yet a small subset of individuals develop complicated grief or grief with a high level of distress that extends 6 to 12 months following the death.3-5 This type of grief was named prolonged grief disorder by the WHO and included in the ICD-11 in 20186 and classified as a formal disorder in the DSM-V TR in 2022.7 Symptoms of prolonged grief disorder include persistent longing for the deceased person, difficulty accepting the death, emotional pain, and feelings of bitterness.8, 9 In addition, recently bereaved individuals face higher medical risks as well, including increased risk of morbidity and mortality,10-13 suicide,14, 15 and lower functional status and quality of life.10, 16
There are a range of decisional dilemmas related to the screening, intervention, and follow-up of bereaved individuals for grief and grief-related needs over time. Broadly, there is ongoing debate about the “medicalization” of grief and its characterization as a disorder. Potential consequences of this medicalization of grief include the overdiagnosis, overtreatment, and the loss of traditional and cultural methods of adapting to the loss of a loved one.17 Then there are important questions related to the appropriate screening of bereaved individuals, or those who may become bereaved, to identify and intervene on maladaptive grief responses, such as prolonged grief disorder. In general, mental health services for bereaved individuals, especially bereaved individuals who are caregivers to individuals at the end of life, are considered to be underutilized.18 The public health model for bereaved individuals focuses on identifying and supporting three groups: a) the bereaved population as a whole (universal approach), b) individuals who may be at risk for prolonged grief disorder (selected approach), and c) individuals who have signs or symptoms of a grief disorder (indicated approach).19 Some argue that a universal approach to screening may overlook some individuals who need more tailored support, while engaging other individuals who may not need intervention.20 In contrast, a selected or indicated approach may overlook the opportunity to support and intervene a wider group of bereaved individuals who could benefit.
Related to approaches to identifying and supporting bereaved individuals is the timing of screening and intervention. A variety of factors are related to the grieving processes that make it challenging to determine the most appropriate time to conduct screening. Bereavement processes are unique to each bereaved individual and the trajectory is cyclical, rather than staged.21, 22 The type and circumstances of death (e.g., expected vs unexpected), preparation for the death, awareness of prognosis, acceptance of death, and readiness to engage in bereavement can all play a role in grief processes and timing. While proactive and early screening provides an opportunity for early intervention during the normal bereavement process, screening that comes too early in an individual’s bereavement process may at best be ineffective, and at worst, create undue distress and anxiety. In contrast, screening that happens later in the course of bereavement may miss a window of opportunity for intervention.
In general, clinicians feel that bereavement screening could be useful yet there are various contextual barriers to implementation in health care settings.23 Many bereaved individuals have time-limited contact with the healthcare system in the context of their loss and typically only if their loved one dies in a healthcare setting such as in a hospital, intensive care unit, emergency room, nursing home, or hospice. This limits opportunity for screening and intervention as well as consistent follow-up, with potential for wide variation in how screening is conducted and by whom. Numerous tools exist, but with little consensus or standardization regarding what to use when, and inconsistent implementation.24-27
There are several decisional dilemmas pertaining to appropriate interventions for grief. Given the cyclical and non-linear trajectory of grief, identifying the optimal time for intervention is a persistent challenge for the field. For example, could bereaved individuals experiencing “normal” or typical grief still benefit from formal interventions, and if so, what types of interventions might be most useful? When does normal grief cross a threshold into prolonged grief, and when is formal intervention likely to be most effective? And who is best suited to deliver grief interventions (e.g., health care providers such as a psychologist or psychiatrist for therapy/pharmacotherapy vs community-based practitioners such as a grief counselor or spiritual counselor)? 28-30
There are also outstanding questions regarding the effectiveness of treatment for bereaved individuals who have been identified as having a grief disorder. Interventions to treat prolonged grief disorder include interpersonal psychotherapy, cognitive behavioral therapy, bereavement programs, peer support and group therapy. Most studies on interventions to treat bereaved individuals, however, are small pilot studies.29 There are conflicting results related to the effectiveness of preventive interventions prior to the death, while interventions after the death have resulted in short and long-term improvements.31 Information on their implementation and use in practice is varied, and there are inconsistencies in the extent to which current practice is substantiated by grief and loss theory. This in turn may diminish their credibility and further limit their use in practice. Innovative interventions such as narrative storytelling32 have recently been developed to address averse emotional outcomes of grieving, but little is known about their effectiveness in clinical practice.
We know little still about how contextual factors might impact the effectiveness and even appropriateness of grief interventions.33 The same factors that might influence the timing and appropriateness of screening likely impact the adoption and effectiveness of grief interventions such as circumstances of the death (e.g., traumatic death, anticipated death, overdose, suicide), and place of death such as the ICU, relationship to the deceased person (e.g., child, spouse, estranged relationship), and social isolation and loneliness.34 Comorbid mental health conditions – both pre-existing as well as new onset – may play a particularly influential role, for example the interaction between grief and comorbid depression, and how this should be integrated into intervention. Cultural preferences may influence whether a bereaved individual engages in the intervention, and what types of interventions are likely to be useful and effectives.
Finally, questions remain regarding feasible and appropriate follow-up of bereaved individuals identified as grieving and with grief-related needs. Because grief and bereavement are cyclical non-linear processes unique to each individual,22 follow-up screening may be particularly useful to capture any new, maladaptive (or otherwise benefitting from intervention) responses to grieving. However, follow-up and longer-term screening and intervention is complicated by the various settings in which bereaved individuals may interact. For example, bereavement support might be available in the hospital following an inpatient death, but service is often discontinued once the bereaved individual returns home. Community bereavement support may be available but is often only accessed if the bereaved individual proactively seeks it out, and even then, systematic follow-up in the community is likely highly limited. Some emergency departments report bereaved family members commonly requested referral to community bereavement resources, but found that consistent follow-up was resource intensive and difficult to implement.35 This gap between intervention and follow-up risks overlooking the potential for maladaptive grief response over the longer-term, when it may actually be more likely to develop.
Key Questions
The key questions proposed for the systematic review, addressing screening approach (Key Question 1), screening tools (Key Question 2), bereavement interventions (Key Question 3), and maladaptive grief-related disorder interventions (Key Question 4) were generally supported by key informants, and slightly refined following their input. We sought input from six key informants; including a patient advocate, a caregiver representative, a supportive medicine physician, a clinical psychologist, an expert in spiritual grief, and a social work representative focusing on policy. Key informants emphasized that grief is nonlinear and differs by individual person, and noted that the lack of guidance around grief and bereavement care reinforces the need for a systematic review. Major considerations or revisions recommended by key informants included 1) the importance of extending the screening and follow-up period to more than 1-year following the loss; 2) the need for clinical interview or qualitative assessment in addition to standardized screening and diagnostic tools; 3) the importance of taking spiritual, religious, and cultural differences into account when screening, assessing, and diagnosing; and 4) the importance of considering different bereavement contexts including the type of death (e.g., illness), nature of the death (e.g., sudden death), setting of death (e.g., hospital), relationship to the deceased person (e.g., spouse), and age of the deceased person (e.g., child). Finally, key informants also noted that screening and intervention can take place in the community beyond healthcare settings; for example, facilitated through religious institutions, support groups, and online organizations.
Following the described input, the key questions are as follows:
Key Question 1: What is the effectiveness and harms of universally screening people for bereavement and response to loss?
- Timing: predeath, acute, or 6-12 months post loss, and more than 1 year post loss?
- Does effectiveness vary by patient characteristic or setting?
Key Question 2: How accurate are tools to identify bereaved persons at risk for or with grief disorders?
Key Question 3: What are the effectiveness, comparative effectiveness, and harms of interventions for people at risk for grief disorders related to bereavement?
- Timing: predeath, acute, or 6-12 months post loss, and more than 1 year post loss?
- Does effectiveness vary by patient characteristic or setting?
Key Question 4: What are the effectiveness, comparative effectiveness and harms of interventions for people diagnosed with grief-related disorders?
- Does effectiveness vary by patient characteristic or setting?
Logic Model
The analytic framework depicts the patient population, the interventions, and the outcomes that will be addressed in the evidence synthesis
References
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- Sealey M, Breen LJ, O’Connor M, et al. A scoping review of bereavement risk assessment measures: Implications for palliative care. Palliat Med. 2015 Jul;29(7):577-89. doi: 10.1177/0269216315576262. PMID: 25805738.
- Rumbold B, Aoun S. An assets-based approach to bereavement care. Bereavement Care. 2015 2015/09/02;34(3):99-102. doi: 10.1080/02682621.2015.1115185.
- Lichtenthal WG, Nilsson M, Kissane DW, et al. Underutilization of mental health services among bereaved caregivers with prolonged grief disorder. Psychiatr Serv. 2011 Oct;62(10):1225-9. doi: 10.1176/ps.62.10.pss6210_1225. PMID: 21969652.
- Bonanno GA, Wortman CB, Lehman DR, et al. Resilience to loss and chronic grief: a prospective study from preloss to 18-months postloss. J Pers Soc Psychol. 2002 Nov;83(5):1150-64. doi: 10.1037//0022-3514.83.5.1150. PMID: 12416919.
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Dec 10, 2023 | Advocacy, Family, Federal Government, Uncategorized
Congress Recedes on Bereavement Leave in the FY24 National Defense Authorization Act
Over the last few weeks, many of you called your U.S. Senators seeking their support in allowing the U.S. Armed Forces to return home when their parents die. This bereavement leave would be an added provision to last year’s National Defense Authorization Act (NDAA) language that allows the U.S. Armed Forces to receive 14 days of paid bereavement leave for the death of a spouse or child.
The U.S. House of Representatives sought to expand bereavement leave for the deaths of servicemembers’ parents, but the U.S. Senate bill did not include the same provision.
To reconcile the differences between the House and Senate versions of the bills, Congress determined that U.S. Armed Forces members would qualify for leave under current leave options provided to servicemembers, and they issued the following statement:
The conferees note that the section 622 of the National Defense Authorization Act for Fiscal Year 2022 (Public Law 117- 81) created bereavement leave as a codified benefit for members of the Armed Services to ensure that no member could be denied paid time off following the death of a child or spouse. This benefit was a compromise borne out of a separate legislative proposal, section 622 of H.R. 4350, the National Defense Authorization Act for Fiscal Year 2022, as passed by the House of Representatives, that would have guaranteed paid leave time for parents who lose a child if the servicemember’s parental leave had already been approved but not yet fully used. But that proposal would not have provided any guaranteed paid leave for parents who had already used their parental leave, and it would not have provided any guaranteed leave for members following the death of a child after the child’s first year of life, as parental leave was required to be used within a year of the birth or adoption of such child. Section 622 would also not have provided any guaranteed time off for members upon the death of a spouse.
The conferees note that bereavement leave was never intended to create an entirely novel statutory entitlement to cover any loss that a servicemember might face, but rather to ensure that members who face the most difficult loss, the death of a child or spouse, could not be denied leave time to grieve such death. The annual leave policy under section 701 of title 10, United States Code, provides a generous benefit for members to take leave for personal reasons, including personal loss. Such statutory entitlement is bolstered by standing Department of Defense policies that provide for emergency leave, advance leave, compassionate reassignment, and many other policies supportive of servicemembers when in need.
Bereavement leave is one additional backstop to ensure that no member could be denied a period of paid time off from work following the death of a child or spouse. Because of this, bereavement leave was made non-chargeable if affected servicemembers had fewer than 30 days of leave so that none could be denied such leave on the grounds that they had already used their accumulated paid leave. The conferees expect that servicemembers who experience the loss of a close family member are afforded as much time off as possible, including via bereavement leave or emergency leave; alternate duties as required; and other accommodations as situationally appropriate.
Because of you, we had wonderful and supportive calls with both Democratic and Republican legislators, and as a result, Congress issued this thoughtful response.
Thank you for making a difference!
Together, we are making the world a more livable place for bereaved people.
Dec 9, 2023 | Advocacy, Community, Data Collection, Federal Government
We Have Achieved So Much Because Of You
Ten years ago, no one talked about bereavement‘s impact on us or the trajectory of our lives.
Today, bereavement is highlighted in major media outlets, in the halls of Congress, and in our communities. Thousands of people believe in our vision, which has been humbling and inspiring.
It is all possible because of you.
In January 2020, before COVID-19 came to the United States, we took your stories and quality data to Congress with a message that bereavement was an urgent concern for millions in America. Congress needed to act now.
Together, we made calls, talked to legislators, and secured the nation’s first bereavement provision in the U.S. budget process — and our work had only just begun.
Over the last three years, together, we have continued to make tremendous strides in helping all bereaved people achieve a healthy, prosperous, and equitable future.
Here are just a few highlights:
And, we have so much up our sleeves for 2024!
The Evermore Board of Directors
Jacqueline Corbin-Armstrong
Evermore, Chair
Norman Greene
Princess Hyatt
Donna Mazyck
Joyal Mulheron
Mark Standard
Sep 10, 2023 | Advocacy, Community, Family, Federal Government, Grief
Visionary & Trailblazing Attorney Kenneth Feinberg Offers Five Reflections On Bereavement
After serving thousands of families, victim compensation attorney Kenneth Feinberg offers five reflections on grief and bereavement.
By Joyal Mulheron with support from Maddie Cohen
Visionary and trailblazing attorney Kenneth Feinberg has long been called upon by U.S. presidents, families, and survivors to navigate payouts following mass tragedies. He started his career as a settlement specialist for Agent Orange, but is renowned for his leadership in overseeing the 9/11 Victim Compensation Fund (VCF), where he served families for 33 months pro bono.
On the morning of September 11, 2001, Feinberg was teaching class action mediation at a law school in Philadelphia. By the end of class, the world had changed.
By mid-November, Congress established the 9/11 VCF to compensate the thousands of people who lost a loved one or suffered a physical injury. Feinberg distributed over $7 billion to victim’s families.
During Evermore’s 2020 Digital Summit, Feinberg shared his reflections with Anita Busch, VictimsFirst President, on working with tragically bereaved families from the 9/11 attacks and the many other compensation or memorial funds from other tragedies.
Here are five reflections Feinberg offers for supporting bereaved families:
1) There is no one way to grieve.
Families grieve in different ways. Negotiating trauma yields a range of responses, including anger and disappointment to uncertainty and love.
Feinberg admits that when he accepted his assignment in 2001, he had no clue how emotional the work would be. Granted, the situation was emotional—but the thought of disappointing grieving families felt impossible.
2) Permission to grieve and a commitment to listening.
During these confidential conversations, he notes that families must be permitted to grieve. The door should be open for each individual to share their perspectives about life’s unfairness and to discuss or validate the memory of a lost loved one.
3) Language matters.
According to Feinberg, a less-is-more approach is best. Even people with good intentions risk saying the wrong thing when they try to show empathy after a tragedy. The families of victims and survivors might not want to hear someone else’s take on their grief, no matter how well the other party means.
Feinberg recalls meeting a bereaved father whose two children worked at the Pentagon. The man’s daughter narrowly escaped through a side door, and his son died looking for his sister.
When Feinberg met this father, he said something he deeply regretted.
This is a tragedy,” he stated. “It’s terrible. I know how you feel.”
The man offered Feinberg some friendly advice. “You have a tough job to do,” he said. “But you have no idea how I feel.”
Feinberg learned a life-altering lesson that day. And he cautions others to be careful as well. While intentions are important, language is too.
4) Be transparent.
The attorney recommends giving grieving families all the information they need in a private setting. It’s a matter of protocol, Feinberg explains—but that protocol is an important first step for people in a fragile emotional state. He adds that keeping the door open in this way has been a key factor in the success of programs like the VCF.
From the community’s perspective, Feinberg clarifies that the most important part of a community’s response to tragedy is transparency. Sharing how the greater community can help and how the distribution of compensation or assistance will work. When the world feels uncertain, clarity becomes even more essential for bereaved families.
5) Empathy matters.
No matter what anniversary it is, shedding light on the importance of empathy matters. Families understand the grief they are navigating and recognize that you cannot bring back their loved ones. Genuinely listening and learning about who they’ve lost can help.
To learn more, Feinberg shares his experiences with victim compensation in the books What is Life Worth? and Who Gets What? In 2020, Netflix released Worth, a movie starring Stanley Tucci and Amy Ryan, plus Michael Keaton as Feinberg, showcasing the challenges in the wake of 9/11.
Key resources
Readers can learn more about bereavement care and acknowledge the anniversary of 9/11 by visiting the links below:
Sep 2, 2023 | Advocacy, Community, Family, FMLA, Grief, Parent
A Grieving Parent Turns Pain into a Purpose
Following the death of his teenaged son, Blake, Tom Barklage fought to secure bereavement leave for Johnson & Johnson employees around the world
By Maddie Cohen
After his son Blake died, Tom Barklage took time off to make space for his grief. Little did he know the loss would result in a push to expand his employer’s bereavement care. Today, the high-level manager has made it his mission to change lives for the better.
Grief alters the course of a parent’s life
The death of a child changes a person—and Tom remembers October 30, 2021, like it was yesterday. His son, then 17, was attending an evening gathering with friends when he lost consciousness. A short time later, he died in the hospital of an unknown heart issue: lymphocytic myocarditis.
Tom, his wife Alison, and their daughter Alexis were devastated. Yet Johnson & Johnson (J&J), where Tom has worked for almost 20 years, stepped up to the plate. The company president held a moment of silence in Blake’s honor at an immunology town hall, and Tom’s boss was gracious about his leave. Months later, J&J gave Tom an additional day off on April 7—Blake’s birthday and the day they buried his ashes—and catered a meal for the Barklages and their guests.
Yet Tom struggled. His employer’s official bereavement policy was just five days. And while the pharmaceutical expert could leverage flex days or “take a knee,” those moments his grief became too much, there was little time to process the complexity of his loss.
Not only that, but Tom realized others might not have the same accommodations. Not everyone at J&J had 18 years’ tenure or the flexibility of working in the field.
A push for flexible bereavement care
Tom set out to change J&J’s bereavement policy. He was determined to honor Blake’s legacy and respectfully challenge the status quo.
The process was far from simple—but Tom had to start somewhere. He began by sharing his thoughts with his boss, and then reaching out to J&J’s Vice President of Human Resources. The goal was to bring awareness to the cause. And while Tom’s advocacy sparked discussion, it wasn’t so straightforward. J&J was in the midst of global change, and some stakeholders thought it best to wait a year.
Plus, Tom was still grieving.
Company leaders were skeptical, but the key account manager reassured them. He explained that he was absolutely in his right mind, and that his advocacy was a matter of great importance.
“It helps to have something to fight for,” he explained.
Now, Tom isn’t advocating for a specific number of days off. He is simply promoting a more flexible bereavement policy—for everyone.
Because parents deserve it. And because, in Tom’s words, Blake had a remarkable ability to use the past to make an even brighter tomorrow.
“That’s why it’s so important for me to give back,” Tom says. “I know that if this bereavement policy goes through, the day that I retire from J&J, I can sit there and say, ‘Blake, we did it.’”
On August 1st, Johnson & Johnson released this statement: We all need to step away from work sometimes, and taking time to heal from the loss of a loved one shouldn’t be an additional worry. As part of our newly-expanded global paid leave offerings, every employee around the globe has access to up to 30 days of dedicated paid leave time for bereavement. Learn about all the ways we offer flexibility to enable everyone on our team to succeed at work while also balancing personal and family needs.
J&J Employee Benefits
Honoring Blake Barklage’s legacy
In 2022, the Barklage family started the Blake Barklage Foundation, also known as Blake Gives Back. The nonprofit supports charitable initiatives focused on intellectual disabilities, education, organ donation, and the prevention of cardiac arrest in children and young adults.
Readers can learn more about Blake’s life and legacy by visiting the links below:
Read the heartfelt letter Tom Barklage sent to Johnson & Johnson.
My name is Tom Barklage and I am a J&J employee of 17 years. I’ve valued the culture at J&J as an employee given the priorities its maintained in support of families and patients worldwide for decades. This email is not easy one to write. Last month, on October 30th, my 17-year-old son Blake suddenly passed away from an undetected heart issue. As a parent, this is the hardest thing my wife and I have ever dealt with. I lost my father a year ago and one of my brothers passed away 10 years ago. Losing my dad and brother was tough, but losing my son is gut wrenching. As I write this, I am struggling to see the keyboard through my tears, but I will get through this.
The company policy of 5 condolence days is a policy I am having a difficult time understanding. As you can imagine, when an employee has the unfortunate experience of losing a child, spouse, partner, etc. the ability to
return to work and be productive is almost if not entirely impossible with only 5 days to recover. Grieving the loss of a child is crushing and deeply personal.
I received the recent J&J employee announcement about the new parental leave providing employees paid leave from 8 weeks to 12 weeks. That is great news!! Wonderful policies like this are one of the reasons I love working at J&J! In the Communication it stated that “J&J has a long history of supporting family health because we believe that advancing health for humanity starts at home.” I agree with that 100%!!
The reason paternity leaves are expanding is because someone raised this as an issue to be re-evaluated. Someone had an experience that wasn’t equitable. It started with a conversation and gained momentum from there. That is what I am trying to do. The loss of a child or close loved one is a monumental event that meets or exceeds the emotional/physical needs of a parent/spouse at the time of a birth. I was blessed to be at the birth of my son Blake and daughter Alexis. Losing Blake is so much harder and difficult to deal with. Please do not take this the wrong way. I am not trying to make it about me. My management team whom I work for have been very accommodating!! The support I received from my Janssen family has been phenomenal.
I went back and forth debating if I should send this note to you. I don’t want to come across as being disrespectful or ungrateful towards J&J. J&J has provided my family and I with opportunities that we are blessed to have. I am so happy to be part of the J&J family. But I know my son Blake, he would want me to raise this concern and ask to consider changing the policy to allow for more time for employees to work through their grief process. As I said earlier, it is not just about me. It’s about the other J&J employees too who have suffered loss and are still committed to their jobs and the purpose they find in their work. Our credo states, “We must support the health and well-being of our employees and help them fulfill their family and other personal responsibilities.” I understand that a change like this can’t happen without gaining as much information as possible and ensuring a diverse set of opinions are gained. I would like to be the catalyst for this change and happy to speak to you. Will you and your leadership team consider re-evaluating our company policy on condolence leave? If you would like to meet in person or connect via Zoom, please know that I would welcome that opportunity.
Sincerely,
Tom Barklage
Janssen Immunology
Senior Key Account Manager