A hospice bereavement card is three or four handwritten lines: the family member's name, the name of the person who died, one small memory from the team, and an open door to your bereavement line. Send one at the death, then around two, six, nine and twelve months, on the person's birthday and at the first holidays. Leave out clinical details, advice and any request for money.
What should a hospice bereavement card say?
Say four things. Use the family member's first name. Say the name of the person who died. Add one small, true memory from someone who was in the home. Then tell them how to reach your bereavement team, with no pressure to call. Fifteen messages to copy follow, grouped by the point in the year when each one is sent.
How long must a hospice offer bereavement support?
Up to a year. The Medicare rule says a hospice must "make bereavement services available to the family and other individuals in the bereavement plan of care up to 1 year following the death of the patient" (42 CFR 418.64). Many programs run for thirteen months instead, so the first anniversary falls inside the program and not on its last day.
This work is required but not paid for. MedPAC, which advises the US Congress on Medicare, notes that the law requires hospices to offer bereavement services and also prohibits Medicare payment for them (MedPAC, March 2026). The same report counts more than 1.8 million Medicare patients cared for by about 6,700 hospices in 2024.
MedPAC also reports a median stay of 19 days. Half of all families knew your team for less than three weeks, so the card carries a relationship that had little time to form.
Cards at the time of the death
This card should reach the family within days, so the team writes it by hand and posts it locally. Whoever knew the family best signs first.
Dear Margaret, we are so sorry about Harold. He made every one of us sit down and hear the ball game score before we could start. It was a privilege to know him. With sympathy, Dana, his nurse
Dear Luis, all of us who visited your mother are thinking of you. Rosa's kitchen always smelled of cinnamon, and she never let us leave without a cookie. With deepest sympathy, Pam and Andre
Dear Mrs Chen, we only knew your husband for a few days, but we saw how you never left his side. We are so sorry. Our bereavement line is on the back of this card, for whenever you want it. Ruth, chaplain
Cards around two months
Dear Margaret, it has been a couple of months, and I wanted you to know we still talk about Harold and his scorecards. There is nothing you need to do with this card. Thinking of you, Dana
Dear Luis, the first weeks are full of people, and then it goes quiet. If the quiet is hard, our Thursday coffee group is small and kind. Come once, or never. With care, Janelle, bereavement coordinator
Cards at six months
Dear Priya, six months. Some people tell us this is when it feels most real. However it feels for you is allowed. I still think of your father's chess set by the window. Warmly, Tom
Dear Mr Okafor, I am thinking of you and of Grace today. She told me the garden was your work and the roses were hers. I hope they came up this year. With sympathy, Janelle
Cards at nine months
Dear Susan, no special date, just a note to say Walter has not been forgotten here. His aide, Marcus, still hums that Sinatra song in the car. Thinking of you, Janelle
Cards for the person's birthday
Dear Margaret, Harold would have been 84 on Friday. I am told the right way to mark it is a hot dog and a cold drink in front of the game. We will be thinking of you both. Dana
Dear Mrs Chen, I know Wei's birthday is on the 12th. You will be in our thoughts that day. Ruth
Cards for the first holidays
Dear Luis, this will be the first Christmas without Rosa at the stove. There is no right way to do it. Keep what helps and skip what does not. Thinking of you and your family, Janelle
Dear Susan, the holidays are over and the house is quiet again. January can be the hard part. I am thinking of you this week. Janelle
Cards at twelve and thirteen months
Dear Margaret, a year ago this week we said goodbye to Harold. We remember the day, and we remember how you cared for him. Thinking of you, Dana and the whole team
Dear Priya, it has been a year. You may feel you should be "better" by now. There is no such deadline. Your father was lucky in his daughter. With care, Tom
Dear Luis, this is our last planned card, but not a closed door. If you want to talk next month or next year, the number on the back still reaches me. It was an honor to know Rosa. Janelle
Do bereavement mailings really help families?
Families ask for them more than for anything else, but no card treats grief. In one study of a large New York hospice, 333 bereaved caregivers screened positive for anxiety, depression or complicated grief. Of those, 66 per cent were interested in mailings and about 7 per cent in one-to-one counseling (Ghesquiere and colleagues, 2018).
That study reviewed the charts of 3,561 caregivers at one hospice, so treat it as a signal. The same paper cites national surveys in which about 98 per cent of hospices send a letter or card at the death or its anniversary.
Timing has evidence behind it too. Deborah Carr and colleagues interviewed 210 widowed older adults six months after their loss. Those interviewed in the month of their late spouse's birthday had clearly higher depressive symptoms. So did those interviewed in January, after the holidays. December itself showed no such rise (Carr and colleagues, 2013). That is why there is a January card above.
A caution. A French trial in 22 intensive care units, with 208 relatives, found that a condolence letter sent two weeks after a death was linked to more anxiety and depression at six months, not less (summarised in a later trial paper). An ICU is not a hospice, but the lesson carries: a card is a kindness, not a treatment. Keep the calls and counseling going.
Who should sign a hospice bereavement card?
A person the family met, by first name, with their role. The nurse, the aide, the chaplain or the social worker for the first card. The bereavement coordinator for the later ones, since that is who will answer the phone. Never "The Team at Lakeside Hospice" alone. A card signed by nobody the family can picture reads like a mailing list.
For how to lay out several names under one closing, see our guide on how to sign a sympathy card.
When should each card be posted?
This is the calendar we would set up, with what starts each card.
| Moment | When it should arrive | What starts it |
|---|---|---|
| The death | Within one to two weeks | Written by hand by the team and posted locally |
| Two months | Week 8 or 9 | A new row in a Google Sheet, with the date |
| Six months | The week of the date | A scheduled card |
| Nine months | Any quiet week | A scheduled card |
| Birthday | A few days before | A schedule on the birthday |
| First holidays | Late November, then early January | One batch from the Sheet |
| Twelve months | The week before the anniversary | A schedule on the date of death |
| Thirteen months | After the anniversary has passed | A scheduled closing card |
MailMyCard writes each card with a real pen held by a plotter, in real ink, and posts it in a sealed envelope. Cards are posted from India and take one to three weeks to arrive abroad, so the first card stays with your own team and the dated cards are ordered well ahead. See how long mail takes.
We do not connect to hospice record systems. A watched Google Sheet or Zapier is the way in, and only three things need to go in it: the family member's name, their address and the first name of the person who died. No diagnosis, no notes. Check that sharing those details fits your own privacy policy before you start. One card is $14.99. For 50 cards or more we agree a per-card price, from $8.99 for a pilot of 50 and lower with volume. Details are on the For business page, and the API is in the developer docs.
What should a hospice leave out of a bereavement card?
Leave out anything clinical, anything that asks for something, and anything that tells the family how to feel.
- The illness, the cause of death or the last days. Not even kindly. The envelope may be opened by someone else in the house.
- A donation request or a memorial-gift form. Never in a sympathy card. If you fundraise, do it separately and much later.
- "At least" and "in a better place". You do not know what the family believes.
- A postcard. Always a card in an envelope.
- Cards to someone who asked for none. Record the request and honor it.
Common questions
How many bereavement mailings should a hospice send in a year?
There is no required number. The rule asks only that services are available for up to a year. The calendar above has eight contacts by post, alongside your phone calls.
Should the card mention God or prayer?
Only when you know the family's faith, for example from the chaplain's visits. Otherwise "thinking of you" suits everyone.
What if the card comes back undelivered?
Update the address once by phone if you have permission to call. If not, stop the mailings. Do not send grief cards to a guess.
Sources
- Electronic Code of Federal Regulations, 42 CFR 418.64(d), bereavement counseling, via Cornell Legal Information Institute: law.cornell.edu
- Medicare Payment Advisory Commission, Report to the Congress: Medicare Payment Policy, March 2026, chapter 10, hospice services: medpac.gov
- Ghesquiere, A. and colleagues (2018), "Hospice bereavement service delivery to family members and friends with bereavement-related mental health symptoms", American Journal of Hospice and Palliative Care: pmc.ncbi.nlm.nih.gov
- Carr, D., Sonnega, J., Nesse, R. M. and House, J. S. (2013), "Do special occasions trigger psychological distress among older bereaved spouses?", Journals of Gerontology Series B: pmc.ncbi.nlm.nih.gov
- Kentish-Barnes, N. and colleagues (2017), "Effect of a condolence letter on grief symptoms among relatives of patients who died in the ICU: a randomized clinical trial", Intensive Care Medicine, as summarised in a later trial paper on communication with bereaved relatives: pmc.ncbi.nlm.nih.gov
