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© 1998 by Joanne Cacciatore, RTS Counselor,
Founder of MISS
One of the most frequently presented dilemmas that those who deal
with death must face is how to manage this harrowing experience. Knowing
what to say and do to help those in crisis takes empathy, understanding
and a willingness to learn about grief. While most first responders
roles during this crisis are frequently transitory, there may be an
occasion where a particular child or circumstance affects you on a
more personal level. Thus, perhaps as a paramedic, firefighter or
crisis interventionist, you have the opportunity to work on a more
intimate and ongoing basis with the family. For such situations, we
have outlined some fundamental guidelines which can foster positive
interaction and confidence for you as a support individual.
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Rational behavior doesn’t come easy....
- So don’t expect parents to be logical or objective when their
child has died. Runaway emotions make it difficult to think clearly.
Instead, allow them to express their feelings by being a good
listener, maintaining clear eye contact, speaking firmly, gently,
and precisely and giving honest answers to their concerns.
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Letting go is tremendously painful...
- In crisis situations, when logic and reasoning are diminutive,
encourage the parents to do what they do best- what is the most
natural behavior. Allow parents to "parent" their child. It is
their greatest responsibility and most innate desire. They need
to participate in their child's care and be with their child as
much as possible. The chance to say goodbye one last time is of
critical importance to most families. In a recent survey conducted
by the MISS Foundation, more than 75% of families who chose not
to hold their child after he or she died, later regretted that
decision. Most families should be encouraged to see and hold their
child, if circumstances allow.
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Understanding the impact of surprise...
- Prepare the family (parents, grandparents and siblings) for
what they will see-before they see it! Explain any machines, tubes,
needles or other equipment if the child is still living. If the
child has died, prepare them by explaining the natural postmortem
process and why the child's body may look different. Try to avoid
complicated terminology or medical vernacular. Encourage them
to ask questions. In the case of sudden death, lividity should
be explained with compassion. Pooling blood can be mistaken for
bruising and may frighten parents. Honest communication about
the physiological changes which have occurred will alleviate some
of the trauma factor and perhaps assuage some of the parents'
fears.
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Maintaining good communication...
- Two things which concern parents most about their child's death
are pain and fear. Often they are afraid to ask questions about
the pain or fear their child may be having or may have gone through
prior to their death, so offer some answers to them as honestly,
and gently as possible. Let them know you believe their child
has died peacefully and without pain, if this is truly the case.
Always tell parents the truth. Remember that good communication
requires trust, and trust can only be achieved through honesty.
Tell them everything you know about their child's condition or
cause of death. Information helps families feel in control of
a situation, which otherwise, is out of their control.
Give parents permission to talk about their feelings and express
their emotions. You will act as a positive catalyst in this
very difficult first stage of grief. Keep in mind that most
parents cope during this early stage of grief with an "emotional
anesthetic." Be patient with them and try to respect feelings
of anger, denial, confusion and delirium. Treat mothers and
fathers equally in giving information. Don't forget that siblings,
grandparents, aunts and uncles grieve too. Though the focus
should be the parents, it may also help to offer information
and support to peripheral family when possible.
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The element of commitment...
- If you have become their main source of support during this
tragedy, then likely you are metaphorically a "life preserver"
for a person drowning. The family will often refer to you for
help in many aspects during the initial stages of the event. Please
don't rush away immediately after speaking with the family. This
is called a "hit and run" and is not acceptable in the bereavement
community.
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Beyond the call of duty.
- If possible, go to the visitation or funeral. It means more
than you can imagine. Always refer to the child by his or her
name. Offer to take pictures or video tape the service for the
family. Offer to answer any questions they may have regarding
their child's emergency care. They will remember your thoughtfulness
for the rest of their lives.
Remember that several months after the child's death can be
even more devastating than the first month or two. Often, it
is at this time when families feel even more isolated and sorrowful.
Check in with them, if possible, at around three-six-and twelve
months. Make sure they kept the support numbers you gave them
and that they know what resources are available to them within
the community.
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Lemonade out of lemons...
- The ultimate no-no is the use of platitudes or cliches! Do not
rationalize a child's death. No matter what the physical condition
of the child or how much of a "burden" the child would have been,
most parents would still prefer to have their child with them
under any circumstances.
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Lean on me...
- Touching is a basic form of comfort and communication. Remember
that it is a crucial time for you as a professional to show your
humanness. If you feel the need to express your own emotions,
cry with them. You are in a position of leadership and you lend
validity to their emotions. Most parents, even years after their
child's death, recall with great fondness a paramedic or physician
who shared a moment and cried with them. Vulnerability can sometimes
reflect immeasurable strength.
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The gift of choice...
- Most parents appreciate being asked about organ donation. They
should be offered the option to consider this. Some parents who
were never asked reported they felt left out or even insulted
that their child may not have been "worthy." Reassure the parents
that their child will be treated with respect and dignity if they
choose organ donation.
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Support doesn't stop here...
- Don't suggest "busy work" as grief intervention or therapy.
Rather, encourage support group participation and give them names
and numbers. The last thing grief-stricken parents need is to
have to search through the telephone directory for support and
help.
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