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THE COMPASSIONATE FRIENDS of cape town


For First Responders Dealing with the Sudden Death of a Child

As their name implies, "first responders" are ordinarily the first on the scene and/or the first to notify family members about their child’s death. If first responders are honest, direct and caring, they will help to ease the pain of the family’s grief process.

The task of those who must break bad news is often made more difficult because they have also had to deal with the physical situation in which the death occurred . . . the legal requirements at the accident scene, the attempts at resuscitation, the operations or the casualty procedures in the hospital, questions from the media, fatigue, the formal obligation to trace and inform the next of kin etc.. It is not easy to transfer from these responsibilities into the mental framework of the bereaved.

NOTIFYING THE FAMILY

Every effort should be made to notify the family quickly and directly. Identifying information should not be released to news media before the family has been advised of the death.

If at all possible, avoid breaking bad news over the telephone but not at all costs. Sometimes the length of time it will take to make personal contact will too much increase the chance of the bereaved hearing the news accidentally. If you have to notify a death by telephone, try by all means to follow it up with a visit as soon as possible.

The most senior or highly qualified person available should take responsibility for breaking the news. Given the circumstances, be certain you are the most appropriate person available to be the news-bearer and whenever possible have someone accompany you. Ideally notification should be made in person by two qualified personnel - in uniform to certify their identification.

Too often, an inexperienced junior is delegated this task, without having had the opportunity of observing how others have learnt to deal with it.

Individuals react to death in various and often unexpected ways. Discuss beforehand how you intend to respond to any situation you may have to confront.

Make sure you have adequate and accurate information about who has died, how, where and to whom you will be giving the news. Be in possession of facts regarding legal requirements. Try not to rush or blurt it out no matter how awkward you may feel; but don't prolong it either.

The family will know or sense you are there with bad news... get to the point as quickly as possible without being blunt.

Break the news in stages: 

1. Briefly identify yourself/ves and confirm the identity of family members. 

2. If possible have them sit down with you. 

3. Tell them that there has been an emergency. 

4. Tell them that the situation was so serious that a death has occurred and identity the deceased immediately.

MAKE THE CONTACT HUMAN

Death diminishes those who remain and so the importance of human contact is a paramount need. Treat the bereaved with dignity. Look them in the eye. Touch them - unless you are aware of any taboos about physical contact. Use the child's name. Cry with them if that's how you feel and if you feel frustrated because you've been unable to prevent the death, it's ok to tell them so.

Be honest and as accurate as you can. Use simple language giving as much information as you are able. Encourage expression of feelings and questions and allow time for both.

The bereaved will re-live this moment time after time even if they don't seem to be absorbing all the details as you tell them. They will remember body attitudes and emotions. Be gentle, sensitive and supportive.

Try to avoid offering explanations, interpretations, conjecture or passing judgement. Offer to return in a day or two for further sharing of information, feelings, etc. If appropriate write down names and telephone numbers of people they are required to contact, include your own name and number and give it to them so that they may get hold of you at a later stage.

Don't lake personally any anger directed at you as the news-breaker. Offload your feelings to someone who will hear you out as soon as you can after the visit.

AT HOME

When the death occurs at home, care should be taken to treat the dead child with dignity. Stay on the scene until proper authorities arrive.

AT THE HOSPITAL

When the child is taken to hospital the family will often be left in a room to wait ... and wait ... and wait. They desire, appreciate, and have the right to information - even if it confirms their worst fears. It's important that they should be kept advised and that there is meaningful contact between them and the hospital authority concerned. As painful as it is, such communication helps to reduce overall tension and trauma. Medical personnel should give the family their name/s, telephone and extension numbers and assure them they will willingly try to answer questions family members may have later.

BOTH IN THE HOME AND HOSPITAL SITUATIONS families, including surviving siblings, if they have the opportunity of spending time with their child after death ... they should be encouraged to do so. Experience has shown that time so spent contributes considerably to the acceptance of the death and is helpful, in the grieving/healing process. Try to avoid the temptation to make decisions for the family ... allow them the dignity of making their own.

In the case of newborn babies, parents may wish to have a photograph of their child, or you may suggest a picture be taken and kept on file for them to have at a later date. Assist in these arrangements if you can.

ENSURE PRACTICAL CONSEQUENCES ARE SET IN MOTION

Identify the support system and ask if family members wish someone to be called to come. Enquire as to whether there is a minister they would like to have visit and whether they wish you to make the call. Similarly, ask if they would like you to contact their doctor. Re-assure that tranquilizers generally are not required - shock is nature's tranquilizer.

If you are giving the news to a person on their own, arrange for someone to come before you leave. Even if they insist that they prefer to be alone, encourage them to accept some company/support for the first day, the first night. Try by all means not to leave either the bereaved individual or the bereaved family alone until other support systems arrive. If identification of the body is required, provide or arrange for transport. Prepare the bereaved for the scene. Do not attempt to discourage them from seeing the body. Ensure they have transport home afterwards.

Have information with you as to procedures for calling the funeral director, Jewish Burial Society, etc.  They will assist with other formalities such as the death certificate.

For some families, several hours may have to pass before they can think or make decisions regarding the funeral. On the other hand, some may become agitated until arrangements are set in motion; delays caused by an autopsy (post mortem) may cause them to become angry and aggressive.

Because the resolution of grief takes a long time, sometimes years, it may be helpful for the family to know that assistance is available - even though they may not immediately wish to make use of it. The Compassionate Friends (TCF) is a nationwide self-help organization offering friendship and understanding to bereaved parents and their families regardless of race or creed.

Community Awareness Presentations are also run as part of TCF's service to the public. If you, or the institution you are associated with, would like further details as to this programme, please contact us.

This brochure was funded by Cosmas & Amalia Mullinos in loving memory of their daughter Michele Elizabeth Mullinos 4.12.68- 1.8.88

Copyright 1996 The Compassionate Friends