Resources > For Crisis Responders When a Child Dies
By Joanne Cacciatore
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Author Biography
Joanne Cacciatore is the founder of the MISS Foundation and the author of the book Dear Cheyenne. Ms. Cacciatore, MSW and doctoral candidate, is a a consummate teacher and professional public speaker in the 'death and dying' genre. Her area of specialization focuses on individual and familial bereavement after a child's death.
Ms Cacciatore was awarded a Fellowship in Thanatology from the Association for Death Education and Counseling. She founded the MISS Foundation, an international nonprofit organization, in 1996, two years after the death of her infant daughter, Cheyenne.For more information or to contact Joanne, please see the MISS site at www.missfoundation.org or email her.
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