||Tasks of acute grief support
||Practical tips for healthcare workers & first responders
||Notifying the family
- Notify the family in person and give the information in a calm and caring manner.
- Talk to the nearest next of kin and consider the order of notification, e.g. spouse or parents before siblings.
- If no family member is present in the hospital, call the nearest next of kin and confirm his/her identity. Introduce yourself and invite him/her to come to the hospital as soon as possible upon the critical conditions of his/her
- Suggest the family member to bring a companion for emotional support.
- Suggest the family member to notify other significant others.
||Arrival of the family
- Escort the family to a quiet area where they can have privacy and minimal interruption.
- Introduce yourself.
- Verify the identity and relationship of the family members with the patient or deceased victim.
- Do not ask the bereaved to sign any document at this stage.
||Breaking bad news
- Do not delay breaking the bad news or communicating patient’s condition.
- Be warm and compassionate. Show your concern and condolence.
- Break the news in stages if the patient is badly injured.
- Clearly explain the occurrence of relevant events in a chronological order (e.g. what happened to the patient, what actions were taken, what treatments and specific care were provided and responses of the patient).
- Gently reassure the family that all possible treatments have been administered.
- Use the patient's name instead of an indefinite address “the deceased”.
- Explain the actual cause of death in simple language.
- Do not use jargons or vague descriptions.
- Support expression of emotions in different ways.
- Be patient and allow the bereaved to ask questions.
- Answer all questions honestly as much as possible.
- Identify if the family shows any risks of self-harm or harming others. Make proper referrals if necessary.
||Viewing the deceased victim
- Treat the deceased person with dignity and respect.
- Try to make the deceased person's appearance more presentable and acceptable to the bereaved. For example, remove unnecessary medical equipment, clean up wounds, put him/her on a bed, or cover the body with a clean sheet.
- Arrange the bereaved to view the deceased as soon as possible. If the deceased was disfigured, prior preparation is essential. Family members should be prepared for this psychologically.
- Encourage the family to say goodbye to their beloved in their own ways, for example, make prayers, give blessings, touch or hold the hand of the deceased.
- Give space and time to the family and respect their need for privacy.
- Ask if the family would like to spend time with the deceased. Check whether the family needs to have the company of hospital personnel.
- If the family experiences difficulties coping with the stressful situation, encourage them to take a break in a quiet and comfortable place before returning to see the deceased again.
- Explain to the family what will happen to the deceased person, for example, if autopsy is required.
- Check the family's readiness to receive the personal belongings of the deceased. Put the items in a presentable box or container neatly, not in a trash bag. Explain what the items are and their conditions.
- Clearly list out things they need to do and give them a written step-by-step list to follow, for example, the procedures for obtaining the death certificate.
- Do not leave the bereaved alone. Arrange someone to accompany him/her anytime when possible.
- Re-express the willingness to address their concerns.
- Do not speak to the media without the family's explicit permission.
||Identification of high risk groups for referral to professional psychosocial care
- Risk factors if the deceased is:
- Young e.g. an infant, child.
- Pregnant or had young children.
- Risk factors if the bereaved has:
- Excessive blaming of oneself / others.
- Uncontrollable rage.
- Poor social support.
- Inadequate coping skills.
- Financial difficulties or were unemployed.
||Facilitation of continued care
- Provide a contact number for the bereaved and invite them to call back for clarifications or questions.
- Educate them on the signs and symptoms of complicated and prolonged grief.
- Provide the bereaved with a list of contact numbers for emergency mental health services and grief support services. Encourage them to seek help if necessary.
- Immediately refer the bereaved to medical or mental health services, if he/she needs services beyond your training and work capability.
- Give follow-up phone calls to the bereaved, particularly those in high risk groups.