Psych

Notifying Family of Child's Death

Notifying Family of Child's Death, Notifying Family of Patient's Death, Breaking Bad News to Parents of Deceased Child, Supporting Family After Death of Child, Support After Family Member Death, Counseling Family After Child's Death, Counseling After Loved One's Death

Epidemiology

Incidence (U.S.): 40,000 childhood deaths per year

Approach
General

State it simply, succinctly and in plain language
1. Example: "We could not save <name> and they have died. I am very sorry."
2. Example: "<name> was dead on arrival to the Emergency Department. I am very sorry"
Avoid additional commentary beyond above
1. But come prepared, knowing the patient's name, and all information regarding the event and Resuscitation
Focus on answering family's questions truthfully
1. Match the response to the level of detail that is asked
2. Avoid medical jargon
3. Do not avoid contact with the family
4. When to leave the room is a judgment call (but warm hand-off family to another staff member)
Allow for memory items (hand or foot mold, lock of hair, or jewelry)
1. Some items may be required to remain until after any planned post-mortem evaluation (e.g. coroner)
2. Allow parents to hold their deceased child if they wish (unless it interferes with investigation)
Allow family to be present at Resuscitation if they wish
1. Typically hospital staff member is assigned to accompany them
2. Assigned staff are there to answer questions they have during the Resuscitation
Do not give advice
1. Do not use phrases of "being in better place, or no longer suffering"
  1. Family may say this, but providers should refrain from this
2. Brochures on support services may be given
  1. However avoid extensive counseling on this initially as parent's will not retain this

Resources

Compassionate Friends
1. http://www.compassionatefriends.org/
Bereaved Parents USA
1. http://www.bereavedparentsusa.org/

References

Majoewsky (2013) EM:Rap 13(5):3-4
Wender (2012) Pediatrics 130(6): 1164-9 [PubMed]