Following a traumatic event or disaster, it is frequently
necessary to notify family members of the casualty or death of a
loved one. Mental health personnel may be asked to serve on
coroners' or medical examiners' casualty / death notification teams
(Sitterle, 1995). What follows is a curriculum on compassionate
casualty / death notification for professional counselors and
victim advocates (Lord, 1996), developed by Mothers Against Drunk
Driving (MADD). It is summarized and printed with the permission of
MADD.
Death Notification Procedure
The coroner or medical examiner is absolutely responsible for
determining the identity of the deceased.
Notify in person. Don't call. Do not take any possessions of
the victim to the notification. If there is absolutely no
alternative to a phone call, arrange for a professional, neighbor,
or a friend to be with the next of kin when the call comes.
Take someone with you (for example, an official who was at
the scene, clergy, and someone who is experienced in dealing with
shock and/or trained in CPR/medical emergency). Next of kin have
been known to suffer heart attacks when notified. If a large group
is to be notified, have a large team of notifiers.
Talk about your reactions to the death with your team
member(s) before the notification to enable you to better focus on
the family when you arrive.
Present credentials and ask to come in.
Sit down, ask them to sit down, and be sure you have the
nearest next of kin (do not notify siblings before notifying
parents or spouse). Never notify a child. Never use a child as a
translator.
Use the victim's name... "Are you the parents of
________?"
Inform simply and directly with warmth and compassion.
Do not use expressions like "expired," "passed away," or
"we've lost __________."
Sample script: "I'm afraid I have some very bad news for
you." Pause a moment to allow them to "prepare." "Name has been
involved in __________ and (s)he has died." Pause again. "I am so
sorry." Adding your condolence is very important because it
expresses feelings rather than facts, and invites them to express
their own.
Continue to use the words "dead" or "died" through ongoing
conversation. Continue to use the victim's name, not "body" or "the
deceased."
Do not blame the victim in any way for what happened, even
though he/she may have been fully or partially at fault.
Do not discount feelings, theirs or yours. Intense reactions
are normal. Expect fight, flight, freezing, or other forms of
regression. If someone goes into shock have them lie down, elevate
their feet, keep them warm, monitor breathing and pulse, and call
for medical assistance.
Join the survivors in their grief without being overwhelmed
by it. Do not use cliches. Helpful remarks are simple, direct,
validate, normalize, assure, empower, express concern. Examples: "I am so sorry." "It's harder than people think." "Most people who have gone through this react similarly to what you
are experiencing." "If I were in your situation, I'd feel very
___________ too."
Answer all questions honestly (requires knowing the facts
before you go). Do not give more detail than is asked for, but be
honest in your answers.
Offer to make calls, arrange for child care, call clergy,
relatives, employer. Provide them with a list of the calls you make
as they will have difficulty remembering what you have told
them.
When a child is killed and one parent is at home, notify
that parent, then offer to take them to notify the other
parent.
Do not speak to the media without the family's
permission.
If identification of the body is necessary, transport next
of kin to and from morgue and help prepare them by giving a
physical description of the morgue, and telling them that "Name"
will look pale because blood settles to point of lowest
gravity.
Do not leave survivors alone. Arrange for someone to come
and wait until they arrive before leaving.
When leaving let him/her or them know you will check back
the next day to see how they are doing and if there is anything
else you can do for them.
22. Call and visit again the next day. If the family does not
want you to come, spend some time on the phone and re-express
willingness to answer all questions. They will probably have more
questions than when they were first notified.
Ask the family if they are ready to receive "Name's"
clothing, jewelry, etc. Honor their wishes. Possessions should be
presented neatly in a box and not in a trash bag. Clothing should
be dried thoroughly to eliminate bad odor. When the family receives
the items, explain what the box contains and the condition of the
items so they will know what to expect when they decide to open
it.
If there is anything positive to say about the last moments,
share them now. Give assurances such as "most people who are
severely injured do not remember the direct assault and do not feel
pain for some time." Do not say, "s(he) did not know what hit them"
unless you are absolutely sure.
Let the survivor(s) know you care. The most beloved
professionals and other first responders are those who are willing
to share the pain of the loss. Attend the funeral if possible. This
will mean a great deal to the family and reinforces a positive
image of your profession.
Know exactly how to access immediate medical or mental
health care should family members experience a crisis reaction that
is beyond your response capability.
Debrief your own personal reactions with caring and
qualified disaster mental health personnel on a frequent and
regular basis - don't try to carry the emotional pain all by
yourself, and don't let your emotions and the stress you naturally
experience in empathizing with the bereaved build into a problem
for you.
