Notifying next of kin

Health workers, law enforcement officials and clergy say it's hard to break bad news to families

Health workers, law enforcement officials and clergy say it's hard to break bad news to families

February 24, 2003|by JULIE E. GREENE

When Dr. Tom Gilbert had to tell parents last month that their son had died after a skiing accident, he made sure a psychiatric social worker was there to help.

After breaking the bad news, Gilbert and the nurses at Washington County Hospital's emergency department turned again to the psychiatric social worker - this time for themselves.

"It's a team approach. You've got to support each other. If you don't talk about these things, if you don't air them out or talk about how you feel, you burn out and won't want to come back to work," said Gilbert, chairman of emergency medicine.


Talking about their feelings to co-workers and family, reviewing their actions, patting each other on the back, hugging, even crying together help the deliverers of bad news cope with their own sense of loss or grief.

"You're human. You learn how to deal with it. If you can't, you can't deal with your job," Gilbert said.

Often when a patient dies in a nursing home or once they're receiving care from hospice workers, the family is already prepared somewhat for the death.

When death is unexpected, calling the family can be awkward, said Sylvia Moats, a licensed practical nurse at Homewood at Williamsport.

"It's a touchy situation. We try and present it as comfortably as possible," said Moats, 46, of Hancock.

"'I called to let you know that your loved one has passed away,'" Moats tells them. Moats tells them how the person died and sometimes ends up crying with the family.

"There have been times they comfort me," she said.

Directness is often the best approach when telling someone a loved one has died, said caregivers with Homewood and Hospice of Washington County.

"It's really a poor practice to beat around the bush," said Lori Slick, director of nursing at Homewood.

Before Libby Fitz began working for Hospice two years ago, she worked in a nursing home caring for 42 patients a night. When it was obvious a patient was in his or her last hours, Fitz would call the family so they could come and say good-bye. She would make coffee for them, set the lighting to a soft level and put on comforting music.

"I was an anomaly," Fitz said. She said she wanted to make the environment warm and inviting for the family because death can be beautiful.

When Gilbert realizes a patient is dying or if he senses the family is having trouble handling the impending death, he will invite family members back into the emergency department so they can see the doctors and nurses are doing all they can.

Sometimes that helps not only the family, but Gilbert, too, he said.

On those occasions when the family doesn't know the person has been seriously injured or has died, Gilbert will call them and ask them to come to the emergency department.

Last month, when 12-year-old Samuel Johnson died at the hospital from injuries sustained when he skied into a tree, Gilbert had to call the mother in Montgomery County, Md., and the father in New Jersey.

Their son had already died, but Gilbert told them only that he was injured and they needed to come to the emergency department.

"It is a bit of a moral dilemma, but I want to make sure they're getting there safely," Gilbert said. "I try to avoid telling them too much on the phone because we don't want them to rush here, especially if they are alone."

He advises they have someone else drive them, as a neighbor who is a police officer did for Johnson's mother, Gilbert said.

Gilbert said his crew won't do death notifications by phone unless absolutely necessary.

Maryland State Police policy calls for death notifications to always be done in person, by an officer and a chaplain, said The Rev. Allan Weatherholt, chaplain for the state police's Hagerstown barrack.

"It is a tough job, but it's one of those things that has to be done," Weatherholt said.

"We want to do it with as much compassion and gentleness as possible," Weatherholt said. "The policy of the state police is to always do death notifications in person. We never do them over the phone.

"You're bringing the shocking news, completely unexpected usually until a state policeman and a chaplain show up at their door," he said.

The trooper answers questions about what happened, while Weatherholt tries to comfort them and arranges for someone else - family, clergy, friend, to stay with the family after he and the officer have left.

"The biggest thing is learn to listen," Maryland State Police Sgt. Steve McCarty said. "People can do their own therapy. They're working their way through by talking to me."

When with the family, "you have to remember first and foremost that it is not your personal grief. It's the family's grief," said Lynn Schlossberg, a social worker for Hospice of Washington County.


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