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Grave Words: Notifying Survivors about Sudden, Unexpected Deaths
Kenneth V. Iserson, M.D.

Extras:
Sample Advance Directives
Non-Verbal Messages
DECOMPOSITION
Funeral Industry Jargon
ORGAN AND WHOLE-BODY DONATION CARDS
A Sample Protocol to Use When Speaking With Survivors
Expected versus Sudden, Unexpected Deaths (Table 1-1)
Sample Slides
SOULS ON ICE

Related Materials:
Pocket Protocols for Notifying Survivors about Sudden Unexpected Deaths
Teaching Slides on Death Notification
The Gravest Words Video

ISBN: 1-883620-02-3
Catalog # 018 $38.95 Paper
343 pages, Bibliography, index
1999

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Table of Contents

Sudden death notification is one of the most stressful-and surprisingly frequent-parts of many professionals' jobs. Only one to seven patients per 100, on average, are discharged from hospitals alive after medics have performed out-of-hospital CPR. More than one-fourth of all in-hospital deaths are unanticipated, rising to two-thirds in the emergency department setting. These figures mean that many people can become involved in a death notification. Yet education and training is often woefully inadequate-with unfortunate consequences for the survivors.

Grave Words: Notifying Survivors About Sudden, Unexpected Death is written to provide all those in the helping professions who must relate tragic news with in-depth information, protocols, and case studies tailored to a variety of situations. Potential notifiers will learn:

· To be aware of non-verbal communication.
· When to use the "D words": death, died, and dead.
· "Helping" phrases and how to avoid clichés.
· Protocols for long-distance telephone notifications.
· Which resources and referrals survivors need.
· Typical questions of survivors-and answers.
· How to request organ or tissue donation.
· How to tell children, parents, and disaster survivors.
· When survivors should view the body of their loved one.
· How to identify acute grief reactions.
· How to build a Memory Box.
· How and when to follow up with survivors.
· Good course objectives for death notification education.

Physicians, nurses, emergency department staff, police, ambulance or fire department personnel, chaplains, social workers, medical examiners or coroners, and others in helping professions will learn to better help survivors and to effectively teach those notification skills to others. National bereavement resources, an educational outline, and in-line-of-duty notification and airline disaster protocols are included.

Grave Words: Notifying Survivors About Unexpected Deaths begins:

Directness, truth, consistency, and clarity are the key factors when delivering information about a sudden, unexpected death. These points were driven home for Jennifer Gilbert, a Galen Press editor, while she was reading this manuscript for the first time. She encountered sudden death one evening and describes the experience:
Hearing Kathy scream my name, I rushed next door. "My baby is dead," she moaned in disbelief as she met me at the door. She had just returned from work to find her 40-year-old fiancée lying face down on the kitchen floor. It was obvious from his coloration that he had been dead for hours. I hugged her hard while I tried to swallow my own mounting panic, fear, and grief. Instinctively, I knew there was nothing I could say-just being there, hugging her, was enough.
"He's asthmatic," she had me relay to the 911 operator as she leaned over his body, "He'd just discovered that the inhaler he was using could cause his heart to stop." Within minutes (it seemed much longer) the room began to fill with paramedics and policemen. Somehow Kathy was pushed out onto the front porch as they proceeded to do something to his now lifeless body. "They're going to take him away from me," she cried. "Why are they working on him? He's not coming back." A paramedic rushed past carrying syringes. "Is he breathing?" she asked. "No, he's not," the young man answered quickly, without pausing or turning his head.
I rubbed Kathy's back as she crouched by a phone, trying to remember people to call. I asked if there was someone I could notify and she had me telephone a nearby relative. "Don't say he's dead," she cautioned, "Say there's been an accident and to meet us at the hospital." I will always remember how clear she was-still thinking about others in the midst of her terrible shock and sadness.
A couple of men brought in a gurney in preparation for the short ride to the hospital emergency room. "I want to go with him. I have to go with my baby," Kathy sobbed. My role had been to hug her whenever she needed support, inform the professionals entering the yard that the dogs were harmless. Now I rushed out to the ambulance and made sure she would be allowed on board. Everyone seemed extremely busy, absorbed in the tasks they no doubt performed efficiently several times a day, but they nodded a brief affirmative.
By the time her fiancée's body was placed in the ambulance, a young policeman, who told her she needed to answer some questions, had stopped Kathy in the living room. "I have to go with the ambulance," she pleaded. But three minutes later the ambulance sped away, carrying his lifeless body and leaving Kathy to follow behind in my truck. This created a lasting (and unnecessary) memory of callousness and pain for Kathy, who needed to spend those last moments with her partner's body. At no time did any of the professionals involved in the response take a personal interest in the one person who would remember this evening forever-Kathy, the survivor.
Death has replaced sex as the major taboo topic in Western culture. Imaginary death-such as cartoon-like violence on television and in movies-has replaced reality for most people. When death strikes, as it must, and especially if it strikes suddenly and unexpectedly, we respond with discomfort, distress, and dismay.


What healthcare professionals say about
Grave Words: Notifying Survivors about Sudden, Unexpected Death:


"I will use this book frequently as a reference when teaching physicians and others about giving bad news. I've never seen a better source on the subject. I'm sure your book will be on the shelf of many care providers who find themselves in the situation of having to deliver bad news to a family."
Kate Christensen, M.D.
Chief of Bioethics, Kaiser Permanente, Northern California

The book is outstanding, both as a text to educate a person in how to make death notifications and as a guide for the development of policies for institutions to use in handling death notification. As a pathologist, I've been involved in both positive and negative experiences related to death announcements. Dr. Iserson's wealth of information-highlighted by his diverse anecdotes-makes for wonderful reading.
Anna R. Graham, M.D.

The lack of communication skills among health care professionals is one of the real barriers to improving care at the end-of-life. Grave Words is the kind of "how to" resource that health care professionals need to communicate better with dying patients and their loved ones. . . . Much of what Iserson provides can be of assistance as health care professionals struggle to "deliver bad news" in a variety of situations.
Myra Christopher, President and CEO, Midwest Bioethics Center, Director, Community-State Partnerships to Improve End-of-Life Care

This book made the "light go on." I never realized how deficient I was in providing comfort and information to the survivors of sudden and unexpected death. I would strongly recommend this book to all emergency personnel. The survivor information sheet is a wonderful idea.
Gary H.Lambert, M.D.

What a terrific resource! Practical, forthright, and sensitive. A critical resource for every healthcare professional!
Kyle Nash, Center for Clinical Medical Ethics, Pritzker School of Medicine, Chicago, IL

ISBN 1-883620-02-3 Softcover, 354 pp.
# 018 $38.95

Extras:
Sample Advance Directives
Non-Verbal Messages
DECOMPOSITION
Funeral Industry Jargon
ORGAN AND WHOLE-BODY DONATION CARDS
A Sample Protocol to Use When Speaking With Survivors
Expected versus Sudden, Unexpected Deaths (Table 1-1)
Sample Slides

Related Materials:
Pocket Protocols for Notifying Survivors about Sudden Unexpected Deaths
Teaching Slides on Death Notification
The Gravest Words Video

 

Copyright 2001-2013 Galen Press, Ltd.