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A study of bereavement care after a sudden and unexpected death
  1. O C WARD
  1. Department of Paediatrics
  2. University College
  3. Dublin, Ireland

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    Editor,—Dent et al state that no studies have concentrated on parents’ perception of standards of bereavement care in sudden death.1 In 1986 Ward et al reported the findings in 100 fami!ies who had experienced a sudden infant death who were visited at home by a social worker.2 Serious deficiencies were highlighted.

    Our Lady’s Hospital for Sick Children, serving the south side of Dublin city, produced new procedures based on discussion between nurses, chaplaincy, social service, and paediatric staff with involvement of police and funeral directors. Specific responsibilities were given to each professional. A parents’ booklet explained their roles.

    A senior paediatrician led the group and the parents saw the paediatrician immediately. He gave them the necropsy results in two to three days. He saw them again in six to eight weeks and ongoing liaison was maintained through the casualty ward sister who maintained an open line of communication. The family doctor and public health nurse were informed.

    An independent review was conducted by The Irish Sudden Infant Death Association in 1989. This confirmed that the guidelines were effective. Familes found the system helped, was sympathetic, honest, and informative. Good procedures can avoid short term dissatisfaction among families. Of greater importance however are the long term benefits. A review by Powell made it possible to make a comparison between those who had been counselled as described and those who had not.3 Only three of 18 families who had had medical counselling had long term unresolved grief problems (18%), as against 17 of 23 (74%) who had not had medical counselling.

    Good procedures can be of long term benefit and every district should review its working practices in the light of the study of Dent et al. 1

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