8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 1/20

  Al-zaytoonah private university of Jordan

faculty of nursingmaternal and child health department

growth and development course ( 801357)group no. : 1 .

Presentation about : Nursing care of the dead child .Prepared by : heba al-khozae , neveen ali , hala al-qebaly ,alaa .

dr. name : dr. ehsan lash .

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 2/20

describe the facing death and loss : social and

psychological issues . describe special conditions of death .

describe phases of grief and mourning .

describe nursing role in caring for the dead child and

his family .

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 3/20

Loss:Loss: T wo categories of loss exist: physical andsymbolic losses. A physical loss is the loss of something tangible, and often others recognizephysical losses. In contrast, a symbolic loss is the lossof something intangible (divorce, retirement, thedevelopment of chronic illness, shattered dreams),

 which is seldom recognized by others as a lossgenerating feelings that require processing

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 4/20

Grief :Grief : Grief refers to the process of experiencing psychological, behavioral, social

and physical reactions to loss. It is a continuingprocess involving many changes over time. It isa natural reaction, and its absence may beabnormal and indicative of pathology. It is areaction to all types of loss, not just death, and

it is dependent on an individuals uniqueperception of loss and does not need socialrecognition or validation by others (ie, it is thespecific subjective feeling that accompanies aloss)

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 5/20

 M ourning :  M ourning :  Mourning is the cultural

and/or public display of grief through ones

behavior. It is the process through which theresolution of grief may be accomplished.

Bereavement :Bereavement : Bereavement is the

entire process precipitated by the loss of a lovedone through death .

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 6/20

S tillbirth (and miscarriage): S tillbirth (and miscarriage): R  yandiscusses stillbirth and miscarriage. Emotionalbonding occurs well in advance of birth, andparents bring with them expectations anddreams about themselves as parents and aboutthe child that they will have. The lost imagesand projections constitute major secondary losses, which must be mourned no matter whatthe age of the child; therefore, even in deathbefore birth, parents lose much.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 7/20

C ongenital anomalies : C ongenital anomalies : Looking at an infant with anomalies from the perspective of an outsider

is very different from seeing that infant from theperspective of a loving parent. Often, parents seethe good features, while the deformities or unusualfeatures will not be that important. Many 

anomalies can be disguised by dressing or wrapping the baby in a blanket, or clothing theinfant.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 8/20

Twins : Twins : Parents have mixed feelings when one twindies and the other one survives , Parents who lose onetwin may have more difficulty during bereavement

than parents losing singleton infants . S iblings : S iblings : Depending on their age, siblings may develop some of the same symptoms that parentsexperience after a perinatal death. Paediatricians and

family doctors should understand, and evaluatechildrens reactions to death by using age appropriateand culturally sensitive guidance while being alert fornormal and complicated grief responses , Parents may become overprotective of their children.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 9/20

A voidance or pr otest :  A voidance or pr otest :  Avoidance or

protest covers the period during which thenews of death is initially received and thetime brief ly thereafter. Generally, it lasts for

a few hours to several days.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 10/20

C onfr ontation and disorganization : C onfr ontation and disorganization : The phase of confrontation and

disorganization is a time when grief isexperienced most intensely, and reactions tothe loss are most acute; it introducesawareness of finality. This is a painful,internal phase .

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 11/20

 Accommodation or reorganization :  Accommodation or reorganization : there is a gradual decline in the symptoms of 

acute grief, and the beginning of social andemotional reinvestment in the world , Thisprocess, which extends for at least one to

two years, indicates the completion of mourning because the person enjoys lifeagain and begins looking toward the future

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 12/20

 Attaching (bonding) and memories :  Attaching (bonding) and memories : 

Many actions in the NICU or in the laborand birth area that are taken to facilitate theattachment of the parents with their infant

 will become memories after a sudden oreven an expected neonatal death.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 13/20

O ptimize immediate interaction  withO ptimize immediate interaction  with parents :  parents :   W henever possible, the news of impending death should be discussed rather

than waiting until death occurs. B y givingcomplete and understandable information,there is a smaller chance that parents will feelthat health care professionals are hiding

something from them. Care providers shouldbe understanding and caring, and it isappropriate for them to express empathy, andto show their feelings and concerns.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 14/20

important actions to be taken d uring and after important actions to be taken d uring and after the death o f a baby : the death o f a baby : 

 Assure parents that it is normal to feeluncomfortable at this time

 Allow parents to spend as much time as they need with their baby 

Make repeated offers for holding the baby 

Name the baby 

Provide privacy, but do not abandon the parentsEncourage relatives and friends to see the baby,according to the parents wishes

 W arn about gasping and muscle contractions

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 15/20

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 16/20

Use simple and straightforward language.

Be comfortable showing emotions .

Listen to the parents and touch the baby.

Im sorry. I wish things would have ended differently.

I dont know what to say.

I feel sad or I am sad for you.

Do you have any questions?.

 W e can talk again later.

 Answer questions honestly.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 17/20

Do not say:

Its best this way.

It could be worse.

You can have more children.

Time will heal.

Its good your baby died before you got to know him

or her well. Do not use medical jargon.

Do not argue with parents.

Do not avoid questions.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 18/20

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 19/20

 W hen giving bad news, both parents or one parent with another support person should be present.Simple language should be used, allowing time forlistening and answering questions honestly.

The best ways that a health care professional cansupport a grieving family are by offering anonjudgmental, deep sense of caring and personalinvolvement.

Before and after the death of a baby, parents shouldbe allowed to spend as much time as is needed withtheir child.

Spiritual support should be made available.

8/8/2019 Nursing Care of the Dead Child

http://slidepdf.com/reader/full/nursing-care-of-the-dead-child 20/20

Chambers HM, Chan FY. Support for women/familiesafter perinatal death (Cochrane R eview). In: The CochraneLibrary, issue 1. Oxford: Update Software, 1999.

Fox R , Pillai M, Porter H, Gill G. The management of latefetal death: A guide to comprehensive care. Br J ObstetG ynaecol 1997;104:4-10.

R  yan R . Loss in the neonatal period: R ecommendationsfor the pediatric health care team. In:  W oods JR , Esposito W oods JL, eds. Loss During Pregnancy or in the NewbornPeriod: Principles of Care with Clinical Cases and Analyses.Pitman: Jannetti Publications Inc, 1997:125-57.