Item# 226-D
ISBN13: 978-0-942679-08-3
ISBN: 0-942679-08-3
Copyright 1994
277 pp.
1.19lb
Form: Paperback, Trade paperback (US)
Price: $19.95

Death Notification

A Practical Guide to the Process

By R. Moroni Leash

If it is your job to notify a family that a death has occurred—or is soon expected—how do you do it right? Using vivid examples, Leash guides the reader through this difficult task in a wide variety of situations. His research and personal experience will help you to meet the family’s needs in a constructive, helpful way—and to avoid the all-too-common mistakes that can compound the tragedy. Important reading for physicians, nurses, emergency personnel, clergy, law enforcement, military, and social workers.

About the Author

R. MORONI LEASH

R. Moroni Leash, PhD, has had a long career in grief counseling and social work. At the time he researched this book he was a clinical social worker, then, later, psychiatric evaluator at the University of California, Davis, Medical Center. During that time, the hospital was the busiest trauma center in the U.S., handling more than 3,500 major traumas per year. He is, today, one of the nation’s foremost specialists in the psychological impact of traumatic bereavement. His book, which includes substantial original research, is widely acclaimed today as the foremost source of information on dealing with this difficult topic.

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What People are Saying                                                                Sample Content
 

 

What People are Saying

“This sensitive, insightful and extremely helpful guide should be read by all health-care providers.”
—Thomas A. Raffin, M.D., Co-Director, Center for Biomedical Ethics, Stanford University

“This book brings sensitivity, empathy, dignity, and respect to a process that tends to devastate both the giver and the receiver of the ultimate bad news.”
—LTC Terry A. Dempsey, Chief of Chaplains, U.S. Department of Defense

“We have only one chance to tell a family that a loved one has died. Mr. Leash’s book can help us to do it right the first time.”
—Frank Nieto, LCSW, Social Work Director, University of California Davis Medical Center

“Death Notification should be read by every police officer and every officer in training!”
—Kevin P. Scully, Chief of Police, Burlington, Vermont

“I would recommend this text to nurses as a comprehensive guide to death notification.”
—Annita B. Watson, Chair, Division of Nursing, California State University, Sacramento

“An informative and well-written text that covers many complex issues surrounding this topic.”
—Dr. Ian C. Hood, Deputy Medical Examiner, Philadelphia, Pa.
y complex issues surrounding this topic.”

Dr. Ian C. Hood, Deputy Medical Examiner, Philadelphia, Pa.

Sample Content

Table of Contents

About the Author
Introduction
Part One: The Notification Process

  1. Initiating the Notification Process
    Within a Hospital
    *Notification by a Physician…Notification by a Nurse…Notification by a Psychotraumatologist…Notification Complexity…Case Vignette 1.1
    In the Field
    *Field Notifier Selection Guidelines…Law Enforcement Officers…Emergency Medical/Fire Department Staff…Coroners Staff…Military Personnel
    Legal Issues in Notification
    Contraindicators for Designers
  2. Information Gathering
    Identification of the Deceased
    *Accident Co-victims…Ambulance/Transport Staff…Law Enforcement Staff…Contents of the Deceased’s Pockets…Miscellaneous Papers and Cards…Other Belongings…Telephone Directory Assistance…Vehicle Registrations…Physical Description…Fingerprints/Missing Persons Reports…Cautionary Notes
    Family Contact
    *Timely Notice…Family Confirmation of Identity
    Death Debriefing
    *Military Issues
    Information and Crisis Management
    *Drug Abuse Deaths…Homicide…Complicating Information
    Conclusions
  3. Notification Staging and Delivery
    Initial Family Contacts
    *Timing the Notification…Telephone Contacts…Telephone Notification “On Demand”
    Selection of Physical Surroundings
    Notification Technique
    *Sequential Notification…Accidental Death…Natural Death…Resuscitation in Progress…Emotional Support
    Screening the Information Released
    Extrapolation of Techniques
  4. Special Issues in Notification
    Long-Distance Notification
    *Travel Time…Telephone Contacts…Case Vignette 4.1…Case Vignette 4.2
    Anticipatory Notifications
    *Case Vignette 4.3
    Telling Children
    *Case Vignette 4.4
    On-Scene Notifications
    *Assessment of Bereft…Surroundings Selection…Notification Delivery…Viewing a Body On-scene…Support and Follow-up
    Notification Contraindicators
    *Accident Co-victims…Surgery or Sedation…Traumatic Brain Injuries…Survivors on Respiratory Support…Alcohol and Drugs
    Homicide
  5. Notification Follow-up
    Debriefing
    *Loss Context…Religious Support Contact…Additional Family Contacts…Helpful Family and Friends
    Viewing the Body
    *You’re First…Family Reluctance…Viewing and Denial…Death Phobias…Preparation of the Body…Positioning of the Body…Escorting Family to the Viewing…Viewing Children/Infants…Photographs
    Consent for Autopsy
    Funeral Arrangements
    *Funeral Expenses…Therapeutic Involvement…Vignette 5.1
    Assessment and Referral
    *Bereavement Literature…Counseling and Support Group Referrals…Follow-up Letters
    Public Information Release
  6. Organ and Tissue Donation
    The Need and the Benefits
    Family Preparation (with suggested dialogue)
    Religious Perspectives on Donation
    Cautionary Notes
    *Case Vignette 6.1

Part Two: Grief Management

  1. Grief Reaction Theories and Typical Notification Responses
    Making Room for Grief
    *Case Vignette 7.1…Case Vignette 7.2
    Understanding Grief
    *The Physiology of Grief…The Behaviors of Grief…Theories of Grief Resolution Patterns
    Identifying Coping Patterns
    Typical Notification Responses
    *Holistic Grief…Action-Oriented Grief…Inordinately Calm Responses…Emotional Withdrawal…Extreme Guilt…Situational Blaming…Grief and Anger
    Demonstrative Notification Responses
    *Highly Vocalized Grieving…Striking Out Reactions…Self-Striking Reactions…Emotive Chanting
    Management Strategies
    *Family Crises…Case Vignette 7.3
    Physiological Responses
  2. Pathological Grief
    Family Disfunction
    *Case Vignette 8.1
    Suicidal Ideation
    *Case Vignette 8.2
    Violent Behavior
    Homicidal Ideation
    *Tarasoff Regulations
    Grief Influenced by Drugs and Alcohol
    Extreme Denial
    *Case Vignette 8.3
    Signs of Pathological Grief
  3. Bereavement Perspectives
    Bereavement Relationships
    *Death of a Spouse/Significant Other…Death of a Child…Case Vignette 9.1…Death of a Parent…Death of a Friend
    Children’s Perspectives of Death
    *Special Concerns
    Cultural Issues
    *Case Vignette 9.2
    Mode of Death
    *Stillborn…Case Vignette 9.3…Sudden Infant Death Syndrome…Abortion…Suicide…Substance Abuse…Murder…Drunken Driving
    Conclusion
  4. Family Assessment and Crisis Intervention
    Physical Assessment
    Emotional Assessment
    Support Systems Assessment
    Mental Status Examinations
    Counseling Techniques for Crisis Intervention
    *The Crisis Intervention Model…Case Vignette 10.1
    Follow-up Needs Assessment
    *Eustress vs. Distress…Preventive Intervention…High-Risk Bereavement Follow-up Check List
  5. Grief Management Strategies
    Primary Goals
    Actualizing Support for the Bereaved
    *Allow Natural Expression…Viewing the Body (Therapeutic)
    Verbal Support for the Bereaved
    *What Not to Say…Potential Dialogue Topics…Life Telling…Fairness…Owning the Pain…The Learning Experience…The Gifts of Love…The Broken Leaf…Life’s Pictures…The “Magic Wand”…Reasoning…Religious Views
    Guidelines for Friends of the Bereaved
    Professional Preparation
    *Case Vignette 11.1
    Recognizing Your Limits
    Staff Grief and Stress Management
    *Case Vignette 11.2
  6. Delivering a Terminal Diagnosis
    The Physician’s Unavoidable Responsibility
    The Importance of the Task
    *Case Vignette 12.1
    Preliminary Steps
    *Staging the Delivery of the News…The Potential for Emotional Reactions, Including Yours
    The Language of Disclosure
    *Timing Delivery of the News…Exploration of What is Already Known…Assessment of the Wish to Be Informed…”Offering” Truth…Case Vignette 12.2…Informed Consent
    Delivery of the News
    *Key Concepts…Practical Application…Let There Be Hope…Use of Humor in Notification
    Responses and Family Perspectives
    *”So, Doctor, how much time do I have?”…Comments on Denial…Cultural Issues…Therapeutic Privilege…Suicide Management
    Necessary Follow-up
    *The Treatment Plan…Case Vignette 12.3…Treatment Plan “Evolution”…Case Vignette 12.4
    Accepting the Patient’s Choices
    *Advance Directives…Do Not Resuscitate Orders…Case Vignette 12.5…Hospice
    Extrapolation of Techniques
    Medical Training
    *Case Vignette 12.6

Part Three: Research Presentation

  1. Formal Research Examined
    Introduction…Assumptions…Research Format…Design…Content…Subjects…Weaknesses…Analysis of the Data…Demographic Commentary…Survey Opinions…Research Summary…Conclusion

Appendices

  1. Telephone Contact Checklist
  2. Tissue Donation Protocol
  3. Organ Donation Protocol
  4. Legal Next-of-Kin Determination
  5. Organ/Tissue Donor Designation in the Absence of Legal Next-of Kin
  6. Religious Views on Organ/Tissue Donation
  7. Media/Information Release Protocol
  8. Acute Symptoms of Grief
  9. Normal Grief Symptoms and How to Cope With Them
  10. Resources for Bereavement
  11. Family Funeral Checklist

Bibliography
Index