Death far away from families
Press Release from the French National Academy of Medicine
November 4, 2020
With the second wave of Covid-19 and the rapid increase in the number of deaths, the introduction of a new containment leads us to recall a few principles on the support of bereaved families.
Any death of a loved one, a fortiori unexpected or brutal, is a confrontation with the end of a common history, or even an unfinished story. Emotional ambiguities and sometimes unresolved conflicts, grey areas that can no longer be dealt with, survive the ordeal of separation. The words that we promised ourselves to say one day will be lost forever.
Every family faced with the pain of a definitive separation is in search of information, of understanding: how did death occur, how did the parent cope with it? Did he or she suffer?
After a first reaction of denial, usual at the time of the announcement, comes the awareness of the reality of death and the fate of the body. These are all questions that call for answers.
The final glance at the deceased is an irreplaceable moment, for many necessary, the cornerstone of acceptance. This confrontation must be proposed as far as possible, in compliance with health safety rules, to the person of trust, the family, and close relatives.
Faced with the death of a loved one, each behavior is special. It is important to respect the choices of each family in their cultural and religious dimensions, to the best of its ability.
The epidemic of Covid-19 and the constraints of containment prevent many families from accompanying the end of life of a relative, especially in the case of residents in EHPAD (Sheltered Home for Elderly Dependent Persons).
The failure to present the body, justified by health safety grounds requiring immediate coffin-battering in a closed coffin, underestimates the need to represent reality, generating feelings of dispossession, even guilt, and worsens the perception of an unfinished emotional story.
Some practices can help: a photograph of the deceased’s face recorded by a caregiver and kept in the hospital medical file available to the family, the availability of the nursing and medical entourage, an interview with a member of the care team, a psychologist, or psychiatrist.
In order to humanize the circumstances of mourning in an epidemic period, the Academy of Medicine recommends:
– to maintain the possibility of visiting a resident in EHPAD, while respecting the rules of health safety, and to facilitate the conditions of the family presence when the medical prognosis suggests a close end;
– to invite the families deprived of proximity to their loved one during the last stages of his/her life, if they wish, to meet a representative of the care or accompaniment team in order to trace the conditions of departure of the loved one.