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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 .
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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 .
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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
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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)
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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 .
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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.
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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.
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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.
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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.
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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 .
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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
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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.
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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.
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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
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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.
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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.
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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.
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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.