Every year, thousands of Swedes die from sudden cardiac arrest. For the deceased’s family members, the time following the death can be very tough. Despite this, few family members are offered support measures from the health care services. A new dissertation by Nina Carlsson points out the need for professional support measures to help family members deal with the grief.
“The loss of a family member or a person close to you is one of the most stressful experiences you can have in your life. For family members, the loss can have a significant impact on both mental and physical health. Despite this, there is no structured support within the health care services today for family members. In order to develop such support, knowledge is required about the grief reaction of family members”, says Nina Carlsson, researcher in health science at Linnaeus University and certified nurse.
Common with grief that does not go away
In her dissertation, Carlsson shows that a significant share of the family members suffer from prolonged grief, that is to say, grief that does not subside over time, but also from anxiety and depression in the aftermath of the sudden loss.
However, health care services often fail to recognise the needs of family members. 86 percent of the family members in the study answered that they had not been offered any support from the health care services.
“Family members sometimes describe that the support they got from staff during the acute stage was helpful, but that later on, after the death, there can be a vacuum where family members do not get any support over time and do not know where to turn for support”, Carlsson continues.
Lack of established contacts with the health care services
One explanation is that at sudden deaths, there is often no established contact between family members and the health care services on which to continue building. It is up to the family member to seek out support, which not everyone is able to do.
“This can be an overwhelming task, which means that the person in grief is at risk of being left on his/her own with the burden of complicated grief reactions. Being able to talk about it is an important part for the family member who must adapt to a life without the deceased person. In interviews, family members described that it can be difficult to understand each other’s grief reactions and that they do not want to burden other people with their grief”, Carlsson continues.
Structured support needed
Carlsson means that the health care services must offer structured support to family members. Every family member should be offered at least that staff from the health care services answer any questions there may be.
Follow-up talks are important for a number of reasons. It reduces the number of questions that the family member may have, while also giving the health care services an opportunity to identify any further need for support for the family member.
“At a sudden cardiac arrest and death, family members are left with many questions. In order to understand what has happened and not get stuck in dwelling on thoughts it is important to get to ask questions and get the answers that are available. This can be questions concerning what happens when a person suffer from a sudden cardiac arrest, fear of being affected by a heart disease yourself, or that someone else will be affected. It can also reduce worry to be examined”, Carlsson explains.
Several good examples
Here we can learn from the palliative care.
“From a palliative approach, health care services has a responsibility also for family member. The health care is designed based on the needs of both the patient and the family member. We do not have to invent the wheel, instead we can learn from good examples”, says Carlsson.
There are many good examples on support for family members in connection to emergency care as well, Carlsson adds. For instance, in cases where there is a designated support person in the emergency stage, who stays on and takes care of family members.
“However, at deaths that take place outside a hospital, there can be a gap, especially if there is no previously established health care contact”, Carlsson concludes.
Nina Carlsson on meeting family members
“We who work in the health care services also need education and training in how to implement a family focus and how to identify family member’s need for support in connection to cardiac arrest. It varies how comfortable members of staff are to meet family members and talk about death. At a sudden cardiac arrest, it is important that both family members and staff get the opportunity to process what has happened. Through education measures, members of staff can become more comfortable with talking about death and meeting existential questions. In the future, I would like to see some kind of additional training with which you can supplement the Cardiopulmonary Resuscitation (CPR) training, with focus on the situation of family members” says Carlsson.
Nina Carlsson’s dissertation in health science: Sorgereaktioner hos närstående till personer som har avlidit till följd av plötsligt hjärtstopp