Death Notification: Helping Survivors Handle Grief
Training Notebook
No matter the size of their department, most firefighters eventually will have to deal with a fatality. Whether a person dies in a fire, car accident, or industrial incident, the firefighters on the scene may have to help survivors deal with the situation. Even on departments with chaplains or other people trained in crisis intervention, the responsibility may still fall to a firefighter until help arrives.
It’s a job few firefighters are prepared for.
“Firefighters receive a lot of training in how to do the physical and technical aspects of the job,” says Dr. James Hendricks, a past president of the National Academy of Crisis Intervenors who has written extensively on death notification.
“It’s unfortunate that they don’t get that much in death notification. They never know when they may be called upon to deliver a death notice, and it needs to be done properly.”
One stumbling block can be the firefighter’s own feelings about death. Since Western society tries to ignore death, few people can discuss it comfortably, and little systematic help is given to survivors. Phrases such as passed on or gone have been concocted to avoid the word death. Even those in the public safety field are not immune to the impact of death, often making grim jokes in an attempt to minimize their natural feelings about it.
“A person can get dragged down into unproductive interactions unless they have first resolved many of the issues surrounding death within themselves,” notes Hendricks, who also works with the American Board of Examiners in Crisis Intervention and teaches criminal justice at Ball State University. “If they haven’t adequately resolved a death in their own family or even thought about their own death, it will inhibit them from assisting others through the grieving process.”
Death notification under the circumstances that are often associated with the fire service can be difficult.
For one thing, the scene of a fire or accident isn’t a good setting for dealing with grief. If at all possible, the firefighter should find a private place to talk to the survivors—such as a neighbor’s house, the chief’s car, or even an equipment van.
Another difficulty is that those at the scene may not know exactly what’s happening. It may not even be clear whether a fatality has occurred. Many ambulance services are required to transport the victim to a hospital unless the person is obviously deceased. If transport occurs, the firefighter should tell the family which hospital the person was taken to. Arrangements should be made to have someone take family members there; they usually are too upset to drive.
Even if a fatality can be confirmed, information about the death may be incomplete. Problems with identification of the victim may interfere with a timely disclosure, for example, or the cause of death may not have been established. In most jurisdictions, the cause of death will be established by the coroner or medical examiner.
Given these difficulties, the firefighter must be extremely careful about what information is given to those on the scene.
If the victim hasn’t been identified, the best course is to tell survivors only as much as can be confirmed—that a fatality has occurred—and explain why more information isn’t available. It’s also important that the survivors then be told where and how they can get more information.
If the victim has been identified, notification should involve only the immediate family members, and it should be handled in a manner that helps the survivors begin the grieving process.
“It is generally best to do this in stages,” Hendricks says. “Start out by saying you have some bad news. After letting them have a few seconds to comprehend, say it is very serious news. The third stage is actual notification by telling them, ‘I’m sorry, he’s dead.'”
If the next of kin at any time asks directly if death has occurred, always answer truthfully.
“When someone asks a direct question, not only are they as ready as they will ever be psychologically to receive the news, but to tell them anything else would be unfair,” Hendricks says. “To do otherwise would be to open up the possibility that their loved one was still alive, only to devastate them a few seconds later.”
After the news is broken, often the survivors will want to know more about what caused the death. This can be a tricky situation. Even with a body charred in a fire, it’s possible that a homicide or suicide occurred. In these cases, Hendricks suggests that “I don’t know yet” is an appropriate answer.
Don’t hesitate to give the family any information you have that’s not of a confidential nature. The fact that a fire has occurred, a short and nontechnical briefing on resuscitation and rescue efforts, and a statement that the investigation is continuing are all appropriate and may be comforting. Promise you will give them more news as it becomes available—and be sure to follow up on it.
Often survivors will lead the conversation by asking questions. This allows them to receive the information they feel is important at a rate they can comprehend, so follow their lead.
As much as possible, keep the interaction directed toward the survivors and their needs. If they make a statement about how the deceased is now “with God” or “in a better place,” respond in a manner that reinforces the comfort they must feel knowing that.
“This is a very traumatic time emotionally,” notes Hendricks. “They will have a lot of questions that are essentially unanswerable, such as why God took their loved one away, etc. It’s best not to respond to these in either an affirmative or a negative manner. Console them and help them redirect their energies to the tasks at hand.”
Research has shown that there are certain types of questions that the bereaved find helpful during the early stages of the grief process. Mitchell Davidowitz and Robert D. Myrick reported in Death Education that responses focusing on what a person was experiencing were perceived as being helpful. Statements that allowed the bereaved to verbalize their feelings, such as “It must be painful” or “Go ahead and cry,” were appreciated more than “I know how you feel.”
The firefighter should be alert for indications about how the survivor is handling the news. Grief reactions are broken down into two categories: typical and atypical. Typical reactions include feelings of guilt, anger, isolation despite people being around, crying, and a sense of loss.
Atypical reactions are the ones that are of the most concern. In these cases, there’s a greater likelihood of survivors hurting themselves, attempting suicide, or lashing out at others. Statements indicating they don’t want to live without the victim, that life is not worth living any longer, that they have plans for doing something harmful, or that they are to blame for the death may indicate that an atypical grief reaction is beginning. Under no circumstances should this person be left alone. Someone needs to stay near the victim until another family member, friend, clergy member, or other responsible party arrives.
“There needs to be an assessment of the situation,” Hendricks says. “If someone says life is not worth living and then goes on to another subject, that is probably typical. To have these feelings and linger with them—to focus on them to the exclusion of other things—is a danger signal. If they have a plan for harming themselves or others, that is automatically atypical and very serious.”
Anger can be manifested in both instances. There are often feelings of betrayal because the deceased has left them, or that they could have done something but did not. The fury may be directed toward the survivor, the victim, or the firefighter. This is a way of coping with death and should not be taken as a personal insult. However, anger that’s not directed toward some constructive purpose, such as making arrangements or notifying other relatives, may become destructive.
Another part of death notification that makes many public safety people uncomfortable is how to handle the situation when children are present.
“That is currently a very controversial subject,” states Hendricks. “If you have a 16-year-old who is the immediate next of kin and the primary survivor, you tell them as you would an adult. If a husband dies and the wife is there with two little children, then you should probably tell her you have some bad news and ask her if she would be more comfortable receiving it without the children present. This allows them to make their own decisions.
“My own personal view is that you should let everyone hear the same thing at the same time, unless factors present themselves that would indicate the contrary. The family has to deal with the death as a unit.”
When the firefighter has provided all the information available, the notification needs to be terminated properly. The firefighter will need to ask again if anything needs to be done for the family, and may offer assistance in getting in touch with friends, neighbors, and other family members. A last assessment of the survivors’ mental status should be completed. If no atypical reactions have been noted, make sure that someone is en route to stay with them and ask them one last time if there is anything they would like to talk about. It you feel comfortable doing so, you may want to give them your name and the station’s telephone number and let them know they can call you there.
Hendricks strongly suggests that information be made accessible to all firefighters on what resources are available in the community—how to find crisis hot lines, mental health centers, and groups that deal with the psychological needs of the survivors. This is especially important in areas where chaplains may not be available. He also says clergy not regularly involved in the fire service are a resource that frequently is overlooked in these situations.
“A person needs to be compassionate, understanding, and genuine,” Hendricks says. “It’s impressive to the survivors when somebody does it correctly. They feel that someone cared about them and helped them through a very difficult time in their lives. Everyone knows that death will happen at some point in their lives; they just want someone to come and be honest with them about it.”
