Specialists help ease the pain of loss

Few events in life are as painful as the loss of a loved one. The grief, shock — even practical considerations — can be overwhelming. For that reason, Mayo Clinic social workers are available in the emergency department (ED) around-the-clock to aid families and patients dealing with traumatic injury or death.

"Our goal is to provide families with practical and emotional support — everything from notifying the police and other family members to liaisoning with the medical team, assisting the nurses in gathering information and being a calm presence in the room," says Clare A. Larsen, L.I.C.S.W., social work manager at Mayo Clinic's campus in Rochester, Minnesota.

Social work also supports people who have experienced devastating traumatic injuries and whose sense of loss can be acute. Larsen says the goal is to help these patients understand what has happened to them and to assist in defining their lives going forward.

Social workers carry trauma pagers and are alerted along with the rest of the trauma team so they can be present when severely injured patients and families arrive. No matter how many people crowd the ED, they work one-on-one, tailoring their services to meet individual needs. "We try to assess what people are able to take in and what they're ready for," Larsen says.

That might mean help with funeral arrangements, a phone number for a bereavement group, or a brochure or pamphlet. Sometimes it's a hand print, a lock of hair or a cloth bag instead of a plastic one for a loved one's clothing. "We try to add that extra measure of comfort," Larsen notes.

Safety, calm and comfort are for the moment. And although the social workers don't continue to work with families outside the ED, they try to help the bereaved take the first steps toward healing and recovery.

"We offer education, guidance and empowerment — whatever grieving families need to help them return to a normal life," Larsen explains. "It's about cultivating resilience — the ability to become strong and healthy again. We can aid in that process."

Helping kids cope

Mayo Clinic's Child Life Program was originally created to help children and parents facing the emotional and physical stresses of hospitalization. Now, child life specialists not only prepare and support young patients through difficult procedures, they also help them cope with a serious injury or death in the family.

"When a child dies in the ED, we offer support to the whole family, though our approach will vary, depending on the situation," says Randy McKeeman, M.Ed., CCLS, who supervises Mayo's Child Life Program in Rochester, Minnesota. "But our main role is to support the surviving siblings, explaining in child-appropriate language what has happened and being open and ready to answer questions. We feel strongly that children should have the opportunity to express their thoughts and feelings in an appropriate way. Adults want to protect children from difficult things, but we feel they need honest yet sensitive information."

McKeeman says it's best if parents talk to their surviving children, but their own grief or inability to find the right words may prevent it. A child life specialist may then offer to step in when a parent can't.

"Kids need to be kept in the loop. They need information and support and the opportunity to ask questions," he explains. "How much children should know or can understand depends on their age. Toddlers don't understand death as something permanent — that comes when kids are school age — but they do understand grief and upset and tears, which are disturbing and difficult for them."

Although the focus is on immediate need, child life specialists, like social workers, also provide families with memory items such as a hand print or lock of hair so they have something tangible to take with them.

McKeeman says addressing the emotional needs of grieving families is a team effort, in which chaplain services, social work, nurses and support staff all play a role. He suggests that small hospitals lacking these resources look for help from clergy or social workers in the community.

Within the Mayo system, the Child Life Program in Rochester is, he says, a "great resource." Information about secondary trauma and talking with families and children about death also can be found online. "Knowing we all worked together to help people through something so difficult is the reward, even though it's emotionally challenging," McKeeman says.

Also rewarding is an annual remembrance celebration for families who have recently lost a child. "It's difficult but always emotionally uplifting," McKeeman says. "The families know that Mayo doesn't stop caring when a child dies."