Recommendations
Chapter 12. Bereavement Adviser
2. Recommendations
2.1 We have considered the evidence and recommend that the
functions of a bereavement adviser include:
- Explaining the circumstances of death, identifying when, where
and who was present.
- Arranging and attending a meeting for relatives with anyone
who was present at the death if requested.
- Encouraging a meeting between relatives and the treating clinician
to explain the clinical circumstances of death and, if requested,
arranging and attending the meeting.
- Ensuring that relatives have a full explanation of the reasons
for post mortem examination including therapeutic, medical education
and research.
- Explaining the need for consent to carry out a hospital post
mortem examination (HPM) and the retention of organs.
- Explaining that consent is necessary for the retention of organs
following a Coroner's post mortem examination (CPM) and that the
consent must be obtained before the CPM is undertaken.
- Ensuring relatives have sufficient time, privacy and support
to reflect upon the request for consent to an HPM or the retention
of organs following a CPM or an HPM.
- Ascertaining whether a clinician will attend the post mortem
examination.
- Facilitating meetings between parents, clinician and pathologist
as appropriate.
- Noting discussions between relatives, clinicians and pathologists
and providing a copy to each party involved.
- Developing and using information packs for relatives on all
aspects of death in hospital.
- Assisting relatives in the following practical matters:
- collecting the deceased's personal belongings and arranging
return to relatives;
- ensuring provision of certificate of death and the formal
notice;
- explaining the procedure to register the death;
- providing support in attending the registry office if requested;
- arranging contact with funeral director;
- arranging contact with hospital chaplain and/or local priest
as required;
- contacting the Coroner's office as appropriate;
- offering to attend if contact with police necessary;
- ensuring that the General Practitioner is informed;
- ensuring that schools are informed as appropriate (including
the schools of siblings);
- assisting the relatives in informing other persons including
other relatives, friends and employers, of the death and its
consequences;
- assisting the relatives in dealing with the Benefits Agency,
insurance company and housing matters;
- assisting the relatives to place announcements in newspapers
if wished.
- Discussing counselling or long-term support needs with relatives,
including the needs of wider family members and making contact
with appropriate counselling/support agencies if requested.
- Ensuring that relatives are aware of the full range of counselling/support
resources available, including those external to the hospital
and bringing these matters to the attention of the relatives.
- Accessing translation/interpreting services including services
for people with hearing or visual impairment and providing appropriate
written/taped information.
- Assisting with any other individual problem presented by relatives
in consequence of death.
- Undertaking general liaison duties.
2.2 We intend this list to be illustrative rather than prescriptive.
There must be recognised training courses for bereavement advisers.
Qualification should be certificated, perhaps at a National Vocational
Qualification level. Annual assessment and appraisal should be routine
and the role should be performance managed. Continuing education
and training is essential. The bereavement adviser should work closely
with the hospital management, clinicians, the Coroner and the full
range of non-medical services including counsellors and other non-medical
professionals. There will of course be relatives who do not wish
to avail themselves of the services of a bereavement adviser. Nevertheless
the service should be offered to everyone, as should the facility
to return to the bereavement adviser in the event of their services
having been declined in the first instance.
2.3 The distinction between a cardiac liaison nurse and the
bereavement adviser is that the nurse has the advantage of contact
with the parents in the period prior to death. We suggest that some
aspect of the bereavement adviser's multi-factorial function will
bring them into contact with the parents before the death of their
child.
2.4 We have been heartened at the support for the concept
of bereavement adviser from parents and clinicians. We commend the
concept for development and implementation.
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