Chapter 2: When death occurs

When families witness a traumatic moment of death

“I have memories of ICU seared into my mind that still cause me a lot of pain…the most traumatic part of all was seeing my mother in terrible pain”. - Family member

People are at greater risk of experiencing trauma if a death is sudden, violent, perceived as preventable, or if the family believes the patient suffered. Some traumatic deaths are inevitable, such as from massive pulmonary embolism; others are less predictable. Sometimes, traumatization can be minimized by strongly recommending that the family step outside.

Unit practices may include family presence during resuscitation.  Some family members wish to be present at the moment of death, even in situations that may be difficult to witness (e.g., cardiac arrest).  In this instance it is important to have a dedicated staff member with the family to coach and support them through what may happen and what they will see, smell, and hear.

Conversation Prompts

“It’s OK if you want to be in the room, and it’s OK if you don’t. I just don’t want you to be surprised if he dies while you’re outside the room. This could be very difficult to witness. I’m here to support you”.

“I’m sorry that you had to go through that. Sometimes things happen that we just can’t predict. It’s very difficult to witness. Would you like to sit somewhere quiet with me for a while”?

“I don’t want you to be alarmed by any of this. They are pushing on his chest to pump his blood throughout his body, and they are pushing oxygen into his lungs. They are also putting in a special intravenous line to give him medication to try to restart his heart. This is a normal resuscitation, and this team is well-trained to do what they’re doing”.