The significance of time

By Gabriella Lake Walker – Bereavement Care Consultant

Grief is a very individual thing.  Its impact depends on many biopsychosocial factors, such as background, gender and age as well as your relationship with the person who has died.

Parents who lose a child are at high risk of ‘complicated grief’, defined as grief that continues for more than six months and can include feelings of despair, purposelessness, numbness and other trauma-responses.  It is associated with high likelihood of depression, suicidality and early mortality.

It is essential therefore, to recognise the extra care that families -in particular parents- will require before, during and after a child’s death.  Emerging evidence suggests that more than the cause and circumstance of the death, how well supported they are during the death itself and immediate aftermath is crucial: The parents’ and other family members ability to create ‘continuing bonds’ and deal with the death in their own way and time, is likely to mitigate risks of this complicated grief. 

A CuddleCot or CuddleBlanket could help with this, through providing a ‘pause’ and slowing the pace at which a body needs to be taken to a mortuary.  Not all families may want to see their child after they have died, but the professional use of a CuddleCot or CuddleBlanket allows parents and family members the time to make that decision – or, importantly, to change their minds.  

wistful black couple hugging in bathroom

Understanding this option can help those working with families whose child has died or when where death is expected to understand how best to support them in those early days and ensure the best long-term outcomes.  

It is essential to respect various cultural practices, and personal choice is  paramount in best supporting a well-managed grief process. The role of the healthcare professional is to provide a wealth of information outlining all of the options that are available to the family. Individual choices should be respected and the family should feel fully informed and supported in making those choices. Some parents will have clear religious/cultural traditions they feel strongly about which can provide comfort as they start to grieve the death of their child, however others will not and they may need time to process how they want to navigate their loss.

As professionals, we should ask open questions but be gentle, clear and direct with our language; don’t leave room for ambiguity or interpretation. Ensure that families know that there is no pressure to make any decisions immediately.  Without the use of a CuddleCot or CuddleBlanket, this can be difficult and may not always be possible, given the physical changes that may occur to the appearance of their baby or child, however with the use a CuddleBlanket or CuddleCot, this natural deterioration can be slowed;  taking some time pressure away from the family and making a huge difference to decision making.    There is some additional training on the use of sensitive language and communication during this very difficult time on our free to access eLearning website.

Although research in this area is in its infancy, there is one theory of the ‘two track grief’ process, which includes the theory of ‘continuing bonds In practice, this is supporting the family to find ways to continue to integrate the child into their lives.

In in the very early days, this may include certain activities that promote and reinforce the idea of parenting after a child’s death such as bathing, dressing, going for walks. Undertaking these activities together allows for a slow and managed goodbye over a period of days. Creating keepsakes and memory items such as foot and hand prints, collection of a lock of hair, castings etc help to provide tangible memories that the parents can cherish in the future)(7).  There are some good tips on the benefits of these things and how to have these conversations with families in the training modules on our website.  

Similarly, parents have talked of extreme distress at having their child taken to a mortuary suddenly and just having to leave a hospital without them.  Not knowing where their child is or feeling that their child is alone after death can be extremely traumatic for any parent.  These are experiences which can be easily avoided by initiating conversations with parents about the choices they would like to make about their child’s death; involving them in decision making, preparing them and speaking with them afterwards about what they wish to happen. 

CuddleCot Unit Equipment

Having equipment such as a CuddleCot and CuddleBlanket keep the child’s body cool, allowing parents to spend time with their child after they die, taking the time they need to say goodbye.  You can read some of what parents have said to us about the CuddleCot and CuddleBlanket here

We also know that it is not easy to embark on conversations anticipating a child’s death, and not all deaths can be anticipated, so the CuddleCot and CuddleBlanket can allow the child to stay close to the parent whilst they process what has happened. We have a range of resources on our website to help explain these concepts to parents in a sensitive way.  

For some parents, their child being taken to a mortuary may indeed be the right thing for them, but for others the opportunity to engage in these activities or simply knowing where their child is, is important and supports healing.  The most important aspect is that parents feel they are given choices and have control over such important decisions. 

There is a range of training available on our website around having all of these conversations as well as child bereavement, these are free to all clinicians.  We also have a range of bereavement resources available for families: from a free counselling service provided by our own GriefChat service, or memory making boxes provided by 4Louis.  Details of all of these can be found here.

In the UK, USA and many Western countries, there is  such a wide range of cultural, ethnic and religious beliefs surrounding death and  grief, accompanied by the personal preferences of the family meaning that there cannot be a ‘one size fits all approach’, and allowing parents time is a precious gift.  Further, death remains a taboo in modern western society and something people rarely come into contact with, particularly younger people with children. 

To be confronted with death in such a brutal way, as parents are when their child dies and having to make important, difficult decisions quickly can be overwhelming and can add to their experiences of trauma and feelings of regret.  Thus, time becomes ever more important, just when it is sadly so limited. 

Some parents may decide to stay with their child for a number of days, whilst others may decide that the time is right to say their goodbyes sooner.  However, simply having  a CuddleCot or CuddleBlanket available ensures they are able to make that decision  when the time is right for them.

To learn more about our clinical led bereavement care training visit: cuddlecot.com/training

To read more from our expert team visit: CuddleCot Clinical Led Articles

  1. Sanders, C., A comparison of adult bereavement in the death of a spouse, child, and parent. Omega, 1979–1980. 10: 303–322. [Reference list]
  2.  Hardest greid = Bonanno, G., Grief and emotion: A social–functional perspective, In: Handbook of be reavement research, M. Stroebe, editor. et al., Editors. 2001. Washington, D.C.: American Psychological Association. Pp.493–516./ Fish, W., Differences of grief intensity in bereaved parents, In: Parental loss of a child, T. Rando, editor. , Editor. 1986. Champaign, Ill: Research Press. Pp.415–428./ Martinson, I., B. Davies, and S. McClowry, Parental depression following the death of a child. Death Studies, 1991. 15:359–367. / Rubin, S. and R. Malkinson, Parental response to child loss across the life-cycle: Clinical and research perspectives, In: Handbook of bereavement research: Consequences, cop ing, and care, M. Stroebe, editor. et al., Editors. 2001. Washington, D.C.: American Psychological Association Press. Pp.219–240. / Sanders, C., A comparison of adult bereavement in the death of a spouse, child, and parent. Omega, 1979–1980. 10: 303–322./ Zisook, S. and L. Lyons, Bereavement and unresolved grief in psychiatric outpatients. Omega: Journal of Death and Dying, 1989–1990. 20(4):307–322.
  3. https://www.ncbi.nlm.nih.gov/books/NBK220798/
  4. https://www.ncbi.nlm.nih.gov/books/NBK220798/
  5.  Bonnano, G. et al., Resilience to loss and chronic grief: A prospective study from pre-bereavement to 18 months post-loss. Journal of Personality and Social Psychology, 2002. In press. [Reference list]
  6. more with younger babies
  7. https://www.ncbi.nlm.nih.gov/books/NBK220798 [98]. 19, 99, 100

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