The death of an infant can create stress in the relationship between the parents. Some parents might blame themselves and/or blame each other for the loss. They may feel they have failed as parents. Parental grief reactions also might vary, leading to a situation where one partner judges the other as not grieving as much. The provider can help by assisting the parents to be aware of the differences in ways individuals grieve and the importance of maintaining communication.
The surviving children, too, may experience sadness, confusion, and anger, and may blame themselves for the death. Generally, providers give the information to parents who then explain the death to the children. Parents need to consider the child’s age, developmental level, and prior experiences with death in explaining the loss. Children often grieve deeply. Parents and extended family members need to support them during this crisis.
Sometimes healthcare providers say they feel powerless to ‘fix’ the grief of family mem- bers. In fact, providers are in a very powerful position to model and encourage a salutary response to loss. Providers can teach healthy grieving practices by their own actions— expressing sadness about the death, offering condolences, encouraging parents to talk to each other, and advocating to see that parental needs are met. These elementary practices generally cut across many cultural variations in grieving customs.
Worden (2008) identified four tasks of mourning. These tasks apply to any loss. For providers, it is one framework to consider the family’s grief process. Note that individu- als in families may be working on different tasks. It is also important to note that indi- viduals may move back and forth between tasks. For example, adjusting to an environ- ment without the deceased can be very painful and intense grief work (task II and III).
Finally, while trying to provide therapeutic grief support to parents, some healthcare providers might also be dealing with their own sadness about the death. Those who are pregnant or parenting infants can sometimes have an intense personal response to the loss, as well. Provider feelings and responses, also in part determined by their own cultural background, may be different from that of the family. Staff discussions can be useful. They provide opportunities for staff to acknowledge their own sorrow and help each other in their efforts to assist bereaved families.
Providing Culturally Competent Care A cultural group can be defined as people who share a common origin, language, customs, styles of living, and a sense of identity. Within each, variations of values and beliefs influence an individual’s grief response. Some key factors include age of the mourner, family traditions, gender, one’s faith foundation, geographic region, educational background, economic status, prior experiences with death and loss, and the historical background of the cultural group. Moreover, the degree of assimilation and acculturation will affect an individual’s grief response. Assimilation is the cultural absorption of a minority group into the main cultural body. Acculturation is the process of adapting to a new culture, which may result in the loss of traditional customs and ceremonies. The generation (whether an individual has relocated to this country or is a descendent of an immigrant) may also make a difference. Adolescence is an example of how age can be a unique factor influencing grief. A teen peer group may more strongly shape a response to loss than the traditions of the family. Adolescents may have attitudes
VOICES FROM THE COMMUNITY: CROSS CULTURAL EXPRESSIONS OF GRIEF AT THE LOSS OF AN INFANT v
THE MOURNING PROCESS: TASKS OF MOURNING (WORDEN, 2011)
Task I: To accept reality of the loss
Task II: To work through the pain of grief
Task III: To adjust to an environment in which the deceased is missing
Task IV: To emotionally relocate the deceased and move on with life.
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