Issue link: https://www.massageandbodyworkdigital.com/i/1174218
STATEMENTS TO AVOID RATIONALE AND RECOMMENDATIONS "How are you feeling?" This question could be misconstrued as insensitive at a time when the family is obviously experiencing loss and emotional pain. Ask, "How may I best support you right now?" "I know how you feel." Or "I understand how you feel." An "I know" or "I understand" comment is less about how the bereaved feels and more about how the speaker feels. Dialogue may be encouraged by acknowledging the person's unique experience: "I can only imagine how you are feeling right now." "You have other people to live for." Or "Think of all the memories you have to be grateful for." Or "Count your blessings." At a time of unbearable loss, these statements seem dismissive and can create resentment. Well-intentioned advice minimizes the family's pain and grief. Instead ask, "Are there family members or friends you would like me to help you contact?" "You're young. You can always have another child." Or "It is good that you have other children." A bereaved family needs to be assured that their child's life was unique, extraordinary, and worthy of remembering and celebrating. Listen for cues in what the family says about the child to engage them in dialogue about their favorite memories or stories. Storytelling promotes coping. "There is a reason for everything." Or "It is God's plan." For a grieving family, no reason in the world will be enough to justify their child's death. Losing a child to death may elicit doubts of faith. Support the family's spiritual world view. For example, "What role does faith play in your life?" "Time heals all wounds." This statement skips to the future and disregards the crisis of the present moment. Validate the family's present feelings by saying, "This is tough, isn't it?" "Your child is in a better place." Or "He/she is better off now." These statements may be perceived as diminishing the child's value. Although some families may voice these expressions, refrain from euphemistic speech such as "passed away," "deceased," "gone to heaven," or "in a better place." Use concrete terminology such as "death," "dying," and "died." Recommendations for End-of-Life Communications 3 Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 59 The first time I visit him in the neonatal intensive care unit, I massage his mother first. When I ask if I can work with Marley, she looks at me like I'm crazy. I place my hand softly, with no weight at all, on her forearm. "Like this," I said. She goes soft under my hand and her eyes fill with tears. She nods and I move slowly to Marley in his crib. I touch him so, so softly. I move with his movements. I whisper to him, "You are doing a great job! Look at you, moving those legs. You're a pretty cute kid, but I bet you know that." I smile at Marley and Marley's mom smiles at me. Eventually Marley falls asleep. As I'm leaving the room, his mother grabs my hand. She stares at her son. She squeezes my hand. I squeeze back. She lets go. When I visit again, there is no hesitation. Marley's mom beams at me, "He really likes massage." Mowbray says one of the many ways the Healwell massage therapists have surprised her is in their ability to get a "yes" from kids and from parents who have expressed fear or reluctance about massage therapy for themselves or for their child. "They listen and teach, and invite families and patients to try something new in a nonthreatening way." One of the most important skills of communication in a hospital setting is what we often call "decoding the no." There are so many unknowns in the hospital, and the general public's understanding of massage does not lend itself to enthusiastic support for its use with tiny, seriously ill babies. When this mother's face said she did not want massage for her baby, she didn't fully understand what was being offered. I provided, in a very experiential way, an opportunity for this mother to see that kind, calming touch is what was being offered. I also knew this demonstration still might not sway this mother. It was about educating, rather than convincing.