Intervention Following a Sudden Death: The Social Work–Medical Examiner Model (Practice FORUM)

Intervention Following a Sudden Death: The Social Work--Medical Examiner Model (Practice FORUM)

In recent years, social workers in both academic and clinical settings have focused on improving the quality of end-of-life care by closely examining the psychosocial needs of the dying person and his or her family (Berzoff, 2008; Cagle & Kovacs, 2009; Crunkilton & Rubins, 2009). Social workers are an essential part of interdisciplinary teams that advocate for the needs of grieving families. Furthermore, many programs and models for professional social work education and training in end-of-life care have been developed (Walsh-Burke & Csikai, 2005). Although social work has recognized the need to address the needs of family members anticipating the death of a loved one, little attention has been given to the needs of families who have experienced a sudden death. In this article, we describe a model program that provides social work intervention in collaboration with the medical examiner department to surviving family members following a sudden death. The social work-medical examiner model was initially developed as a nine-month pilot project by Sara Kintzle and the Johnson County Medical Examiner Department in Iowa City, Iowa. The purpose of this article is to demonstrate the practice model that emerged for implementation in other medical examiner departments. According to the Centers for Disease Control and Prevention, sudden death remains one of the leading causes of mortality in the United States (Heron et al., 2009). In 2006, accidental death, suicide, and homicide (respectively, the fifth, 11th, and 15th leading causes of death) accounted for 173,472 deaths. Sudden death is defined as any unexpected death that occurs within minutes to 24 hours following the onset of symptoms (Talbott, Kuller, Perper, & Murphy, 1981). Thus, unanticipated death due to disease processes, such as cardiac arrest or stroke, also fit the definition, drastically increasing the number of sudden deaths occurring each year. Despite the prevalence of sudden death, there is a paucity of resources to provide support for the millions of family members who grieve these difficult losses each year. The lack of resources available for this population exacerbates an already complicated grief reaction that may be compounded by intense crisis and trauma (Women, 2009). Research has demonstrated that survivors of sudden death have an increased susceptibility to the development of complicated grief reactions (Currier, Holland, & Neimeyer, 2006; DeRanieri, Clements, & Henry, 2002; Green, 2000; Miyabayashi & Yasuda, 2007). This vulnerability is most often attributed to the intense emotional reactions that frequently follow the death. Research suggests that sudden death may overwhelm survivors to such a degree that for an initial, undetermined period of time, they may be unable to function at the level required for grief processing, thereby causing a delay in grief reactions (Clements, DeRanieri, Vigil, & Benasutti, 2004; McKissock & McKissock, 1991). However, this vulnerability can be countered through timely intervention delivered by skillful, trained professionals who assist survivors in maintaining or regaining emotional stability through the initial stages of crisis (Roberts, 2000).

Intervention Following a Sudden Death: The Social Work--Medical Examiner Model (Practice FORUM)

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