Grief

The Amazing Benefits of Accept-and-Connect Bereavement Care

How keeping parents in charge of their own journeys benefits them—and you.

Posted Sep 05, 2020

In a previous post, we explored protect-and-direct bereavement care. When we protect and direct, we're assuming that we know best and that parents need our guidance. We jump into action, conveying our ideas, suggesting next steps, and urging parents onward. In short, we put ourselves in charge of the parent’s journey. Unfortunately, protecting and directing bereaved parents can undermine their ability to cope with the death of their baby.

But what’s the alternative?

Accept and connect. When we practice accept-and-connect bereavement care, we make room for parents to be in charge of their own journeys. Instead of protecting, we accept parents as they are. We are compassionate witnesses who simply accept their thoughts, feelings, and experiences without trying to soothe, distract, or reframe. And instead of directing, we follow their lead. We are nonjudgmental companions rather than trying to fix, redirect, or take over.

Accept-and-connect bereavement care also changes our focus. Instead of just conveying our ideas, we mostly listen to theirs. Instead of always suggesting the next steps, we ask them what they want. Instead of simply educating them about grief, we inquire about theirs. Instead of seeing them as lost and falling apart, we see them as competent and resilient. And by accepting and connecting in these ways, we boost parents' ability to cope.

Another important distinction: Protecting and directing violates healthy boundaries and robs parents of agency, which only exacerbates their suffering. In contrast, accepting and connecting enforces healthy boundaries and honors parents' agency. There is no judging, fixing, or taking charge. Instead, we approach parents with compassion (which is better than empathy), curiosity, and listening ears. And as a result, we become nonjudgmental witnesses to their experience. In this role, we can affirm their baby, validate their grief, see their competence, trust their resilience, and accompany them along their path, all of which eases parents' suffering.

To further illuminate the contrast between these two opposing approaches to bereavement care, listed below are common examples of protect-and-direct actions (see previous post). Following each example is an alternative accept-and-connect action, along with the benefits to parents. As you read through these examples, take note of the kind of care you truly wish to offer.

  • When we protect and direct, we tend to avert pain by using clinical terms, such as “the pregnancy” or “blighted ovum,” “fetus,” or “products of conception." Alternatively, when we accept and connect, we listen to how parents refer to their experience, including whether they use the word "baby" and any name or nicknames, characteristics, and importance, and we reflect their narrative of that little life and its significance to them. Parents benefit when their perspective is affirmed.
  • When we protect and direct, we tend to try to soften parents' realities by employing euphemisms, such as “loss" and “passed” and “angel.” Alternatively, when we accept and connect, we employ honest language, such as “death” and “died” and "your baby." These words accurately describe the parents’ experience, reflect reality, and adequately acknowledge this tragedy. Parents benefit because they feel seen and heard, and their grief is validated.
  • When we protect and direct, we tend to shy away from discussing difficult topics. Alternatively, when we accept and connect with parents, we openly engage in emotional conversations, such as inviting parents to tell us about their baby, their feelings and concerns, and their ideas on what could be meaningful ways to say “hello” and “goodbye.” Our listening presence provides nonjudgmental support as they process their fears, consider their options, and determine what is meaningful and what they want. Parents benefit because when we listen, they feel supported and understood. 
  • When we protect and direct, we tend to feel cautious about parents being with their baby, and we may ask simple “yes or no” questions or insist that they see their baby on our terms. Alternatively, when we accept and connect, we consult with parents and then follow their lead. Parents benefit from being in charge of their experiences because they regain a sense of control in an otherwise out-of-control situation.
  • When we protect and direct, we tend to take parents through a protocol of activities during the time they spend with their baby. Alternatively, when we accept and connect, we recognize their competence as parents to this baby and trust them to express their devotion in ways meaningful to them, and to collect the keepsakes they will cherish. Parents benefit because they are fully seen as their baby’s parents, capable of nurturing their baby and acquiring meaningful memories.
  • When we protect and direct, we tend to rush parents through their time with their baby and push them to relinquish the body. Alternatively, when we accept and connect, we can slow down and let parents determine their pace and their path, including whether they want to take their baby home. Doing so honors their parental bond, trusts their process, and reduces regrets. Parents benefit because they are better able to lean into this time with their baby and to fully express their devotion.
  • When we protect and direct, we tend to cover up the parts of the baby's body that are underdeveloped, deformed, or deteriorated. Alternatively, when we accept and connect, we remember that parents look at their babies through the eyes of love. We model total acceptance and encourage them to fully examine their baby’s body. Parents benefit because they can express their natural parental curiosity and “get to know their baby” more fully, appreciate their baby’s beauty, notice familial similarities, and feel proud of their little one.
  • When we protect and direct, we tend to avoid the full tragedy of their baby's death or the depth of their grief. Alternatively, when we accept and connect, we accept that parents will dwell on their baby and grieve deeply, with or without us; we connect by using the baby’s name, inquiring about their experiences, and asking them how they’re really doing—and then listening. However much they wish to share with us, parents benefit from feeling seen, heard, and accompanied.
  • When we protect and direct, we tend to want parents to buck up and wipe away their tears. Alternatively, when we accept and connect, we can receive them as they are, wherever they are in their grief. We don’t judge how their grief finds expression—we can tolerate intense displays of emotion and accept jumping into action. Parents benefit from knowing they have us in their corner as nonjudgmental witnesses, rather than feeling rejected or judged by us for “doing it wrong.”
  • When we protect and direct, we tend to offer platitudes: “You’re young, you can have another.” Or “It’s a blessing in disguise.” Alternatively, when we accept and connect, we trust parents and their grieving process. We see them as competent, smart enough, and strong enough to find their way and ultimately adjust and heal. Parents benefit when others don’t see them as broken or their grief-stricken thoughts and feelings as “crazy.”

The bottom line: When we accept and connect, parents report feeling grateful and supported, rather than crazy and alone, which boosts confidence in their ability to survive this tragedy. And really, that’s the outcome we intend.

But even more amazing? When we accept and connect, our core mission becomes making sure parents remain in charge of their own journeys. Setting boundaries is not only best for parents, but it also makes our jobs easier, and our work feels more satisfying and rewarding, all of which protect us from burnout.

Continuing this theme of growing and improving your practice, a future post explores the three critical skills you need for practicing accept-and-connect bereavement care.

References

Book: Relationship-Based Care: A Model for Transforming Practice, edited by Mary Koloroutis, MSN, RN

Book: Perinatal and Pediatric Bereavement in Nursing and Other Health Professions, edited by Beth Perry Black, PhD, RN; Patricia Moyle Wright, PhD, CRNP; and Rana Limbo, PhD, RN

Consulting and Education: Creative Health Care Management

Professional Support and Education: PLIDA: The Pregnancy Loss and Infant Death Alliance