Today we’re here to discuss a topic that often doesn’t receive the importance it should: the psychological support needed in a cadaver identification procedure.
From a psychological perspective, what is the importance of proper cadaver management?
The inadequate handling of cadavers and the treatment family members receive during identification will have a lasting and profound effect on the grieving process.
The treatment bodies receive in these situations has a very profound and lasting impact on the family’s grief and on the mental health of survivors. Therefore, proper management of bodies and correct identification, within this context, leads to a reduction in repercussions for family members (Morgan, Tidball-Binz, and Van Alphen, 2006). Typically, the identification of the deceased represents the first confrontation with the reality of the death of their loved one. For this reason, the treatment received at such a difficult time and the preparation for the identification situation will have a great impact on the subsequent process of grief processing (Losada, 2004).
Psychological intervention in cadaver identification
Given such a complicated situation, it is important to consider the following phases:
Phase 0: Prior considerations
It is important to clearly establish a hierarchy of responsibility and authority among those involved, so that at all times, all professionals know whom to address in case of doubt or confusion, thus promoting a more direct and clear flow of information among professionals, both upward and downward. Furthermore, it is important that assistance always be provided by the same professionals, ensuring continuity of intervention.
Phase 1: Presentation of the cadaver to loved ones
At this moment, it is crucial to emphasize non-verbal language, showing empathy and control of the situation. This includes providing necessary information regarding the psychologist’s functions, announcing and attempting to facilitate the tasks to be performed, accompanying during the process, and communicating news, it not being mandatory to accept help. In case of acceptance, the psychologist will establish a relationship with the family group, accompanying them in the process and facilitating the expression of thoughts and emotions (Alarcón et al., 2005).
Phase 2: Psychological management of information for family members
Family members should be the first to know information related to the discovery and identification of their loved ones. Therefore, it is important to previously explain the identification process, including methods, and deadlines set for recovery and identification. This data should be contrasted with their expectations. All available information about the missing relative should be provided at all times (PAHO, 2002). The information given at each phase of the process must be honest and accurate, showing respect at all times to the deceased and their families. Their cultural and religious beliefs and needs must be respected. Compassionate treatment should be offered to family members, providing them with psychosocial support to family and close relatives (Morgan et al., 2006).
Phase 3: Data collection
For families, it is a priority to know with certainty the fate of their missing loved ones (Morgan et al., 2006).
To this end, the psychologist will collect the necessary data from the family, the missing family member, and in the event of death, will inform about the status of the identification process.
Phase 4: Psychological support in decision-making
It is necessary to designate a family representative who will carry out the identification. In this process, the psychologist can offer assistance in this choice, which is usually guided, among other aspects, by closeness to the victim, competence to perform the task, or the express wish to carry out said identification (Alarcón et al., 2005).
Phase 5: Psychological preparation for cadaver identification
During the identification process itself, it should be avoided that several families are in the same room, thus preventing emotional contagion or the so-called “domino effect” of emotional reactions. This also provides the necessary privacy for the family during such painful moments. Regarding the psychologist’s intervention, a first stage is included, where the psychologist checks the condition of the body, i.e., its visual appearance, smell, and number of remains. The psychologist’s prior visit to the identification site allows for gathering information and understanding the reality they must face (Alarcón et al., 2005).
And with this data, the second stage will take place, where the psychologist will prepare the family for the situation they must face, for what they will encounter (Losada, 2004).
Knowing possible reactions is important, anticipating their possible presence and normalizing their expression, in such a way that we normalize the symptoms and give them legitimacy (Lillo et al., 2004).
Phase 6: The moment of cadaver identification
Once the person who will carry out the identification of the deceased has been chosen and prepared for the situation, the family member is accompanied to the room designated for identification. It is important that family members do not enter the identification alone, as it is preferable that they be accompanied by the psychologist in order to provide emotional support (PAHO, 2004).
In the identification room, the psychologist should withdraw enough to allow privacy and yet remain close enough to offer assistance.
They should be allowed to touch the body if that is what they ultimately wish, promoting minimum conditions of comfort and ensuring human care (PAHO, 2009).
Phase 7: Post-cadaver identification psychological assistance
After the completion of the identification procedure, it is important to promote a space for catharsis, so the aim is to guide or orient towards the expression of their emotions.
It is important to explain the benefits of talking about the experience following basic rules such as listening, showing interest, respect, trust, showing affection, not interrupting, not advising, not interpreting, not judging or criticizing (Privado et al., 2007).
The person should be invited to recount what happened, allowing the expression of their experiences and emotions during the event.
In this communication, it is important to pay attention to signs of danger such as suicidal ideation (Lillo et al., 2004).
Psychological guidelines vary depending on the person, as coping styles differ. Therefore, it is important to offer individualized and personalized treatment.