Bereavement Information 1 South Eastern Sydney Local Health District Bereavement Information South Eastern Sydney Local Health District
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Bereavement Information 3 South Eastern Sydney Local Health District Acknowledgement of Country South Eastern Local Health District acknowledges the peoples of the Dharawal, Gadigal, Wangal, Gweagal, and Bidjigal peoples as the Traditional Custodians of the lands we operate on. We pay our respect to Ancestors, and Elders, past and present. South Eastern Sydney Local Health District is committed to honouring Aboriginal and Torres Strait Islander people’s unique cultural and spiritual relationships to the land, waters, and seas and their rich contribution to society. South Eastern Boundaries is based on the South Eastern Sydney Local Health District boundary map and replicates the locations of the facilities from Sydney’s Central Business District in the north to the Royal National Park in the south. Artwork
South Eastern Sydney Local Health District Bereavement Information 4 The next few days to weeks may be very difficult emotionally, physically and spiritually. This booklet includes information that may be helpful to people anticipating a death or who may have recently had a loved one die. This booklet has been designed to help you to navigate next steps, from practical matters to accessing support services. Maybe not all of it is relevant to you, but we hope some of the information is useful to you. Contact person:
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South Eastern Sydney Local Health District Bereavement Information 6 Contents The dying process The role of the Palliative Care Team Organ and Tissue Donation Anticipatory Grief What to do first What to do in the first five days Finding the Will Look after yourself Useful information to know Other information you might need Arranging a funeral Using a funeral director Finding a funeral director Funeral Costs Accessing financial support Paying from the person’s bank account Important information if the person died in hospital Death Certificate and Registration Special Circumstances 8 10 11 12 14 15 15 15 16 16 18 18 19 19 20 20 21 23 24
Bereavement Information 7 South Eastern Sydney Local Health District Death reported to the NSW Coroner’s Court A death at home Repatriation of bodies overseas Who to notify Understanding grief and loss Allow yourself to express emotions Looking after your wellbeing Legacy and remembering When to seek further support Supporting children Children’s Understanding of Death Useful resources South Eastern Sydney Local Health District Bereavement Grief and Bereavement Counselling Service Calvary Bereavement Counselling Service Notes 24 25 26 28 31 31 32 32 34 37 41 42 43 43 44 46
South Eastern Sydney Local Health District Bereavement Information 8 The Dying Process If we are experiencing the death of a relative or friend for the first time, it is understandable that we may have questions about what this process will look and feel like. In some cases, the dying person might have expressed specific wishes about what they would like at the end of life; these can be shared with the treating team, and where able, we will ensure that these wishes are carried out, including ensuring that your loved one is cared for and is as comfortable as possible. The following information may help you understand, anticipate and respond to some of the signs you might notice before, during, and after death. If you have any questions or specific concerns, please always ask your nurse. We may not have been present when someone has died before; it may be useful to know that the moment of death is often peaceful. You can bring enormous benefit to the person you are caring for simply by sitting with them, holding their hand and speaking in a calm and reassuring manner. Even if the person does not respond, they may still be able to hear you. ‘Being with’ can be more important than ‘doing for’. The Dying Process Appetite and Thirst The person’s appetite and thirst may decrease. This concerns many carers, but this is a natural process, and it is not painful. Small sips of water or a moist mouth swab will help to provide comfort. You can ask the nurses to show you how to help with mouth care. Attempting to feed someone who is unable to swallow may make them distressed and may cause harm. Sleep and alertness Changes in the person’s body mean that they may spend a lot of time sleeping; they may become increasingly drowsy or find it difficult to wake. It is best to talk to the person when they seem most alert and allow them to sleep when they need to. It is best to speak softly and naturally.
Bereavement Information 9 South Eastern Sydney Local Health District A person’s body temperature may change. Sometimes the person’s hands, feet and legs may become increasingly cool to touch, and at other times they may feel hot and clammy. Sometimes, parts of the person’s body may become blotchy and darker in colour. This is due to the circulation of the blood slowing down and is a normal part of the dying process. If the person indicates that they feel cold, use light bedding to keep them warm. Temperature Secretions As coughing and swallowing reflexes reduce, saliva and mucus may collect in the back of the person’s throat, causing gurgling, bubbling or other noises. As indicated above, these noises can be of concern to carers, but do not usually cause distress to the person. Medications can be given to slow down the production of saliva and mucus and thus improve the dying person’s comfort. Restlessness Due to the decrease in circulation of blood to the brain, as well as other changes happening in the body, the person may become restless or agitated. We can support people to feel calm by speaking in a quiet, natural way, lightly massaging the person’s hand or forehead, or softly playing familiar music. Let a team member know if the person becomes restless or agitated as medications can be given to reduce this. Regular breathing patterns may change. Sometimes breathing may be fast, and at other times there may be long gaps between breaths. Breathing may be shallow or noisy. This is a normal part of the dying process and is not painful or distressing for the person. These changes may prompt us as family and care givers to feel distressed, particularly when breathing appears noisy or laboured. The nursing and medical team will ensure that every measure to provide comfort to your loved one will be taken, including management of pain and their breathing. Breathing Incontinence The amount of urine that the body produces decreases due to the reduced amount of fluid the person is drinking. The urine may smell stronger and be darker in colour. Many carers are concerned that the person will lose control of their bladder and bowels. This does not happen to all people, but if it does, nursing staff can provide pads, easy to use equipment, and special absorbent sheets, to enhance comfort and hygiene. Sometimes a person may need a catheter to help drain their urine. *Not all the signs mentioned above occur with every person, nor will they occur in any particular sequence. These physical signs are part of the normal, natural process of a person’s body gradually slowing down.
South Eastern Sydney Local Health District Bereavement Information 10 The Role of the Palliative Care Team South Eastern Sydney Local Health District offers Palliative Care services across each hospital, with the aim of providing holistic, end of life care with a focus on promoting dignity; and to prevent and reduce physical and emotional suffering at end of life. This might include: • Pain and symptom management • Emotional and Practical support for loved ones • Honouring social, spiritual and cultural beliefs • Partnering with patients and families to ensure wishes at the end of life are respected. • Providing information to patients and loved ones about care needs. Referral Pathways to Palliative Care If you require a palliative consult or would like to self-refer, please speak with the current treating medical team, or ask to speak with the Nurse Unit Manager on your ward.
Bereavement Information 11 South Eastern Sydney Local Health District Organ and Tissue Donation Organ Donation If the patient is a registered organ donor or has expressed a wish to donate their organs with family, please speak to the treating medical team. The treating clinical team should contact the DonateLife hospital staff or DonateLife Agency at the earliest opportunity once there is medical consensus that ongoing treatment is not in the patient’s interests and the patient will be transitioning to end-of-life care. The treating medical team will discuss with you whether organ donation can occur. Tissue Donation If the patient is a registered tissue donor or has expressed a wish to donate their tissue with family or loved ones, please speak with the treating medical team. Deceased tissue donation is donated when your loved one has died. Tissue donation covers those tissues such as corneas, heart valves, bone and tendons and skin. Tissues can be retrieved up to 24 hours after death. Tissue only donors don’t have to die in a hospital, it’s not uncommon for tissue retrievals to occur in either mortuaries or funeral homes.
South Eastern Sydney Local Health District Bereavement Information 12 Anticipatory Grief Grief takes many forms and is not only experienced after a person dies. Anticipatory grief is the experience a person may have in the days, weeks or even months prior to their own death or the death of a significant person. It is the experience of knowing that change is coming, and is felt on many levels, emotional, physical, and spiritual. It also affects how we think and our relationship with others. For instance, a person experiencing anticipatory grief may feel uncertain about what the future holds or guilt about wanting a person’s suffering to end. Anticipatory grief is a normal process, and it has a purpose. For those who are dying, anticipatory grief provides an opportunity to reflect on a life lived and to find meaning. For families and friends this period may offer an opportunity to reconcile differences or to give and grant forgiveness. For all, it is a chance to say goodbye. Common experiences of anticipatory grief include: • Sadness/tearfulness •Anger • Fear • Depression •Anxiety •Guilt • Emotional numbness If you are struggling with these feelings, know that support is available to you. You may wish to speak with a Social Worker or other health professional. This information comes from the Australian Centre for Grief and Bereavement website.
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South Eastern Sydney Local Health District Bereavement Information 14 What to do first The death of a family member or friend can feel sudden no matter the circumstances. It is important that you and those around you take time to process the death. If you have any questions that you would like answered, please ask staff for assistance. Staff will continue to care for your family member or friend with respect and dignity after their death. If your family member or friend is in the hospital and you or other family and friends wish to see the deceased person to say goodbye, it is encouraged that you do so while they are still on the ward. Staff can facilitate further viewings in the hospital mortuary the following day. Unfortunately, however, we cannot facilitate viewings outside of business hours. If you wish to arrange a further viewing, please ask to speak to the social worker on the ward. Please let staff know if there are any cultural or spiritual practices that need to be observed while your loved one remains in our care. Our staff respect your cultural and spiritual traditions and will do our best to meet these needs. Please let us know how we can help. If you are in hospital, you can also ask to see the chaplain.
Bereavement Information 15 South Eastern Sydney Local Health District What to do in the first five days There are a few steps which need to be taken shortly after a person has died. This includes starting the funeral arrangements (see page 18 for more information) and checking if there is a Will in place and its location. Confirming if there is a Will The first place to check for a will is with the person’s solicitor, if they have one. If there is a will in place, you will need to contact the executor (this person will be nominated in the will) to enable the executor to start the process of arranging the person’s affairs. If there is no Will If there is not a will and there is an estate to manage, a decision will need to be made to nominate a person to manage affairs. The nominated person will need to contact the Supreme Court of NSW Probate Registry. Usually this does not need to happen straight away and can be followed up on later. Call: 1300 679 272 Email: sc.probate@justice.nsw.gov.au Website: supremecourt.nsw.gov.au/wills-probate.html If you are uncertain if someone has a Will If you do not know if there is a will in place and the persons Solicitor does not know if there is a Will, call the NSW Trustee and Guardian on 1300 109 290 or visit the website tag.nsw.gov.au. Look after yourself There are several practical matters to attend to after someone has died, but it is also important to look after yourself at this time. You can refer to page 31 for some tips on coping during this time. You may also wish to ask a friend, family member or someone you trust to assist with these practical matters if possible. There are some practical matters that can wait and do not need to be rushed or feel pressure to complete at this stage. These include notifying various agencies. You can find this information on page 28.
South Eastern Sydney Local Health District Bereavement Information 16 Useful information Useful information to know • Medicare number • Date and place of birth • Date of marriage or civil partnership (if relevant) • Tax File Number Other information you might need • Full name of the deceased at their time of death • Any previously used name (e.g. maiden surname) • Their last known address • Their occupation (if relevant) • The full name, occupation and date of birth of surviving spouse or civil partner. • Whether the deceased was receiving State Benefits (such as a Centrelink or Veteran’s Affairs payment).
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South Eastern Sydney Local Health District Bereavement Information 18 Arranging a Funeral A funeral service can be an important and meaningful way to say goodbye. It is common to have a funeral service before burial or cremation. If funeral arrangements have not been pre-planned, the executor of the Will is legally responsible for organising the funeral. However, it is usually the closest Next of Kin who will make the practical arrangements. If there is no Will or identified Next of Kin, then a family member or friend may organise the funeral. Using a funeral director It is not compulsory to use a funeral director, but they can make things easier and simpler at a difficult time. A funeral director can help organise, and support your choices regarding: • Completion and lodgement of death registration forms • Placement of any press notices • Selecting a venue for the service (you might like to hold the service outside, or in a place that was important to the person such as a surf club or community centre) • Planning a personalised service • Liaising with clergy or funeral celebrant (or person you choose to conduct the service) • Ensuring particular cultural or religious practices you wish to follow, such as the option to embalm and view the deceased are carried out. • Cremation or burial • Flowers and order of service Members of your family or community, or a faith/spiritual leader, might also be able to give you guidance or support with this. Once you have chosen a funeral director, they will liaise with the NSW Health facility to arrange transfer of the person’s body from the place where they have died, into the care of the funeral director until the funeral is held.
Bereavement Information 19 South Eastern Sydney Local Health District Finding a funeral director NSW Health, including staff at this facility, are unable to recommend any funeral directors. • A full listing of funeral directors is available from the Australian Funeral Directors Association, call 1300 888 188 or visit their website afda.org.au • This national website lists funeral directors by postcode and cost gatheredhere.com.au • Search online for ‘funeral director Sydney’ Family, friends or faith centres (such as the church, mosque or temple) may be able to offer recommendations. Funeral costs Funeral costs can vary significantly, we suggest contacting two or three funeral directors to request detailed, itemised quotes (including costs of burial, cremation and service fees, flowers etc.) before making any arrangements. This process can help you find a funeral director you feel comfortable with and give you a clearer understanding of your financial options. Under New South Wales law, all funeral directors are required to provide an itemised quote, making it easier for you to compare services and pricing. It is essential to discuss the costs and available payment options in your initial conversations with the funeral director and agree on costs prior to the funeral. Please note that the person who organises the funeral is legally responsible for the account and is the only individual authorised to make arrangements with the crematorium or cemetery, including signing the necessary burial or cremation permits. If cost is a concern, consider searching online for terms such as ‘low-cost funerals Sydney’ to identify potential providers offering more affordable services. You are encouraged to ask funeral directors about payment plans or flexible payment options. If you anticipate difficulty covering the funeral expenses, it is important to raise this early in the process, before entering into any agreements. Should you have ongoing concerns about payment, you may request to speak with a hospital social worker or a designated support contact within the health service.
South Eastern Sydney Local Health District Bereavement Information 20 Accessing financial support There may be various sources of financial assistance available to help cover funeral expenses. These could include entitlements through DVA, unions, superannuation funds, or sickness and accident insurance policies. It is advisable to check whether the deceased held any such memberships or policies, and to contact the relevant organisations for further information. If possible, also determine whether the person had prepaid for their funeral, as records of this may assist in managing costs. If you belong to a religious or faith-based community, you may wish to reach out to them. Aboriginal and Torres Strait Islander peoples may be eligible for other supports — please speak with staff at your facility for more information. Depending on the individual’s circumstances, there may also be financial assistance available through Centrelink. To determine eligibility and learn about the application process, it is best to contact Centrelink directly and ask what bereavement payments may be available to you. Paying from the person’s bank account If the deceased has funds in their bank account, most financial institutions will allow a direct payment to the funeral director. If the available funds are sufficient, this may cover the full cost of the funeral. Otherwise, the bank may release the amount available to contribute toward funeral expenses. To arrange this, you will typically need to visit a branch in person and provide both the funeral invoice and the medical certificate stating the cause of death. It is advisable to complete this process before the funeral takes place, so you have a clear understanding of how much is available and whether any additional costs will need to be covered. Please note that this process is strictly limited to funeral expenses; funds cannot be used to pay other bills or debts. If you have any questions or concerns regarding the conduct or practices of funeral directors, you can contact NSW Fair Trading on 13 32 20 or visit their website for more information www.fairtrading.nsw.gov.au
Bereavement Information 21 South Eastern Sydney Local Health District Important information if the person died in hospital - release from hospital A consent form must be signed before the hospital can release a deceased person into the care of a funeral director or funeral company. The form can be signed by the Executor of the Will, or Next of Kin (if a Will does not exist, or the Executor is not available). An Executor of a Will is a person or organisation appointed in the Will to administer the estate. It is their job to carry out the instructions in the Will. If there is no Will or the Executor is not available, then the senior Next of Kin (or their delegate) can perform this role. Next of Kin of a deceased adult is determined by the following order of seniority: 1. Any person who is named as the Executor of the person’s Will 2. A person who was a spouse or de-facto (including same sex partner) of the deceased immediately before the person’s death 3. A child of the deceased person who is 18 years or older 4. Either of the deceased person’s parents 5. A sibling of the deceased person who is 18 years or older. Next of Kin of a deceased child is determined by the following order of priority: 1. A parent of the child 2. A sibling of the child who is 18 years or older 3. A person who is Guardian of the child immediately before the child’s death.
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Bereavement Information 23 South Eastern Sydney Local Health District Death Certificate and Registration The ‘Medical Certificate of Cause of Death’ is completed by a medical practitioner who certifies the facts and circumstances of the death. This medical certificate is provided by the hospital to your chosen funeral director who will, if requested, submit an application for the official ‘Death Certificate’ to the Registry of Births Deaths and Marriages on your behalf. There is a cost involved for the issuing of an official ‘Death Certificate’. A death certificate is the official copy of information held at the Registry of Births, Deaths and Marriages about a person who has died. It can be helpful to make multiple copies of the death certificate nsw.gov.au/family-and-relationships/deaths/death-certificates It can take several weeks for the NSW Registry of Births, Deaths and Marriages to issue the official Death Certificate. If you require documentation urgently before receiving the official Death Certificate, discuss your needs with your funeral director, registry or the hospitals medico-legal department.
South Eastern Sydney Local Health District Bereavement Information 24 Special Circumstances Deaths reported to the NSW Coroner’s Court In some situations, the circumstances surrounding a death are reported to the NSW Coroners Court to be investigated. Coroners investigate certain kinds of deaths to determine the identity of the deceased and the date, place, circumstances and medical cause of death. There is specific NSW legislation which doctors must adhere to in relation to this process. You will be informed by hospital staff if this is required and be provided with an information sheet titled Initial steps after a death is reported to the Coroner for more information about the role of the coroner and the process. The coronial process can take time; however, you can begin making funeral arrangements as soon as you are able. The funeral director you have appointed will find out from the coroner when your loved ones’ remains can be released and will organise transportation to the funeral home. Counsellors are available at the coroner’s court to assist relatives and friends by providing information, counselling and support with viewings if required. You can call the Coronial Information and Support Program (CISP) Forensic Counselling Service on (02) 8584 7777 for guidance on when a funeral can be arranged. If you would like to arrange a viewing with the NSW Health Coroner please email: NSWPATH-FASSFM-SocialWorkSydW@health.nsw.gov.au Additional Information can be sourced from coroners.nsw.gov.au
Bereavement Information 25 South Eastern Sydney Local Health District A death at home When a person dies at home, and the death is expected and support is being provided by the community palliative care team, it is not necessary to call emergency services. The community palliative care team will discuss the process ahead of time and advise you on what to do. Key Points to consider It can be helpful to choose a funeral provider in advance, even if you are not yet ready to plan the funeral itself. Selecting a company, you feel comfortable with and keeping their contact details readily available can ease decision-making during a difficult time. When a person dies, a doctor usually their general practitioner (GP) will need to complete a ‘Medical Certificate of Cause of Death’. It is important that the GP has seen the person recently, typically within the weeks leading up to their death. If the GP is unavailable to attend the home, a nurse, paramedic, or another qualified medical professional can issue a ‘Verification of Death’ as an interim measure. You may wish to speak with your community nurse or GP in advance to discuss and prepare for this process. Once either the ‘Medical Certificate of Cause of Death’ or a ‘Verification of Death’ has been issued, you can contact the funeral provider to arrange for the person to be taken into their care. There is no need to rush this step. If you or your family would like some time at home for farewells, it is completely acceptable to proceed at your own pace. You can inform the funeral provider of your wishes and ask them to delay their arrival until you feel ready.
South Eastern Sydney Local Health District Bereavement Information 26 Repatriation of Bodies Overseas Repatriation involves transfer of your loved ones’ remains from one part of the world to another (either interstate or overseas). It is understandable that family and friends may want their loved ones’ remains to be returned home, to be laid to rest in accordance with their wishes. The process of repatriation can be daunting, particularly whilst grieving. A funeral director who specialises in interstate and international repatriation can assist you in navigating this. Costs can vary widely; therefore, it is recommended that you obtain several quotes before appointing a funeral director. The Funeral Directors Role The funeral director’s role is to register the death, manage required paperwork, including hospital certification and letter of non-infection status to facilitate the repatriation and coordinate safe transfer of your loved one from one location to another, ensuring that local customs and spiritual and cultural beliefs are respected. The funeral directors may need to make interstate, and/or international arrangements with relevant state and federal government departments, and the Consul-General of the country your loved one is travelling to. Timeframes Once a funeral director is identified repatriation from Australia usually takes about 5-10 working days, from time of release from the coroner or hospital. This time frame can sometimes vary depending on government departments processing and issuing of paperwork, and flight availability etc.
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South Eastern Sydney Local Health District Bereavement Information 28 Who to notify When a person has died there will be some people and organisations that need to be notified. This will vary depending on the person’s circumstances; however, these are some suggestions that might be relevant. The Australian Death Notification Service can assist with some of these notifications once the death certificate has been issued. The service doesn’t cover all the places you will need to notify but can help with a few. You can access the service here: deathnotification.gov.au You may also wish to consider what to do with the person’s social media accounts. Each platform has a slightly different process after a person has died. Depending on the platform you can choose to memorialise the account, delete the account or leave the account open. This website has a guide to handling social media accounts after someone has died: willed.com.au/guides/social-media-after-death Person or organisation to be notified Contact Number Date notified (if relevant) Accountant Australia Post (If mail needs to be redirected) 137 678 Australian Electoral Commission 132 326 Australian Tax Office 132 861 Centrelink 132 300 Child Support Services 131 272 Clubs, memberships or subscriptions Community service provider (i.e. Homecare) Dentist Department of Veteran Affairs (if relevant) 133 254 Education Provider (Schools, University, and Day Care) Electricity provider Employer Executor of Will
Bereavement Information 29 South Eastern Sydney Local Health District Person or organisation to be notified Contact Number Date notified (if relevant) Financial organisations (banks, credit unions) Funeral Director Gas provider GP and other doctors/specialists Insurance companies Landlord, Tenet or Housing NSW Local council (if paying rates) Medicare 132 011 My Aged Care 1800 200 422 Other: Paid TV streaming services and/or internet Private health insurance Public Trustee 02 9240 0732 Relatives and friends Residential Aged Care Facility / Nursing Home Schools Service NSW (Car registration) Service NSW (Licensing) Solicitor Strata Superannuation fund Telephone companies Utilites (Gas, Electricity, Water) Water provider
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Bereavement Information 31 South Eastern Sydney Local Health District Understanding grief and loss Grief is a natural and deeply human response to the loss of a loved one. It reflects the important role that person held, and continues to hold, in your life and heart. If you have not experienced grief before, you may feel unprepared for the wide range of emotions that can arise. Common emotional reactions include shock, disbelief, sadness, guilt, anger, fear, and loneliness. Physical symptoms may present, such as fatigue, sleep disturbances, gastrointestinal issues, changes in appetite or weight, and somatic complaints such as muscle tension or headaches. Grief is not a passive or linear process; it is active and deeply personal. There is no “right” way to grieve, and the journey will be different for everyone, shaped by your unique relationship with the person who has died. It can be helpful to think of grief not as something that simply happens to you, but as something you experience and navigate, allowing you to make choices about how to move through it in your own time and way. In the days and weeks following a death, you may receive increased support from others, which can gradually lessen over time. As this happens, it is important to consider ways of caring for yourself in the months ahead. Support remains available, and seeking help is a sign of strength, not weakness. Allow yourself to express emotions • Identify someone you feel able to talk openly with and who is a good listener. • Allow yourself to express emotions, it is okay to cry. • Journal or write down feelings. • Creative expression, writing a letter or poem, painting or drawing. • For stronger emotions like anger or resentment, try directing energy into physical activity like walking or running.
South Eastern Sydney Local Health District Bereavement Information 32 Looking after your wellbeing • Keep to a meal routine and drink lots of water. Sometimes you may not feel hungry, but eating and drinking water regularly is an important way to support yourself • Maintain gentle activity, such as walking, yoga, tai chi, or swimming • Spend time in nature, like at the beach, river or in bushland • Do any activity that brings you a sense of satisfaction • You may find social situations more challenging and feel you need more time for yourself Legacy and remembering • Keeping memories around you and your home can help you feel connected. This may include photos, playing music that reminds you of the person or keeping to the routine you shared, such as having tea in the sun. You may wish to invite others to share these moments with you. • Sharing memories and stories with friends and family, thoughts and feelings can be comforting and strengthen feelings of connection. • Draw on religious or spiritual beliefs. • Use cultural or religious practices that are meaningful for you personally. At times you may not feel able to do any of these things. Self-compassion and being gentle with yourself are important when you are grieving.
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South Eastern Sydney Local Health District Bereavement Information 34 When to seek further support Although grieving is expected and individual, sometimes you might want professional support. Some indicators that you may benefit from professional support include: • Over time, you remain preoccupied and acutely distressed or distracted by your grief. • You experience panic attacks or other serious anxiety or depression. • Thoughts of hopelessness. • If you’re using different coping methods more than usual, like increased or changed eating patterns, alcohol or other drugs to lessen the pain. • Finding yourself unable to do tasks in your daily life or find pleasure in activities you usually enjoy. • Finding ongoing issues with sleep. • You do not feel you have access to someone who can listen to you. While any of these conditions may be a temporary feature of normal bereavement and grief their continued presence may be cause for concern and may require attention by someone beyond the regular support figures in your life. If you or someone known to you is having an extreme grief reaction and could be at risk of harm, please contact the following: Local Hospital Emergency Department (24hrs/7 days). Mental distress, call NSW Mental Health Line on 1800 011 511 If life is at risk please call Triple Zero (000) to receive immediate help
Bereavement Information 35 South Eastern Sydney Local Health District Hospital Phone Number The Sutherland Hospital Social Work Department 02 9540 8300 St George Hospital Social Work Department 02 9113 2494 Calvary Hospital Social Work Department 02 9553 3111 Our external community, partnerships and collaborations Grief, psychological and emotional supports Service Phone Number Website Australian Centre for Grief and Bereavement 1800 642 066 grief.org.au Beyond Blue Helpline 1300 551 800 beyondblue.org.au Cancer Council NSW 13 11 20 cancercouncil.com.au Calvary Bereavement Counselling Service (02) 9240 0732 calvarycare.org. au/hospitals/calvary-health-care-kogarah/services-and-clinics-4 Compassionate Friends 1800 671 621 thecompassionatefriends.org Catholic Care Counselling support 1800 324 924 catholiccaredbb.org.au/ therapy-services/counselling
South Eastern Sydney Local Health District Bereavement Information 36 Further support can also be accessed through health care professionals that you are known to, including social workers, psychologists and your GP. Service Phone Number Website Homicide Victims Support Group 1800 191 777 hvsgnsw.org.au National Association for Loss and Grief NSW 9489 6644 nalag.org.au National Centre for Childhood Grief 1300 654 556 childhoodgrief.org.au Kids Helpline 1800 551 800 kidshelpline.com.au Lifeline (24/7 Counselling) 131 114 Solace (support group for widows/ widowers) 9519 2820 solacegriefsupport.org.au Standby–Support after suicide 1300 727 247 standbysupport.com.au Grief, psychological and emotional supports cont.
Bereavement Information 37 South Eastern Sydney Local Health District Supporting Children Talking to children about death and dying Talking to children about death can be difficult, particularly when we are also grieving. It is also common to want to protect children from death out of concern that they will not understand or will become overly distressed. However, in general, children are resilient and have strengths to cope with death when supported by a primary caregiver. ChildrenandYoungPeoplemaybecomemore anxious, confused or fearful if we exclude them from important conversations or attempt to hide our own grief. When we are able to talk openly and honestly with children about death and dying, we can support with their understanding of these big concepts, assist them to feel safe and secure, normalise sharing emotions and feelings with trusted caregivers and supports and allow them to ask questions. Conversations may also help to prepare children for significant events, such as viewings and funerals. When to talk with children about death Once you know a loved one has died or is dying, take time to explain this to your child as soon as you feel you are able. You may wish to elicit the support of another person when having these discussions. If you have more than one child in your family, you might wish to talk together as a group or tell each child what has happened individually. It is helpful to consider the age and characteristics of your children when deciding how to talk to them about the death. What to say when talking about death Children sometimes need help to understand what death and dying means. We can assist with their understanding by explaining what has happened as truthfully and as simply as possible. For example, ‘I have some sad news to tell you. Grandpa died this morning’. It is important to use words such as ‘death’ and ‘died’ to assist with the child’s understanding. Ambiguous explanations, such as “grandpa went to sleep”, or ‘passed away” may be confusing or may cause your child to become fearful and anxious.
South Eastern Sydney Local Health District Bereavement Information 38 For example, a child who is told that ‘Grandpa has gone to sleep forever’, may develop a fear of going to sleep, believing they may not wake up. Younger children may not have a concept of what it means when someone dies; we may need to describe death in terms they understand and explain that sadly, death does not go away, and the person cannot return. For example, ‘dying means that grandpa’s heart or body has stopped working and they are not breathing anymore’. If you feel uncertain about how to approach the conversation or talk about death with your child, you can practice with another adult first. You can plan what you will say and how you will answer your child’s questions. It also helps to think about what you might say if you don’t know the answer to your child’s questions. It’s okay to say something like, ‘I don’t know, but I will try to find out’. It may also be useful to check to see if a child has understood what has been said, by asking them to repeat this back to you. Cultural and Spiritual Beliefs People from various cultures and faiths hold different beliefs about what happens after a person dies. Some faiths believe in the dreamtime, or another kind of after-life (heaven, nirvana) and others may believe that we are re-born or reincarnated. Some families hold different beliefs entirely, for instance that we become stars in the night sky or simply return to earth to join the great circle of life. Often parents will wish to share their spiritual beliefs and cultural customs with their children. Your explanation of what occurs after death will be in keeping with your faith or spiritual beliefs. What might children feel when someone dies? Just like adults, every child or young person’s experience of grief is unique. Children’s reactions to death vary depending on their age and stage of development, relationship with the person who has died and any previous experiences of grief. Young children may act out, their behaviour might regress, or they may become more anxious following the death of someone close to them. Children can experience a range of feelings, including sadness, anxiety, longing, anger, numbness and confusion; these reactions are normal. Some children may appear confused or not seem affected by the death at all. They may express feelings of guilt, believing that they did or said something to cause the death. Some might seek out the person who has died, asking where they are or become anxious when separated.
Bereavement Information 39 South Eastern Sydney Local Health District when separated from primary caregivers and express fear that you or another family member might also die. Children may also develop fears that they themselves will become unwell and die. It is important to provide children with comfort and reassurance at these times. Talking about feelings when someone dies Listen and provide comfort, offer cuddles, and reassurance. Answer their questions honestly and validate their feelings and reactions. Sharing your own feelings of grief with your child or allowing your child to see your sadness or tears may help them to understand what might be happening for you, and your family. For example, ‘Sam you seem really angry that Grandpa died. I’m feeling angry too. I really loved him, and I don’t like it that he can’t be here with us anymore. I miss him all the time’. If your child knows that it is okay to talk about how they are feeling –and that you can cope with their feelings – they will be more likely to talk and seek support at times when they feel overwhelmed. For some children, using toys, books, music or drawing might help them to express or show their feelings. Should children visit someone dying / attend funerals? Children should be given a choice about whether they visit a dying relative in hospital or attend funerals. Funerals are important family rituals and can have therapeutic benefit, as they reinforce the reality of the death– which is often critical for a child. Funerals also provide opportunities for support. Rituals such as funerals and memorials validate grief and empower memories of the deceased. If a child hasn’t attended a funeral, they may need to know what to expect. Describe everything from how the room is laid out, to how the deceased may appear should there be an open casket. Most funeral directors will be willing to assist – taking the child to an empty room and showing them what a casket may look like. Offer options and choices. Children can attend part or all of the events. They may go up to the casket (if there is one) or not. Support, including answering the child’s questions, taking them for a walk if the child needs respite, or just offering a shoulder to cry may be provided by a parent of a close family friend.
South Eastern Sydney Local Health District Bereavement Information 40 Tell your child what to expect If the death of a person means changes in your child’s life or routine, explain what will happen. We can help prepare children for events that will happen and allow children to join in rituals like viewings, funerals, or memorial services. Tell them ahead of time what will happen. For example, “Lots of people who loved Grandpa will be at the funeral. We will sing and talk about grandpa’s life. People might cry and hug. You can stay near me and hold my hand.” It can also help to ask the child if they would like a role at the funeral. Having a small, active role can help children feel part of things and help them to cope. They might like to read a poem, pick a song to be played, gather some photos to display, or make something. They may like to place an object or flower on the coffin. Let children decide if they want to take part, and how. Help your child remember the person. In the days and weeks ahead, encourage your child to draw pictures or write down stories of the person who has died. Don’t avoid talking about the person who died. Sharing happy memories can help with grief. Tips to help children who are dealing with death When someone dies, you can help children of all ages by: • Trying to keep to a routine • Letting them know that it’s OK to play, be happy and have fun • Telling teachers or caregivers what has happened so that they support the child.
Bereavement Information 41 South Eastern Sydney Local Health District Children’s understanding of death depends greatly on their age and stage of development. Toddlers and pre-school aged children Children in this age group may view death as a journey from one place to another, but they may not understand that death is final. Your child might ask whether they can visit the person who died and when the person is coming back. They might ask the same questions over and over. This is their way of trying to understand what has happened. Some children might regress in their development–for example, they might begin wetting the bed or want to sleep in your bed. Young children (6-10 years) At this age, children understand that death is the end of life, but they might believe that death can be prevented or that not everyone will die. They may deny the death has occurred, blame other people or themselves, or feel guilty for not “being good” to the dead person. You can help your school-age child by: • Letting them know that the death wasn’t their fault • Letting them see you are grieving too • Answering questions openly and honestly–for example, if your child asks whether you’ll die, you could say, ‘Yes, I’ll die one day. Everyone dies, but it mostly happens when people are old or very sick’ • Suggesting a memorial activity–for example, planting a tree, writing a letter or drawing a picture. Children and young people 11 years and above Like adults, they will have difficulty understanding and managing their emotions and may not express their feelings, preferring to keep them inside. Sharing our grief will assist young people in sharing their emotions. Involve the young person in decisions or ask for contributions if they choose to share. If they don’t share their feelings with you, it may help to let others in their life know, such as a sports coach, friend’s parents, or teachers. Children’s Understanding of Death
South Eastern Sydney Local Health District Bereavement Information 42 Useful Resources The National Centre for Childhood Grief Call 1300 654 556 childhoodgrief.org.au Grief Australia This website has information about grief and supporting children and adolescents in different age groups. Call 1800 642 066 grief.org.au/ga/Resources.aspx Cancer Council This Cancer Council resource gives guidance about possible reactions children may have based on their age, and suggested approaches for support. Although the resource is from the Cancer Council, it is a useful resource for anyone with children: cancer.org.au/cancer-information/types-of-cancer/childhood-cancers/talking-to-kidsabout-cancer Headspace Headspace is Australia’s National Youth Mental Health Foundation, providing early intervention mental health services to 12-25 year olds. Headspace provides online and phone counselling services, and vocational services. Headspace can help young people with mental health, physical health (including sexual health), alcohol and other drug services, and work and study support: headspace.org.au Cancer Hub Cancer Hub supports families dealing with a cancer diagnosis to more easily access the support they need, when they need it. Canteen, Camp Quality and Redkite have together to offer a range of practical and emotional cancer support services for families facing cancer (with children aged 0-25 years) through this one stop shop, Cancer Hub: cancerhub.org.au/services
Bereavement Information 43 South Eastern Sydney Local Health District Grief and Bereavement Counselling Service The Sutherland and St George Hospital, Grief and Bereavement Counselling Service offers confidential counselling support and is a free service. Individual bereavement counselling is available to families and significant others of patients known to inpatient or community teams at either The Sutherland or St George Hospital. This service is available for people aged over 18. Counselling affords time and a private safe space to talk about your grief and receive assistance and emotional support. Counselling can also help in accessing your own resources, strengths, and ways of coping. You can discuss how your grief affects you and ways of managing this, in addition to your usual day-to-day support. Service is provided by appointment only, please contact to book a session. Contact details Service available within business hours. A health professional can refer you to the Grief and Bereavement Social Worker on your behalf, with your consent. Available locations • The Sutherland Hospital (Phone: 9540 8300) • St George Hospital (Phone: 9113 2494)
South Eastern Sydney Local Health District Bereavement Information 44 Calvary Bereavement Counselling Service This service provides counselling for any bereaved adult living in the St George & Sutherland Shire area or any bereaved person living outside the area, but the deceased died within the area. Many people who lose someone close to them often start to feel the impact of their loss at the very time it is expected they will be feeling better or “getting over it”, and, when social support is withdrawing. A professional counsellor can provide a listening ear and an opportunity to explore and process complex thoughts and feelings which may be experienced. Counselling can be helpful for people even some time after the event of death, particularly if there is a sense of being “stuck”, or not being able to “get on” or generally “not coping”. Calvary Bereavement Counselling Service is located in a comfortable cottage near Calvary Health Care Kogarah. It is a free service. Self-referral essential. Office hours are 8am to 4:30pm Monday to Friday. You can contact Calvary Bereavement Counselling Service on Phone: 9553 3025 for further information or to make an appointment. Reviewed August 2025
Bereavement Information 45 South Eastern Sydney Local Health District This resource was produced by the social work departments of The Sutherland and St George Hospitals based on resources from Sydney Local Health District, SLHD Bereavement Counselling Service, Royal Prince Alfred Hospital, Concord Hospital and Balmain Hospital Social Work Departments. The booklet has been developed through shared knowledge and contributions have been received with thanks. This resource has been endorsed by The Sutherland Hospital Consumer Advisory Group. Reviewed August 2025
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