Trying to cope with family road deaths

Statistics suggest that 40 to 50 people will die on the roads between now and New Year's Day. Up to five of the dead are likely to be under 17. Of the older victims, it is likely that many will leave bereaved children behind.

The immediate aftermath of an accident is chaotic, says Ms Bernie Price, a social worker at Temple Street Children's Hospital in Dublin.

"What you are presented with is a family arriving not knowing whether the person who was in the accident is dead or alive," she says. "There is a sense of panic and a need for information about how the person is. Is the person dead? What are the injuries?"

If the person has died, "there's the whole matter of identifying the person. I think the family needs preparation for that. If the person is badly injured, the family members should not see the person without some preparation".

But even if the body is very badly mutilated, the family should be encouraged to see it, "even though it will be difficult".

At this early stage "families are very numb and very immobilised", she says. "They are swamped with having to make decisions about funerals in the most horrific circumstances."

Her job "is about trying to help the family to take back some control in an out-of-control situation".

"In three to four days the family will make decisions they will be happy with for the rest of their lives or that they will regret for the rest of their lives. How will they say goodbye? Will they bring the body home? Will they involve the children? What kind of service will they have?"

The reactions of bereaved children can surprise adults, she says. Sometimes "the child will seem to take it in and be upset but will then get on with normal play or ask when am I getting my dinner? It can sometimes upset the parents that the children can seem to be almost cold and get on with their lives as if nothing had happened".

She believes one of the things that is happening is that the children are protecting the parents from additional pain. Because of this, she says, "people need to volunteer information and create a situation where children can ask questions".

In general, she believes, children should see the body of the other child or parent who has died. Where the person was badly injured in the accident, these injuries may not be as bad as the child would otherwise imagine. "Many times children say `I thought it would be worse'."

But, she warns, "they do need to be prepared. This may be the first dead person they have ever seen. They may not know they will be pale, that they are going to be cold. They need to know what the room will be like. Will the person be in the coffin or not in the coffin?".

Many hospitals do not have staff trained in the work Ms Price describes - "the psycho-social side of fatal accidents" - and she believes this should be addressed.

Hospitals have worked out how to provide facilities - rest rooms, privacy, access to telephones, a social work service - in a major disaster, she says, but these services should also be provided when "ordinary" fatalities happen.

And, she argues, helping bereaved children to grieve in normal ways can avoid psychiatric problems in years to come. Temple Street Children's Hospital has run such groups for some years.