Facing the death

The death of a patient in ICU is always a dramatic event: despite the most appropriate care, the disease may be too severe and treatments could prove insufficient. You do not always have time to get prepared for the mourning, since the clinical conditions may precipitate quickly.

In front of the death of your dear one, at first it is important to try to well understand what happened, by talking with health care providers and discussing with your family members.

In most cases, it is easy to understand what happened, since the heart of your dear has stopped and does not beat anymore. The brain no longer receives oxygenated blood and then dies, thus causing the individual's death. In these cases, only one doctor is sufficient to certify death.

In some diseases, however, the brain dies, while the heart continues to beat if supported by medicines and machines. Although this heartbeat, this condition coincides with the death of the individual: the fact that your dear has died is perhaps more difficult to understand and accept, but when the brain dies, the whole individual dies. In these cases, the intervention of a committee of three doctors (intensivist, neurologist, coroner) is necessary to diagnose death. Once highlighted death, machines and drugs no longer make sense: at their shutdown, all vital functions end and the body is moved to the morgue. It is possible to preserve only temporarily the integrity of some organs, by continuing to support circulation and breathing.

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 Within a situation already in itself difficult and painful, it could be proposed to you the donation of tissues (non-hearth-beating donor) or organs (hearth-beating donor) of your dear one. Your role as caregivers at this time is crucial to report to health care professionals the wishes expressed by the deceased while still alive. In a moment of very strong emotions, it can be heartening to think that you are not required to express your will, having to choose on behalf of your dear. Thinking back to his/her values, the words he/she had expressed in the past, the reasoning he/she would have done, you can realize his/her wishes even after his/her death.

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