05/18/18

How to Talk to Kids About Death

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Discussing death with your kids can be a real concern and many tend to avoid it. Death is however an inevitable part of life and it is our responsibility to ensure our kids are aware of it and know it’s okay to discuss it.

If we allow children to talk to us about death, we can give them needed information, prepare them for a crisis, and help them when they are upset. We can encourage their communication by showing attention and respect for what they have to say. We can also make it easier for them to talk to us if we are open, honest, and at ease with our own feelings.

Death is very much a part of our lives on many different levels. We may be surprised at how aware children already are about death. They see dead insects, dead birds and animals on the road or a family pet may have died. Children read about death in their fairy tales, watch it in cartoons and even role-play death in school plays. Without realising it they already have some exposure to the concept.

Problems That Make Discussing Death Difficult

  1. We avoid talking about things that upset us. We bottle it up and hope that by saying nothing will help it go away. Children are sensitive barometers of emotion and are tremendous observers. They know something is wrong by simply watching us. Our body language, emotions on our faces, what we say and what we don’t say are all communicating a message to our kids.When we choose not to discuss an issue with our kids they too hesitate to ask questions. They automatically think “If Mummy and Daddy are so upset that they can’t talk about it, I had better not talk about it either……it must be bad!”. This causes our kids to stress and worry more as they don’t know how we are feeling.
  2.  We feel uncomfortable when we don’t have all the answers. As a teacher and parent myself, kids will often expect us to know everything, even all about death. Take it as a compliment and know that they look up to us.It is okay to say to your child “I’m not sure myself about that” or “I just don’t know the answer to that”. Children respond to this honesty beautifully and feel connected in our openness towards them. It helps them feel better about not knowing everything also. In discussing death, we may find different answers at different stages in our life or grieving process.Share with children your beliefs. Expose them to the belief of others, for example some people believe in afterlife, others do not. Allow them to be comforted in knowing your beliefs and allow them to choose their own.
  3. Death is often a taboo subject– in some cultures death is an integral part of family life. People died in their home environment, surrounded by loved ones (adults and children alike). They comforted each other and mourned together.Unfortunately today death is much lonelier. Many people die in isolation and loved ones miss sharing their last moments. The living has in some ways become separated from the dying; consequently, death has taken on added mystery and, for some, added fear.

Help to diminish this trend and openly discuss death with your child when an appropriate time arises. Model appropriate behaviour regarding death, for example express your sympathy towards someone who has lost a loved one in front of your child. Show them that it is kind to acknowledge a loss and express care towards others.

Developmental Stages of Understanding – A General Guide

  • Preschool children mostly see death as temporary, reversible and impersonal. In stories they read or watch characters will often suddenly rise up alive again after being totally destroyed. It’s not surprising they don’t understand, yet it is appropriate for their age level to think this way.
  • Between the ages of five and nine, most children are beginning to see that all living things eventually die and that death is final. They tend to not relate it to themselves and consider the idea that they can escape it. They may associate images with death, such as a skeleton. Some children have nightmares about them.
  • From nine through to adolescence, children to begin to understand fully that death is irreversible and that they too will die some day.

It is important to remember however that all children develop at different rates and that children experience life uniquely. They have their own personal ways of handling and expressing emotions.

It is not uncommon for a three year old to ask questions about death, for a child to be openly unconcerned about the death of a grandparent yet devastated over the death of a pet. Some children show their understanding of death through playing with their toys.

It is important to explain death in simple terms for young children. For example, when someone dies they don’t breathe, or eat, or feel hungry or cold and you won’t be able to see them again.

No matter how children cope with death or express their feelings, they need sensitive and nonjudgmental responses from adults. Careful listening and observing are important ways to learn how to respond appropriately to a child’s needs.

Talking About Death With Preschoolers or Young Children

Many people feel challenged when approaching the subject of death to preschoolers and young children. They in particular need brief and simple explanations. Using concrete and familiar examples may help. For example, death may be made more clear by explaining it in terms of the absence of familiar life functions – when people die they do not breathe, eat, talk, think, or feel any more; when dogs die they do not bark or run any more; dead flowers do not grow or bloom any more.

Children learn through repetition so they may need to go over this quite a few times. A child may immediately ask more questions, others may be silent, then wish to revisit the subject again later. Children sometimes get confused with what they hear so it is important you check their understanding by revisiting the subject at appropriate times.

As time passes and children have new experiences, they will need further explanations and sharing of ideas and thoughts.

It may take time for a child to comprehend fully the ramifications of death and its emotional implications. A child who knows that Uncle Tom has died may still ask why Aunt Julie is crying. The child needs an answer. “Aunt Julie is crying because she is sad that Uncle Tom has died. She misses him very much. We all feel sad when someone we care about dies.”

There are also moments when we have trouble “understanding” what children are asking us. A question that may seem dreadfully thoughtless to an adult may be a child’s request for reassurance. For instance, a question such as, “When will you die?” needs to be heard with the realisation that the young child perceives death as temporary.

While the permanency of death is not yet fully understood, a child may think that death means separation, and separation from parents and the loss of care involved are frightening.

Being cared for is a realistic and practical concern, and a child needs to be reassured. Possibly the best way to answer a question is by asking a clarifying question in return: “Are you worried that I won’t be here to take care of you?” If that is the case, the reassuring and appropriate answer would be something like, “I don’t expect to die for a long time. I expect to be here to take care of you as long as you need me, but if I did die, there are lots of people to take care of you. There’s Daddy, Aunt Laura and Uncle John or Nan.”

It is important to check which words you use when discussing death with your kids. Some children confuse death with sleep, particularly if they hear adults refer to death with one of the many euphemisms for sleep – “they died in their sleep”, “eternal rest”, “rest in peace.” Resulting from this confusion, a child may be afraid of going to bed, incase they don’t wake up either!
Similarly, if children are told that someone who died “went away”, brief separations may begin to worry them. Grandpa “went away” and hasn’t come back yet. Maybe Mummy won’t come back from the shops or from work. Therefore, it is important to avoid such words as “sleep”, “rest”, or “went away” when talking to a child about death.

To avoid confusion with preschoolers and very young children, it helps to explain that only very serious illness may cause death. When they hear that sickness was the cause of death, we don’t want them to assume that minor ailments are a cause for major concern.

When a child associates death only with old age, they can become very confused when they learn that young people can die too. It is important to explain that most people live a long time, but some don’t. However we do expect that we will live a very long time (always reassure them)!

Religious References

Religion is a real source of strength for many people in a time of grieving. If however religion has not played a part in your child’s life before dealing with death, it may be very confusing and worrying to hear religious references. For example, the explanation “Big sister is with God now” may comfort an adult, but frighten a child. They may fear that God will come and take them away as He did big sister.  Ensure that your child has an affiliation for your terms so they feel familiar and can understand.

Other messages may confuse children, including statements such as “Tommy is happy in Heaven with the angels”. They may wonder why everyone is so unhappy when they say that Tommy is happy. They need to hear about the sadness being felt from losing Tommy, along with our expressions of religious faith.

It is important to help children understand the realities of death, being the loss and the grief. Trying to shelter children from these realities only denies them from the opportunity to express their feelings and be comforted. Sharing feelings between you and your child will benefit you both.

Other Opportunities To Talk About Death

Children tend to be extremely curious when they discover death, particularly dead flowers, birds, trees and insects. This may open windows of opportunity to discuss death further and answer all the detailed questions that may arise. Try to reinforce the concept that all living things eventually die, but it makes room for new things to join us on earth.

Other opportunities to discuss death with your kids arise when well-known persons die and their funeral receives a lot of media coverage. This is a natural time to clarify any misunderstandings they may have about death. If the death is violent or aggressive however, you need to reassure your child that they are safe and most people do not behave this way towards each other.

Attending Funerals

If your child is to attend a funeral, they need to be prepared beforehand for what they might see and hear before, during and after the service. Explain that it is a very sad occasion and that some people will be crying and others feeling very sad.

Seat your child next to you or someone they are familiar with who is able to cope with their questions and be prepared to offer explanations. If your child prefers to not attend the funeral, they must not be forced.

Mourning

We all need to mourn in order to heal our sorrows and move on in our lives. By being open with our emotions and showing our sorrow and tears, expresses to our children that it is okay that they also feel sad and cry. We should never associate tears and expressing feelings with weakness.

Children often feel guilty and angry when they lose a close family member. They need reassurance that they have been, and will continue to be, loved and cared for.

In Summary

A grieving child needs information that is clear and comprehensible for their development level. They need a lot of reassurance that they are safe and loved and be made feel that they can discuss their feelings openly. Children need to maintain their activities and interests as they desire and revisit questions regularly.

When preparing a child for an anticipated death, allow them to help care for the dying person if they desire, receive lots of affection and answer questions, be given information about the physical, emotional, and mental condition of the terminally ill person and be given a choice of visiting or remaining away.

Complete Article HERE!

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05/11/18

How young children understand death – and how to talk to them about it

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Some big questions.

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“Mummy, what happens after we die?” Many parents have been asked this kind of question, and it is often difficult to know how best to reply. Should you be open about your own beliefs – whether they are religious, agnostic or atheist? And is it OK to sugarcoat? Recent research in developmental psychology provides some advice.

Death is a fascinating subject to many children, as shown, for example, when they come across a dead animal or plant. Their observations and questions show a healthy curiosity as they strive to make sense of a complex world.

Yet to many parents, death is a taboo subject for children. But children’s questions actually provide an excellent opportunity to encourage their inquisitiveness and to support their learning about, for example, biology and the life cycle. However, there are situations when you need to show great sensitivity.

What children know

Most preschoolers do not grasp the biological basis of death and tend to believe that death is a different state of life, like a prolonged sleep. At this age, children often say that only old and ill people die. They also think dead people feel hungry, need air and can still see, hear or dream. To gain a mature, biological understanding of death, children must acquire knowledge of a few key facts about death.

Typically, between the ages of four and 11, children gradually come to understand that death is universal, inevitable and irreversible, follows the breakdown of bodily functions, and leads to the cessation of all physical and mental processes. That is, by the age of 11, most children grasp the idea that all people – including their loved ones and themselves – will die one day and remain dead forever.

However, some young children will understand these components sooner, and here experience and appropriate conversations are influential. For example, those who have already experienced the death of a loved relative or pet, and those with more experience of the life cycle through interacting with animals, tend to have a better grasp of the death concept.

Another predictor of relatively early understanding is parents being better educated, irrespective of the child’s intelligence. This suggests that parents can and do help their child’s understanding of death by providing appropriate opportunities and clearly explaining the biological facts during the primary years.

Religion and culture also play an important role in shaping children’s beliefs. During their conversations with adults, children often encounter biological facts but also “supernatural” beliefs about the afterlife and spiritual world. Developmental psychologists have discovered that as children grow older and grasp the biological facts about death, they typically develop a “dualist” view that combines biological and supernatural beliefs.

For example, ten-year-olds may recognise that dead people cannot move or see because their bodies have stopped working, but at the same time believe that they dream or miss people.

Honesty and sensitivity

Recent research on children’s understanding of death has a number of implications for how best to discuss this complex and often emotionally charged subject.

The most important thing is to not shy away from the topic – don’t ignore a child’s questions or try to change the subject. Instead, see them as an opportunity to nurture their curiosity and contribute to their gradually gaining a better understanding of the life cycle. Similarly, listening to what children ask and say about death will enable you to gauge their feelings and level of understanding, and to work out what requires explanation or reassurance. An oversimplified message can be uninformative and patronising, and an overly complex explanation might add to confusion and possible distress.

For example, offering detailed information or graphic details about how someone died or what happens to dead bodies may cause unnecessary worry and fear, especially in younger children. For some children, the idea that a dead person continues to watch over us can be reassuring, but for others it might be a source of confusion and distress.

Another key aspect is to be honest and avoid ambiguity. For example, telling a child that a dead person is “asleep” could lead them to believe that dead people can wake up. Research has shown that children who understand the normality, inevitability and finality of death are likely to be better prepared for, and better able to make sense of death when it happens. Indeed, children with such understanding actually report less fear of death.

Being honest also means acknowledging the uncertainties and mystery of death and avoiding being dogmatic. It is important to explain that there are some things that nobody can know, and that it is normal to hold apparently inconsistent beliefs simultaneously. However strong your religious or atheist beliefs, acknowledge that others may hold very different views. This approach will encourage tolerance of others’ beliefs, support children’s naturally strong drive to make sense of the world and inspire an appreciation of its wonder and mystery.

Perhaps the most important thing is to acknowledge that sadness is normal, and that it is natural to worry about death. We all feel sad when a loved one dies but we gradually overcome our sadness as life goes on. To ease concern, you could offer realistic reassurance. Point out, for example, the likelihood that they and their loved ones will continue to live for a very long time.

If a child is coming to terms with the loss of a loved one, or is dying herself, great sensitivity is required. This does not mean being less honest or open. Children manage their anxiety and fears better when they can rely on truthful explanations about the death of a loved one. For children who know that they are dying, it is important to provide them with opportunities to ask questions and express their feelings and wishes.

Whatever the circumstances, children try to fill in the gaps in their knowledge if truthful information is kept from them. Often their imagination can be far more scary, and potentially far more damaging, than the reality.

Complete Article HERE!

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03/24/18

Dying Young and the Psychology of Leaving a Legacy

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Often the biggest existential distress that we carry is the idea that no-one will remember us when we are gone—initially we know that our friends and family will hold who we are, but after a generation, these people are likely gone too. At the end of life, the pressure to leave an unquestionably relevant legacy can be crippling for people, particularly for young people. When coupled with the limited energy that people have when they are unwell, the very nature of what people expect to achieve in the world shrinks, and the really important pieces come into focus.

When time is seen to be limited, every moment can take on a weight that has never before been experienced. Some of these expectations come from within and some externally, but regardless of their origin they can be paralyzing for the young person facing their mortality, particularly when unwell. Culturally, there are multiple references as to what ‘dying young’ is meant to mean and most refer to extraordinary and often unobtainable expectations. For instance, members of the ‘27 club’ (celebrities who die on or before their 27th birthday) and notable cancer-related concepts around ‘bucket lists’ and works of fiction (e.g., The Fault in Our Stars). Most young people, particularly those who are dying, do not have the capacity or the options to engage in an extraordinary feat, they can become overwhelmed and paralyzed by what they are ‘meant to be doing’.

Often, as is the case with many things in life, simple and small are the gestures and moments which are the most meaningful, with huge projects and adventures feeling too overwhelming and out of the grasp of someone with limited energy and resources. As such, the fantasy of what something may have looked and felt like, had they have been well, is a much more satisfying space for them to sit with. Similarly, relationships become much more meaningful, as do the simple things that are taken away through the treatment process, like being able to sit in the sun or go to the pub with a friend.

Young patients can be bombarded with well-intentioned suggestions about what they ‘need’ to do, including making future legacy-based activities, such as leaving cards for each of their younger sibling’s birthdays, video journals of their death, or chronicling how they feel about all the people in their world. Although these are good ideas, they are emotionally and physically difficult to manage with limited resources. Patients need to be feeling very resilient and well before attempting any of these things with most being abandoned due to the confronting nature of conceptualizing the world without them present in it. It is a difficult ask for anyone to be able to take the relatively abstract idea of the world continuing following your own death; this does not change for young people and, in some ways, it is even more challenging due to their pervasive sense of self, even in the face of very real threats to their mortality.

The way that young people respond to being presented with a very limited life expectancy can vary tremendously. Some may stick their head firmly in the sand and refuse to discuss or conceptualize anything about what may happen in the lead-up to their death, or following. Others will organize everything about the end of their lives, including where they want to die, how alert they want to be, as well as what will happen following their death—such as where their belongings go and how they want to be remembered. For most people in this situation, in an existential sense, almost everything is out of control, the disease will do what it does, the pain is what it is, and they are an observer to the things happening in their bodies. The things that people can control is what they talk about, how much they talk about it, and who they talk about it too.

Just because death, dying, and legacy are not being talked about, does not mean that it is not in the consciousness and thoughts of the person pondering their own end. Instead, it may be that they have done as much thinking and talking about it as they need to do; it is often these patients that have very well-considered plans about what they want to happen as they deteriorate and the decisions that must be made about their care.

Complete Article HERE!

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03/14/18

What is the best way to explain death to a child?

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The popularity of bestselling memoirs such as When Breath Becomes Air and The Bright Hour, both meditations on death by authors who died young, suggest that death is a topic many of us like to think about (while alone, reading silently) – yet, it is still a subject many of us are woefully bad at talking about, particularly when it comes to discussing it with kids.

We all need a better “death education,” says Dr. Kathy Kortes-Miller, an associate professor of social work at Ontario’s Lakehead University and author of the new book Talking About Death Won’t Kill You: The Essential Guide to End-of-Life Conversations. Like a new website launched last November by the Canadian Virtual Hospice, the book takes what remains a taboo subject and shows how to talk about it openly and honestly. The Globe and Mail’s Dave McGinn spoke to Kortes-Miller about having that conversation with children.

Why do we have such difficulty talking to children about death?

As parents we are cultured and conditioned to protect our children. Our generation, we didn’t really learn how to talk about it. Before I was a parent, I was really good at talking to children about dying and death. And then I became a parent myself and found that it was a lot harder than I thought it was.

What’s the risk of ignoring the subject, or not bringing it up unless they do?

It keeps it as an unknown and as a scary and almost a taboo topic. We [need to] recognize that this is a transition event in our life and one that we can prepare for and one that we can learn about, and by doing so, that’s going to help us to live life more fully and prepare ourselves for the end of life.

What is the best way to explain death to a child?

It depends on the age of the child, of course. But one of the ways to do it is by looking around at nature. Kids are inquisitive. They’re interested in how things die and what happens to them. So often they’ll see things in nature and ask questions. Those are really good ways to get the conversation started. As they get a little bit older they start to watch TV and they start to read books. There is a lot of dying and death in media that children are exposed to, and those are also really good conversation starters.

You mention that nature often presents an opportunity to talk about death. I’ve been guilty of telling my kids a dead squirrel they saw was just sleeping.

That’s an easy one to do. We’re almost scared to use the D words – dead, dying and death. But we confuse them if we use euphemisms. Having worked with young kids in a counselling role as a social worker in a hospice unit, when we talk about “oh, grandpa’s just gone for the big sleep,” instead of he’s died, kids get nightmares. Kids don’t want to go to bed at night because grandpa went to sleep and he didn’t wake up.

When a child wonders what death is, is there a good description of the physical process that won’t scare kids?

I would sometimes talk about it from a physiological perspective. The reality is that sometimes we get really, really sick or we get old and our body no longer functions the way we need it to, and as a result, some of the things such as our heart or our brain stop working, and as a result, our body dies. It stops working. And that’s kind of the way I would begin that conversation. I would leave it then on the young person to ask some questions, to see what they want to know more about.

You say in the book that bedtime can be a good time for these conversations. Why?

Bedtime can be great depending on the age of your child. Often, there are rituals and time spent at bed reading books and tucking in and doing all that stuff, which is a great time to have conversations. As children get older and we move in to more of what I call the chauffeuring ages, car-time conversations are really good too, particularly because the kids don’t have to make eye contact.

Is there a euphemism for death that you loathe most?

One that’s probably most common is the idea that people “pass away.” I talk about this story of Sam in the book when he got really confused because he was in school and in school they talk about passing to the next grade, and the only person he knew who had passed was his mom. So that one I think particularly for children is a big one.

Kids usually seem capable of processing much more than we give them credit for.

Yes. For sure.

Helping a child or teenager who is grieving the death of a parent or loved one is always difficult. What do you tell them? How do you help them understand matters? The Canadian Virtual Hospice recently launched a website, KidsGrief.ca, to help answer those questions. It is especially important to talk to young kids about the four C’s, says Andrea Warnick, a Toronto-based registered psychotherapist and co-lead on the project.

“The four C’s are four common concerns that kids have when either somebody’s seriously ill, dying or has died in their life. We’re really trying to encourage families to address these even if kids aren’t bringing them up,” she says.

  • Cause: Am I some way responsible? “A lot of parents are really surprised when they find out that their child has been thinking that they did something to cause the illness or death in their family,” Warnick says. She has worked with children who thought their mom got throat cancer from yelling at them to clean their rooms. “We really want families to let their kids know that this is not their fault, they did not cause this in any way,” she says.
  • Catch: “A lot of families will avoid the word of the actual illness. So as opposed to saying, ‘Daddy has cancer,’ or ‘Dad has ALS,’ they’ll say, ‘Daddy’s sick.’ And for kids whose reference for sickness is that it gets spread across the daycare, or one person gets the flu and then the next person does, that scares them and they often think it’s going to happen to them to or they can catch it,” Warnick says. You can still hug your dad, still kiss him. You can still cuddle.
  • Cure: You have to let your kids know they can’t cure it. “This is not in their control,” Warnick says. “A lot of kids will use the power of their imaginations to come up with pacts, promising a higher power that they will never fight with their mom again if they cure them, and then of course they fight. I’ve had a number of kids feeling very responsible that they did something that could have happened otherwise.”
  • Care: This is one of kids’ biggest fears. “If there’s a parent or a primary caregiver who is ill or dying, who is going to take care of me?” Warnick says. Or if the person has already died, is this going to happen to my other parent or whoever it is who is now taking care of them? “A lot of kids are really worried about that. And that’s where we really walk families through how to talk about that. Some families are tempted to say no, it won’t happen to me. And we can’t promise a child that. So we really encourage families to say: Most likely I’m going to live to be very old, but if anything does happen to me, this is who is going to take care of you. Hopefully, guardians are picked out. Let them know what the plan is.”

Complete Article HERE!

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03/12/18

Helping Children Come to Terms With A Death In The Family

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We often try to shelter our children rather than help them address the loss of a parent, grandparent or family friend


One of the biggest mistakes people make is waiting too long to tell a child a loved one is dying.

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When a child is facing the death of a loved one, our first instinct is often to try to shelter them. Unfortunately, following that instinct may do more harm than good.

One of the biggest mistakes people make is waiting too long to tell a child a loved one is dying, says Andrea Warnick, a Guelph, Ont. grief counsellor with more than 20 years’ experience.

Warnick says she understands the reluctance. It is difficult to tell the children — except it is usually worse to say nothing, in part because kids will often use their imaginations to fill in the unknown details, which may be even worse than reality. And they will often blame themselves.

“It’s never too early,” Warnick insists. “You don’t need to wait for absolutes.”

You can simply say that the doctors are concerned that Mom could die, she says, by way of example. Kids need to feel that they can trust the adults in their lives to be honest with them, which is important for resilience.

“It’s better for them to find out from those who are closest to them,” she continues, adding “there’s less anxiety when they know what’s going on.”

And when children have only one parent left, it’s important they know what the plan is if the remaining parent dies.

Warnick cautions against waiting for children to bring the subject up. She says it’s the adults’ responsibility to open the conversation because children will try to protect parents by not bringing it up.

When talking to children, use clear language. “Don’t just say, Mom is sick. Call the illness or condition by its name. Avoid using euphemisms for death and dying. Don’t say we lost Grandpa or that Grandma is in your heart. “Kids can be very literal,” Warnick says.

With teenagers it can be easier to talk when they are in a car or when doing another activity such as going for a hike or doing a puzzle. “It doesn’t need to be a matter of ‘We are going to sit down and talk,’” she explains.

On the other hand, she advises against forcing children to talk. Let children take the lead on how much they want to know, she says. “Encourage them to ask questions and share concerns but let them know they are allowed to say ‘pass’ if they don’t feel like talking.”

Warnick isn’t surprised that many of us don’t know how to support someone, child or adult, who is grieving. She doesn’t mince words. “Ours is a death-denying and grief-illiterate society,” she says.

Her travels have taken her to other countries such as Botswana which have a rich story-telling culture and people freely share stories about their ancestors.

There is a misconception that you get over a death and move on, says Warnick. “We think we’re doing it wrong if it comes up again,” she says. “But this is natural… kids grieve in chunks. They will revisit it as they develop.” Children will also experience joy in between the sad times, and that’s okay too, she says.

Warnick adds that it’s okay for adults to cry in front of the children. This models a healthy grief response.

Another mistaken belief is that death ends a relationship, continues Warnick. “A child whose father has died still has a dad. Don’t try to sever the connection,” she says. Instead, children can be encouraged to participate in rituals or activities that memorialize the person who has died. For example, on the birthday of their loved one who has died, Warnick knows of one family who do “one act for the earth” in his memory because that was important to him.

Warnick attributes her own interest in helping those who are grieving to the death of her aunt when she was young. Warnick’s cousins were just children when their mother died. Once they were adults, they wanted to know more about their mom so they invited family and friends to share their memories on the 20th anniversary of her death. They were comforted by the outpouring that came from friends and family who were glad of the opportunity to remember her.

When an infant dies, people often struggle with how to best support the family. “The significance is often not recognized by society,” says Warnick, who points out that part of the grief is for the “unlived future.”

However, Warnick insists it is still possible to create meaningful rituals to express the grief, although it may require being creative. For instance, you can light a candle in memory of the child and talk about how you wish he or she was still here. “Families can nurture the relationship and hold space for the part that is not physical,” she says.

Grief is messy and involves many emotions including anger, fear, loss of confidence, shame, and guilt. It is non-linear and you don’t get over it in a few months or a year, emphasizes Warnick, who also cautions against praising children for “being strong” for holding in their emotions. This sends the wrong message to children who should feel free to express themselves.

If children cry, adults shouldn’t feel the need to fix it. “You can bear witness to their feelings by listening to them. The goal is not to fix the heartbreak. It’s to learn how to live with a broken heart.”

Strategies for supporting children who are grieving

When you want to talk to a child about a difficult subject, start by creating an appropriate space with minimal disturbances. Get on the same level as the child.

Begin by asking what the child understands. “I’m wondering what you understand about what happened…”

Ask if the child has overheard anything he/she didn’t understand. “I’m wondering if you’ve heard other people talking about any information that’s confusing to you?”

Words are powerful. Use correct terminology. Call the illness or condition by its name. Avoid euphemisms for death.

Don’t praise someone for “being strong.”

Don’t try to sever the connection with the person who died.

Encourage kids to ask questions or share worries.

Answer honestly using simple, concrete language.

Be honest when you don’t have the answer.

Explain that grief is a natural response and not a problem to be solved.

Let kids know it’s okay to feel happy and still enjoy life even when they are grieving.

Signs that more support is needed

Seek out a counsellor if there are signs of:

  • Self-harming behaviour
  • Suicidal thoughts
  • Chronic physical symptoms
  • Panic attacks
  • Sleeping/eating disturbances
  • Risk-taking behaviour

Kid-friendly explanations

“Dead means that a body has stopped working and will never work again. The body cannot move, breathe, think, feel, see, smell, talk…The body does not feel pain or hunger or fear.”

“Suicide is when a person causes her or his body to stop working. The body dies.”

Warnick prefers to say that a person died from suicide rather than committed suicide.

“Cremation is when a dead body is put through very high heat causing it to break down into small pieces that look like sand/dirt.”

Grief is all the different feelings and thoughts that occur when something really difficult happens in life. It can include anger, guilt, shame, loneliness, resentment, sadness, fear, regret, etc.

Address the four Cs

Children will want to know:

Did I Cause it? Can I Catch it? Could I have Cured it? Who is going to take Care of me?

Complete Article HERE!

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02/10/18

What terminally ill children taught this doctor about how to live

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Dr Alastair McAlpine asked some of young patients what gave them joy and meaning – their answers surprised him

Dr Alastair McAlpine asked some of young patients what gave them joy and meaning. Their answers were surprising and positive.

By Alastair McAlpine

As a pediatric palliative care physician, I spend my days working with children who have life-threatening or life-limiting illnesses and their families.

Although many people think of us as the harbingers of death, in reality, doctors like us aim to maximize quality of life, especially when that life is likely to be shortened. We recognize that these children are so much more than just their illness and that they are part of a family. We focus not just on their medical needs but also on their psychosocial and spiritual ones as well.

Last year, as part of my diploma in pediatric palliative care, I was tasked with evaluating the attitudes of my little patients towards life. I asked some of them what gave them joy and meaning. Their answers were surprising and positive.

In fact, they made me completely re-evaluate my relationships with friends and family. I now spend more time with the people I love and I tell them how I feel about them. I have tried to make kindness a priority in my life.

I decided to share some of the children’s responses on Twitter, to provide some perspective to the fractiousness that is so prevalent there. The response was overwhelming, to say the least (my thread has been retweeted nearly 100,000 times).

The kids were not hung up on “stuff”. What mattered were the things that we all intrinsically know are important, but often forget in the hustle and bustle of daily living. The biggest takeaway for me is that the happiest, most meaningful moments were simple ones that did not require vast sums of money or effort to attain, but instead embraced the importance of human connection. It was also surprising how frequently the so-called small things were the ones that turned out to have enormous significance at the end.

Here are the top six lessons that my little patients taught me about life:

1. Spending time with family and pets is incredibly important.

Whether talking, laughing, playing, or just sharing silence, time spent with loved ones and pets was priceless. Towards the end, the only regret many of the kids had was that they didn’t get to spend more time “with mum and dad and my big brother”.

2. Humor and laughter are vital.

Even though they were squarely facing death, these kids derived amusement from the same things that normal children do: silly antics; clumsy adults; slapstick humor. Laughing is so important for many reasons but key among them is that it reduces pain.

Finding levity in the face of overwhelming tragedy can be difficult, and some of the parents dug into unimaginably deep wells of courage to provide mirth when their hearts were breaking. One dad pulled funny faces through his tears. But it always paid off. And whether ill or healthy, children will always be delighted by farting.

3. Good stories told and read by a loved one offer inspiration.

The written word and vivid fantasies told with basic toys enabled children to create alternate realities away from the often sterile hospital environment. They were sources of inspiration to continue fighting, even when the “battle” seemed lost. After all, if Harry Potter could continue to face Voldemort, then they could defeat their own “monsters”.

Stories also allowed the children to construct a meaningful narrative to explain the often incomprehensible diseases they were so bravely facing. Many believe that our ability to create and share stories is what defines us as human beings, and these kids demonstrated that. Stories inspired, captivated and transported them.

4. Swimming in the sea, playing on the sand and eating ice cream (even on a cold day) are simple, memorable pleasures.

Children vividly remembered the simple pleasures that cost little except the effort of being truly present; the moments that may have seemed small at the time were often, upon reflection, priceless.

5. Children as young as four worried about what would happen to their parents.

Many of the kids had made peace with their fates but wanted to protect mum and dad from additional heartache. This role-reversal is surprisingly common and indicates that children are far more attuned to their bodies than we think they are. Death is the elephant in the room. Part of my job is to encourage honesty and to get everyone talking, even when it’s painful.

6. Simple acts of kindness were treasured and remembered until the very end.

Kindness, whether from the classmate who offered a sandwich or a nurse’s smile, was the virtue that made the biggest impact on the children. They loved kind people and remembered acts of kindness until the very end. The last words I heard from one little girl were: “Thank you for holding my hand when I was scared.”

None of these revelations are new or earth-shattering, but when they come from children who are bravely facing death, an extra level of profundity is added, which has prompted many (including myself) to re-evaluate just what is important with the very limited time we have. Now, if you’ll excuse me, I’m off to the beach to eat an ice cream.

Complete Article HERE!

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01/29/18

Morbid? No – Coco is the latest children’s film with a crucial life lesson

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Some say we’re forcing children to face issues beyond their years. But films can help make them resilient, self-aware adults

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At the weekend Disney Pixar’s new film, Coco, hit cinemas. It topped the UK box office and has already won a Golden Globe, so you can probably guess what it’s about. Princesses, right? Or dinosaurs, maybe.

Nope. It’s death: actual send-the-12-year-old-hero-to the-afterlife-to-meet-his-dead-relatives-type death. Set during the Mexican Día de Muertos (Day of the Dead), when people remember their departed loved ones, its core message is that those we lose live on in our memories. Speaking of memory, there’s also a character with senile dementia. Really kid-friendly stuff.

Children’s films have always had life lessons at their heart. And while most of them have traditionally sat in the positive platitudes category – work hard, be brave, do the right thing – there have been some home truths over the years, too: people are cruel (the Dumbo lesson); you’ll outgrow your childhood and its trappings (thanks, Toy Story 2).

But in recent years, as young people’s lives have become more complex and challenging than ever before, kids’ movies have stepped up, tackling increasingly tricky subjects. If there’s something you’re loth to talk to a child about, chances are there’s a film that will do it for you.

Death is one tough subject that has always been common – even if not quite as central as it is in Coco. Disney’s first heroine, Snow White, was an orphan, and they were soon offing loved ones on screen, starting with Bambi’s mum. In fact, a 2014 British Medical Journal study found that, proportionally, main characters die on screen in more children’s animated films than dramatic films for adults.

By 1994, The Lion King’s Simba was experiencing real grief, and in Toy Story 3 (2010) the heroes slid towards seemingly certain death, hand-in-hand, eyes closed, accepting. But they escaped: death was still a plot point. These days it is the plot.

If you’re thinking life can be as painful as death, modern kids’ films have got that covered too. Take the opening sequence of Pixar’s Up (2009). You know, the one that shows you how dead you are inside by how long you can last without blubbing. It charts every punishing blow of adult life from losing a baby to money troubles to repeatedly putting your dreams on hold.

In the last decade, Disney films have also turned their gaze outwards, championing society’s mistreated and marginalised. Disney’s 2013 megahit Frozen was a feminist triumph, with two kick-ass female leads and a finale centred on sisterhood. It also briefly showed what many believe was Disney’s first same-sex couple, complete with cute kids. And it opened a conversation about parental abuse. Not the overt torture of Disney’s early wicked stepmothers, but a more insidious brand that saw Elsa’s parents shame her for being different.

In 2015, Pixar’s Inside Out tackled what is often the very trickiest subject for children to understand – their own feelings. Set inside the head of a young girl struggling with life, it personified her four key emotions, and concluded that it’s actually totally fine to feel sad, something any child struggling with depression will find deeply reassuring.

And if that wasn’t grown-up enough, 2016 saw Disney release Zootropolis, an anthropomorphic comedy with a hard-hitting message about racial inclusion – highly subversive given the xenophobic political rhetoric that was rife at the time.

Some may say we’re forcing kids to face issues that are beyond their years – that we should go back to the old days where, aside from the odd bereavement, most troubles were solved with a little courage and a singsong. But times have changed, and the way children experience life has changed, too. There are new pressures, new fears, new opportunities, and the chance to mix with people whose identities and choices are, thankfully, being newly embraced by society.

Films are the perfect way for children to understand all this – not only via storylines that they can relate to but in a safe space where they can ask questions freely.

What’s more, the common reference point that films provide means that answering those questions becomes easier for parents, and a more open and honest conversation can develop. Lets face it, most kids won’t even bat an eyelid at the stuff adults worry will shock or confuse them. Kids accept the society we present to them, meaning films that normalise any and every expression of what it means to be human are a key tool in moving us towards a more inclusive society.

But perhaps most importantly of all, films can help kids cope better when life’s struggles hit them for real. They’ve already experienced some of the associated emotions vicariously. They’ve seen how the characters handle the situation. Perhaps they’ve even thought about what they’d do in the same position. If modern kids’ films can help the next generation grow into resilient, self-aware, inclusive adults, I say: keep them coming.

Complete Article HERE!

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