01/10/18

In a new book for kids, the son of Grim Reaper offers lessons about death and dying

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Portland writer and illustrator Winslow Furber wrote the book to help parents and kids talk about mortality.

Winslow Furber wrote and illustrated “A Very Young Reaper,” about Tim Reaper, far right, the son of the Grim Reaper, to help families talk about death and dying.

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As a parent, Winslow Furber wanted a better way to talk to his kids about death. As a creative person, he was seeking an outlet for his ideas.

The result of both yearnings is Furber’s first children’s book, “A Very Young Reaper,” which tells the tale of young Tim Reaper, the son of Kim and Grim Reaper. Everything Tim touches dies, leaving him sad and alone because no one wants to meet the son of the Grim Reaper. Until one day, when he meets a very old porcupine who teaches the boy that what makes him different than everyone else is also what makes him special.

Furber wrote and illustrated the book, issued by an Indiana-based on-demand publishing house, to help families talk about death and dying with kids, as well as the concept of death with dignity. The book also speaks to the idea of adapting your world and lifestyle to accommodate people who are different and who possess peculiar, other abilities.

Furber, who lives in Portland and works as a building contractor, has been thinking about death with dignity and related issues since college, when his roommate’s mother suffered a difficult, painful death from cancer. “I’ve had some experience with the death of pets and having to have that conversation with my own two children,” he said. “I just thought it would be nice to have something that works around the whole death-with-dignity theme. I started thinking about a very young reaper – the son of Grim Reaper – and how he would grow up, overcome obstacles and come to grips with his own unique circumstances. How does he adapt to the fact that everything he touches dies?”

“A Very Young Reaper.” By Winslow Furber.
AuthorHouse. $16.99.

Furber is sharing proceeds of book sales with the Center for Grieving Children, the Animal Refuge League and the Death with Dignity National Center.

Furber, 54, has always had artistic instincts, but spent most of his professional life working for others. He was a financial planner for many years – “the worst mistake I could have made” – and worked as director of development and maintenance for SailMaine, which supports community sailing programs in the state. He’s an avid sailor and loves spreading his family’s love of sailing with other families.

A few years ago, he went off on his own as a contractor, enabling him to work for himself and balance his many interests. He went to Middlebury College, where he majored in sculpture and also studied math and physics. He also makes jewelry, and ultimately would like to make art all the time. “I’d like to stop swinging a hammer and tell more stories,” he said.

The book is a step in that direction. He attended a children’s book conference in New York last February and began writing the book soon after. He pitched “A Very Young Reaper” to several publishers and ultimately decided to go the self-publishing route because he didn’t want to wait for a publisher to come around to his idea.

“I sent it out to six or eight publishers, and got one to talk to me. The publisher said, ‘It’s a beautiful story, but you are going to find it very difficult to find a publisher willing to take a flier on it,’” he said. “I felt it was important to get it out. I would have loved to have had something when my kids were little, when the bunny died. That’s what Tim does. He helps people who are old or sick.”

Complete Article HERE!

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01/3/18

‘There will be an afterwards’: how a mother prepared her sons for her death

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When Kate Gross was dying, aged 36, she told her sons there would be life after her death. But how would they actually cope with losing her?

‘Afterwards, you will need to …’ Kate Gross with her twin sons Isaac, left, and Oscar

By Jean Gross
When my grandson Isaac was very small, his mother, Kate, would say, “I’ll miss you” when she travelled away for work. Later, when he was three, I remember him running after her in the park when he couldn’t quite keep up with her, crying: “Don’t miss me, Mummy.” To him, “to miss” meant “to leave”. “Don’t miss me, Mummy”, meant don’t leave me.

But, in the end, Kate did have to leave him, and his twin brother, Oscar. When the boys were five and she was 36, she died. It was Christmas Day 2014, minutes before the boys woke up to ask their dad, Billy, if it was time to open their stockings.

In the months before Christmas, once Kate had been told her cancer was terminal, she came up with a way in which we could all talk about a future without her. She called it Afterwards. “Afterwards,” she would say “you will need to …”, “Afterwards, Billy will …” Now, with some distance between us and that worst of Christmases, I want to write about Oscar and Isaac’s Afterwards – how they have managed, and whether Kate’s fears for them, or her best hopes, have come true.

It is a positive story. The boys are now sturdy, happy eight-year-olds. We have learned, with surprise and relief, how resilient they are, and how easily they have taken to the fact that their mum is not here – and yet is still here, in the fabric of her house, in the memories, in the ways in which we constantly tell them they resemble her.

Initially, the boys each reacted very differently to their loss. Oscar is stoic and factual by nature, with a passion for numbers. When we told the boys their mum was going to die, he asked how old people were when they got cancer. Billy said it was usually when you were old; their mum was unlucky.

“How old is Mum?” asked Oscar.

“Thirty-six,” said Billy.

Then, “And how old are you, Dad?”

Oscar was working it all out, with numbers as his guide, and Billy knew to tell him that he wasn’t likely to get cancer, too.

Of the two boys, Isaac has always been a little more worried about love and loss, always at a different point on the objects-facts v people-feelings scale. After Kate died, he initially had more hurt places than Oscar – manifest in tummyaches at school and a wish to stay in and “help” his kind teacher, or occasional oblique insights into sadness. I remember being in the car taking the boys to change from school clothes into smart new jumpers and shirts for Kate’s funeral. I told them that some people might cry at the funeral. “Why?” asked Isaac. It’s just something grownups do, I said. “Why?” persisted Isaac. I said they would be sad because they missed Mummy. There was a pause, then Isaac said: “I had a dream.” I asked what his dream was about. “I was on a train and Dad wasn’t and the train went off without him.”

But apart from these brief moments, there has been little sign of grief or worry. Oscar likes to tell me his bad news, like a cat bringing a mouse it has caught and tenderly laying it on your pillow. Once told, it becomes less important. But the bad news has never been about Kate, only grazed knees, fluffing a save in football, missing his computer time at school. Her death did, however, offend his sense of justice. “It’s not fair,” he said when we first told him she would die soon. “The other children in my class will have mummies.”

Kate and her mother, Jean Gross, with Isaac, left, and Oscar

Grieving, I think, asks that you live in the remembered past or a denuded future. Oscar and Isaac still pretty much live in the present. Nor have they a great capacity for introspection. Once I told them they had been unlucky to lose their mum. “Why?” asked Isaac. They didn’t understand; they were unable to examine their experiences, as distinct from simply living them.

There is little point in expecting young children to be sentimental. The summer after Kate died, we were on holiday in France, visiting a church; the boys saw candles and asked if they could light some. For Mummy, we said, and thought of her. But for them what mattered were the immediate sensory experiences – the physical act of striking a match, and the satisfying clunk as the offering money fell to the bottom of the collection box. Things don’t stand for things when you are small. They simply are.

I have often wondered why is it that some children cope with adversity, while others falter and fall. Research tells us that resilience is linked to social support – a sense of belonging to a community, and having at least one adult in your life who believes in you as a worthwhile person. And they have social supports in abundance – Billy, their dad, of course, and all the family and Kate and Billy’s friends. Just as important has been the boys’ own social circle. The children at their small, loving, Catholic school, and their parents, have closed around Oscar and Isaac and created a force field that keeps the Dark Side well away.

Science has been helpful to the boys, too; their dad is, after all, a scientist. They wanted, and got, proper explanations about cancer cells and death. A few months after Kate died, we heard them chatting in bed: “Everything dies eventually,” said Oscar.

“No one lives to infinity,” said Isaac.

Religion, doled out at school, has given the boys a language in which to talk about their loss. People often told them that their mum was in heaven, and they accepted this. In one bathtime discussion, Oscar told me: “There must be heaven.”

“Why?” I asked.

“Because if there wasn’t, where would God live?” he said triumphantly.

Even so, you have to be careful. One of Kate’s friends, whose wife died when his three girls were small, told us that one of them had said she wanted to be run over by a bus, “so I can go to heaven and be with Mummy”. As for, “God took your mummy because he wanted her to be with him in heaven,” I can’t think of anything more likely to make a child seriously annoyed with such a selfish higher power.

Angels are safer territory. At a birthday party, when the children were colouring in angels, Isaac said: “My mum’s an angel.” Oscar agreed: “Yes, she is.” But the angel for the top of the Christmas tree got broken last year and this year we had to get a star instead. I wondered if the boys were confused, what with these broken and unbroken angels. How do children make sense of all this? And how do they reconcile science and belief?

Becoming older and growing in understanding, the boys have talked recently with their dad about this. “It’s belief until it’s proved and then it’s science,” the boys told me.

“So what about angels,” I asked.

“They must be belief ’cos you can’t see them flying round, can you,” Isaac replied.

It is hard to know exactly what the boys do remember about Kate. We try to help by talking about her, whenever we can. Many people have told us how important it is to keep the person who has died in the conversation. A kind stranger, for example, wrote to us: “Both my parents died of cancer. I’m sorry for your loss. PLEASE tell stories about your Kate to your lovely grandsons. We stopped talking about our mother when she died – it was a black space that became hard to fill.”

Sometimes, I hold Kate up as an example for the boys to live up to. When they were complaining about having to keep going back over pieces of writing at school, to “improve” them, I told them that when their mum was writing a book, she had an editor who suggested changes to words and things to move around. I told them how hard she worked to make those changes. “And did she have a rubber?” asked Isaac, concerned.

We had a letter from a woman who lost her own mother as a child. She wrote: “My middle sister and myself had funny little memories of my mum and it truly wasn’t until I had my first child that I recall missing her.” Perhaps that will happen to Oscar and Isaac; I expect they will circle round the idea of Kate’s death and come to it at unexpected moments in unexpected ways. Maybe some later loss will take them back to how it felt in childhood. Or maybe, in a few years, the loss of a mother will simply give them a convenient hook on which to hang their inevitable non-specific teenage angst.

I hope they will be OK, long-term. But right now it is clear to me that they are not diminished by Kate’s absence, unlike us – my husband and I – who are. And if Kate could come back, just for a moment, I would tell her that she need not have been afraid. Oscar and Isaac are fine, just fine.

Complete Article HERE!

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11/7/17

How to Help Your Kids Cope With the Loss of the Family Pet

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Pets are part of the family, so it makes sense that losing one is tough on everyone, including our children. A pet’s death may be the first time they’ve ever experienced a real loss, and as a parent, it can be difficult to know how to start a conversation about life, death, and grieving in a way they can understand, but that won’t heighten their sadness.

Last week, we put our 12-year-old dog to sleep five weeks after he was diagnosed with lymphoma. It was a brief but rapidly debilitating illness, and I wondered if my kids would understand that a dog who was quite healthy only two months ago was now gone. Surprisingly, they took it much better than I did. My 3-year-old gave me a hug, then told me, “I don’t know why you’re crying, Mom. Gus was sick, and now he’s in heaven with grandma’s dog. He’s not sad he died. He’s still happy.”

After briefly wondering if my child was a pet psychic, I realized that his logic was pretty sound. While my son would miss our dog, he knew our pup had been suffering, and he was prepared for the death. He had processed the loss faster and more easily than I did precisely because he was a kid. If you’re dealing with the loss of a family pet, here’s how to help your children process their feelings.

  1. Make sure your child understands what death means. Gently make sure that your child understands that their pet’s death means the animal will never be physically present again. Don’t be alarmed if it takes awhile — even years depending on their age — for your child to understand that means that your pet can no longer breathe, feel, or ever be alive again. If the death was sudden or unexpected, explaining why or how your pet died might be important to help your child understand the permanence of the loss. Of course, consider your child’s age and ability to understand and only give them developmentally appropriate information.
  2. Be honest. Telling your child about the death openly and truthfully lets your child know that it’s not bad to talk about death or sad feelings, an important lesson as they will have to process many other losses throughout their lives.
  3. Follow your child’s lead. Sometimes children are better than adults at accepting loss, especially when they’ve known for some time that their pet had a limited life span or was ill. Don’t attempt to make your child’s grief mirror your own, but do validate any emotions that come up as your child goes through the mourning process, and be ready to talk when they have questions. Age-appropriate books like Sally Goes to Heaven and I’ll Always Love You can also help with communication.
  4. Don’t be surprised if your child grieves in doses. Children often spend a little time grieving, then return to playing or another distraction. This normal, necessary behavior prevents them from becoming overwhelmed and makes the early days of grief more bearable for them.
  5. Say a formal goodbye. Consider having a small memorial service where you can all say goodbye, discuss favorite memories, and thank your pet for being part of the family, even if the service is just in your backyard or around the kitchen table.
  6. Find a way to memorialize your pet appropriately. We often don’t realize how constant our pets were in our lives until they’re gone. By making a photo album, turning a collar into a Christmas ornament, or commissioning personalized art work through Etsy, your whole family will have a positive remembrance of your beloved pet for a lifetime.

Complete Article HERE!

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10/22/17

Disney and Pixar films present opportunities for parents to discuss end-of-life with children

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By Bert Gambini

Bambi’s mother, Mufasa from “The Lion King” and Elsa’s and Anna’s parents in “Frozen” represent some of the characters who die in Disney and Pixar animated films, and these potentially shocking moments for young audiences provide critical opportunities for adults to discuss end-of-life issues with children, according to a new study by a University at Buffalo researcher who specializes in end-of-life communication.

“These films can be used as conversation starters for difficult and what are oftentimes taboo topics like death and dying,” says Kelly Tenzek, a clinical assistant professor in UB’s Department of Communication. “These are important conversations to have with children, but waiting until the end of life is way too late and can lead to a poor end-of-life experience.”

Starting the end-of-life conversation with children early allows the dialogue to continue and develop throughout their lives, and the deaths in these film can actually help children relate to and understand death in ways that otherwise might be very challenging for them.

“We believe that Disney and Pixar films are popular and accessible for children and adults so that a difficult conversation can begin in a less threatening way earlier in life,” says Tenzek.

Tenzek and co-author Bonnie Nickels, a visiting lecturer at the Rochester Institute of Technology, analyzed 57 Disney and Pixar movies in which 71 character deaths occurred.  Four themes emerged from their analysis, each of which can serve as a platform for adults to discuss end-of-life issues with children.

The results of their research appear in Omega-Journal of Death and Dying.

Tenzek says the current study uses categories from research conducted in 2005 on end-of-life depictions in 10 Disney and Pixar films. That earlier research distinguished character’s status, such as antagonist or protagonist (Tenzek and Nickels added side characters to this category); cause of death; whether the death was presented on film or implied; the reactions of other characters; and if the death, within the context of the film’s plot, was permanent or a reversible, fantasy occurrence.

With that template and their expanded list of 57 films, the new analysis yielded four general opportunities, or themes, on which to base an end-of-life discussion:

“First, some of the portrayals of death are unrealistic, such as when the character returns or returns in an altered form,” says Tenzek. “But this is a chance for a child to better understand the difference between fiction and real life.”

Tenzek says managing the end of life, or the emotional response to death, could be helpful for children and adults.

“How the characters portray their responses to dying can help children understand the nature of expressing emotion,” she says. “‘Big Hero 6’ (2014) and ‘Inside Out’ (2015) specifically address emotional responses to death and dying which were not present in earlier films.”

The third and fourth themes dealing with intentions to kill and transformation and spiritual connection, with its moral sub-theme, are more complex. Religious and spiritual content are not always overly present in Disney and Pixar films, however, Tenzek says, the films can still serves as opportunities to discuss religious beliefs and end of life.

“We acknowledge that a child’s psychological development is important when considering these discussions,” says Tenzek. “It’s not our intent to have these conversations with a 3-year-old, but as children mature, then the films fit naturally into that growth.”

Many of the possible benefits arising from these films extends from parents’ power to engage children, according to Tenzek. The films can be a tool to help explain the difficult end-of-life process to children and help them make connections that lead to better understanding.

“I teach end-of-life communication,” says Tenzek. “My goal is to educate and help people become more comfortable with the end of life.

“One way to do that is through these films,” she says.

Complete Article HERE!

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10/19/17

How to help your kids say goodbye to a beloved pet

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Tips on how to guide little hearts through their grief to help them deal with their loss and recover from it

By Jennifer Walker

Saying goodbye to a pet is an inevitable experience many families will experience.

And telling the truth to children and allowing them to grieve is crucial in helping them deal with their loss, as well as recover from it.

“I think it is important to tell children the truth but depending on their age and developmental level, the information you communicate will differ,” said Kyle Newstadt, individual and family therapist and director of Integrate Health Services. “Regardless, they should know the truth and if you know the pet is sick or death is on the horizon, it is important to communicate that with children.”

According to Ms. Newstadt, books can be helpful to introduce the topic to a child with the family without any other distractions. She said parents could explain to their children that the animal has been to the doctor for medicine and that they’re waiting to see if it helps the situation.

“Don’t hide the truth and say the animal is sleeping or he ran away; it’s abstract and kids wont understand that,” said Ms. Newstadt. “Stick to the truth and avoid unknown language, explain death but leave it up to the child and what they’re asking — children can surprise us.”

A toddler is unlikely to understand death but those words should be used, she added.

“Parents could explain that medicine was given to dog and it will help him close his eyes and he will die peacefully,” said Ms. Newstadt. “Wait for them to ask “what does death mean?’ and, depending on religious beliefs, that would be a good time to talk about that.”

According to the local therapist, it is important to allow your child to express their feelings and deal with grief. A pet memorial would be a crucial part of the process for a child and the entire family, she said.

“Ask the child and give them choices in ways they would want to memorialize their pet and maybe each child can think of something they want to do; a burial outside, pictures in places around the house, creating a scrapbook, or a special ceremony to talk about the memories they had with their pet is important and helps them deal with grief,” she said. “This will open lines of communication which is so important when a child suffers from the death of a pet.”

According to Durham Region registered vet technician Sarah Macdonald, it is required of veterinarian clinics to dispose of a pet’s body once it passes away. A large majority of clinics also offer cremation, she said.

According to Ms. Macdonald and Ontario.ca, homeowners are permitted to bury their pets on their own property. For those living in an apartment, Ms. Macdonald recommends cremation.

The ashes can be kept in a special urn inside the pet owner’s home or be scattered in a special location for a ceremony or as part of a memorial, she said.

For those looking for more ways to memorialize their pets with keepsakes, funerals, cremation ceremonies, and more, Ms. Macdonald recommends Gateway Pet Memorial, specializing in pet aftercare throughout North America.

Parents should be focusing on positive coping strategies by modelling self-expression, letting the child know that it is OK and normal to have these feelings of sadness and that it is important to express, said Ms. Newstadt.

“Children experience grief in different ways from adults; there is no right or wrong way,” she added. “They may appear to be coping well and weeks later experience sadness. Meet the child where they’re at.”

According to Ms. Newstadt, parents shouldn’t approach the conversation until the child is expressing sadness.

“It’s OK if the child isn’t demonstrating that they’re sad, there is no right or wrong way to experience grief,” she said. “It is typical for a child to ask questions or to say they’re feeling sad and then engage in play, it’s a developmentally appropriate way of grieving.”

Complete Article HERE!

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10/8/17

Many kids dying of cancer get intense care at end of life

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By Lisa Rapaport

Nearly two-thirds of children and teens with terminal cancer receive intense care at the end of life, often in hospitals and intensive care units, a U.S. study suggests.

Certain patients, including kids under age 5 and teens aged 15 to 21 as well as ethnic minorities and patients with blood malignancies were more likely to receive aggressive care than other children, the study also found.

“The rates of medically intense end-of-life care we found in our study and the disparities we found raise the question: Are we providing a palliative approach to end-of-life care for these patients?” said lead study author Dr. Emily Johnston of Stanford University School of Medicine in California.

“I hope this study makes pediatric oncologists and others taking care of these patients reflect on the end-of-life discussions they are having, particularly with these high-intensity groups,” Johnston said by email. “I also hope it lets families experiencing the loss of a child due to cancer know that there are different ways for that death to happen, so they can think about and advocate for what is best for their child and their family.”

Many adult patients with cancer who know they are dying choose less intense care, and aggressive treatment is associated with worse outcomes for families and caregivers, Johnston and colleagues write in Pediatrics. But less is known about treatment choices for children, Johnston told Reuters Health.

For the current study, researchers examined data on 3,732 patients age 21 years or younger who died of cancer in California from 2000 to 2011.

Researchers examined the intensity of medical interventions at the end of life by looking at how often patients had cardiopulmonary resuscitation (CPR), intubation, intensive care unit (ICU) admissions or dialysis within 30 days of death. Researchers also looked at how often patients had intravenous chemotherapy within 14 days of death and how many patients died inside hospitals.

Overall, 63 percent of patients died inside hospitals and 20 percent were admitted to ICUs.

Children were more likely to receive aggressive interventions at the end of life when they lived closer to a hospital, or when they received care at a hospital that wasn’t a specialized cancer center, the study found.

One limitation of the study is that the results also may not reflect what would happen outside California, or represent more recent trends in end-of-life care, the authors point out. Researchers also lacked data on how patient and family preferences or other factors might have influenced care decisions.

“We do not know a lot about how the end-of-life experience of children impacts on family bereavement outcomes,” said Dr. Joanne Wolfe, co-author of an accompanying editorial and director of pediatric palliative care at Boston Children’s Hospital.

“Some earlier studies have shown that the child’s experience of pain impacts bereaved parents’ long-term outcomes including anxiety and depression,” Wolfe said by email.

Communication is also key, said Dr. Kim Beernaert of Ghent University and Vrije Universiteit Brussel in Brussels, Belgium.

“We know that communication and information about decision making, treatment options, prognosis etc. is very important for how bereaved parents cope afterwards,” Beernaert, who wasn’t involved in the study, said by email.

With the right information and support for parents and families, many children who die in a hospital might be able to die at home instead, said Dr. Amos Bailey of the UCHealth Palliative Care Clinic at the Anschutz Cancer Pavilion in Aurora, Colorado.

“However, it is physically and emotionally challenging to care for a loved one in the home through death, and parents and children may feel more comfortable and safe in a hospital where it is likely they have been admitted before and come to trust and depend on staff,” Bailey, who wasn’t involved in the study, said by email.

“It will be important to understand if more parents or children would want to die at home or out of a hospital if they were supported,” Bailey added.

Complete Article HERE!

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09/2/17

Why teens need to understand care plans for dying parents

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By Lisa Rapaport

When children lose a parent during adolescence, their mental health as young adults may depend on how comfortable they were with the treatment and support provided at the end of their parents’ lives, a recent study suggests.

To understand the lasting psychological impact of the death of a parent during adolescence, researchers surveyed young adults who had lost a parent to cancer six to nine years earlier, when they were 13 to 16 years old.

Overall, 105 of the 593 young adults (18%) said they had little or no trust in the care provided during the final week of the parent’s life.

Compared to the participants who were satisfied with the final week of care, those who were unhappy were more than twice as likely to suffer from mental health issues like depression, anxiety and eating disorders, researchers report in the Journal of Clinical Oncology, online August 8.

“We already knew that children who have lost a parent are at risk for long-term psychological challenges including depression, risk of suicide, and risk of self-injury,” said Dr. Jennifer Mack, a researcher at Harvard Medical School and Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

“However, a link to trust in the medical providers of the parent was not previously understood,” Mack, who wasn’t involved in the study, said by email. “This is important because it offers a potential path forward to greater resilience and healing after a parent’s death for young people who experience this type of profound loss.”

The current study focuses not on how teens felt when their parent was dying, or immediately afterwards, noted lead study author Kim Beernaert of the End-of-Life Research Group at Vrije University Brussels and Ghent University.

Instead, it looks at how they feel after several years have passed, Beernaert said by email.

Young people who had little or no trust in the care parents received at the end of life were at least twice as likely to report still feeling bitter toward health providers for failing to make the correct initial diagnosis, stopping or never starting treatment, or not doing everything possible for the parent, the study found.

The mistrustful young adults were also more likely to still want more information about the parent’s disease, treatment decisions, and death.

The study wasn’t a controlled experiment designed to prove whether or how teens’ experiences during a dying parents’ final days influence mental health later in life.

Another limitation is the potential for factors not examined in the study to impact mental health for these young adults, as well as the potential for teens with psychological problems to be less trustful of medical providers than adolescents without mental health issues, the researchers note.

Still, the results highlight the importance of providing age-appropriate support and grief counseling to children and teens during a parents’ final weeks or months of life, said Dr. Amos Bailey, a palliative care researcher at University of Colorado Medicine in Aurora.

Resources tailored to young people are often lacking outside pediatric hospitals, Bailey, who wasn’t involved in the study, said by email.

“What is at stake for bereaved families is the potential for lifelong mental health problems that are probably more socially significant for a teenager (who) will live with this grief for 60 or more years as opposed to a widow who may outlive her husband by 3-5 years,” Bailey said.

Complete Article HERE!

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