This is how Claire is preparing her family (and herself) for her death

Claire Romeijn was 29 when her doctor gave her life-altering news.

Claire says she didn’t want to overload her daughters with ‘disastrous news’ when she found out she was terminally ill.

By Tahnee Jash

She had been experiencing severe abdominal pain three weeks after having a baby, but it wasn’t until her daughter was eight months old that she decided to find out what was wrong.

“When I finally had a colonoscopy and endoscopy, they couldn’t get the cameras through because the tumour was so large,” Claire says.

“It was a big shock to everybody.”

Following a diagnosis of bowel cancer, she underwent surgery and chemotherapy and for a period was cancer free — until she was back to see the doctor again.

“I got the second diagnosis that it was back, and I was now stage four,” Claire, who is now 33, says.

Without a cure and the cancer spreading to other organs in her body, Claire is now going through her last chemotherapy treatment available.

She spoke to ABC podcast Ladies, We Need to Talk about how she’s coping.

Talking about death with your children

As Claire was still processing the news, she knew she had to figure out how to tell her five daughters — in particular her eldest, who was 10.

She says she didn’t want to overload anyone with “disastrous devastating news” around being terminally ill.

So, the Sunday after receiving her diagnosis, Claire made fresh pancakes and told her children gently over breakfast that she was starting chemotherapy again.

“I said, ‘Mummy’s going to have to do chemo again’.

“My oldest was at the end of the table and she was very, very quiet, just processing it. [Then] she says, ‘Does that mean your cancer’s back?’ And I said, ‘Yes’.”

Claire says it’s been especially hard for her children and partner to process her diagnosis.

“[My eight-year-old] was crying [one] night and I said, ‘What’s wrong? And she said, ‘I don’t want a new mummy’,” Claire says.

“I said, ‘I will always be your mummy, that’s never going to change’.”

Clinical psychologist and director of the Death Literacy Institute, Kerrie Noonan, has spent her career helping people feel more comfortable talking about death.

She says it can be hard to explain it to children, especially when they’re young, but her advice is to talk openly.

“For young children, grasping death as a permanent thing is an important part of their grief,” Dr Noonan says.

Religion or spirituality can be a source of comfort when it comes to grief but helping children grasp the physical process is just as important.

“Often our inclination is to say to kids, ‘When I die, I’m going to heaven’,” Dr Noonan says.

“It’s not concrete enough for a young child to kind of understand.”

“So, [instead you might say], ‘When I die, my body stops working, I won’t have any pain anymore and my body will be buried’,” she says.

Claire’s still trying to work out the best way — and time — to tell her kids she’s terminally ill and says it’s been an overwhelming experience preparing her family for her death.

One thing that is helping her is creating special keepsakes for her daughters to cherish.

“My big girls will remember, I know they will but the five, three and one-year-old is a different story of what memories they’ll hold on to,” she says.

“I want to write a letter to them all individually, about how much I love them [and] funny little things their dad might not remember.

“I want to write a list of ‘Mummy’s advice’, for when they are older, but I’ll definitely be putting the aunties on the ‘period talk’ because I don’t trust their father,” she says, laughing.

Talking about death with your partner

Claire also worries about her husband and how he’s coping with all the changes.

“He’s not someone to dwell on the negative, so it’s really hard to get him to open up,” she says.

“We’ve had moments where we will grieve together, [but] he doesn’t talk about it, not even with mates.”

Avoiding discussion is a common way some people cope, but Dr Noonan says the best way through it is trying to being open with each other.

“I guess the first thing is to acknowledge just how bloody hard it is,” Dr Noonan says.

“[We think] ‘Oh she’s got enough to worry about, I can’t talk to her about how scared I am about the future, so I’ll just suck it up and keep going and same [goes] the other way’.

“Everyone’s protecting everyone, but no one’s actually talking and that can be one of the biggest barriers.”

After going through intensive treatments like chemotherapy, intimacy is often the last thing on a couple’s mind, but Dr Noonan says it could provide the comfort and sense of relief that the relationship is longing for.

“People may not want to feel like having sex as such, but they may really still have that great need to touch, connect and have comfort from that touching and connecting,” she says.

Claire and her husband find it hard to talk about the future, but something that’s helping them is focusing on the present.

“We focus on making memories,” she says.

“My husband gets through it by planning extravagant trips in his mind … he bought his own calendar to write down where we’re going and put [down] every country.

“[He] is super optimistic and it really kind of keeps me together,” she says.

‘I allow myself to be sad, but I don’t let it overcome me’

Claire’s been given a life expectancy date by her doctor, and she says there are days where she feels anxious about it.

“My oncologist ended my appointment with a ‘you better make holidays this year’ and that’s a real downer but it’s also a reality,” she says.

To help ease some of the anxiety, she takes antidepressants, but it’s her family who help her through those difficult days.

“I allow myself to be sad, but I don’t let it overcome me,” she says.

“I’ve got ive girls who need me, and they are the ones who make me get out of bed and try to keep [life] as normal as possible.”

Complete Article HERE!

Shift in Child Hospice Care Is a Lifeline for Parents Seeking a Measure of Comfort and Hope


Hospice nurse Raul Diaz checks Aaron Martinez’s vital signs. Despite his mom’s seemingly healthy pregnancy, Aaron was born with most of his brain cells dead, the result of two strokes and a massive bleed that occurred in utero.

By Bernard J. Wolfson

When you first meet 17-month-old Aaron Martinez, it’s not obvious that something is catastrophically wrong.

What you see is a beautiful little boy with smooth, lustrous skin, an abundance of glossy brown hair, and a disarming smile. What you hear are coos and cries that don’t immediately signal anything is horribly awry.

But his parents, Adriana Pinedo and Hector Martinez, know the truth painfully well.

Although Adriana’s doctors and midwife had described the pregnancy as “perfect” for all nine months, Aaron was born with most of his brain cells dead, the result of two strokes and a massive bleed he sustained while in utero.

Doctors aren’t sure what caused the anomalies that left Aaron with virtually no cognitive function or physical mobility. His voluminous hair hides a head whose circumference is too small for his age. He has epilepsy that triggers multiple seizures each day, and his smile is not always what it seems. “It could be a smile; it could be a seizure,” his mother said.

Shortly after Aaron was born, doctors told Adriana, 34, and Hector, 35, there was no hope and they should “let nature take its course.” They would learn months later that the doctors had not expected the boy to live more than five days. It was on Day 5 that his parents put him in home hospice care, an arrangement that has continued into his second year of life.

The family gets weekly visits from hospice nurses, therapists, social workers, and a chaplain in the cramped one-bedroom apartment they rent from the people who live in the main house on the same lot on a quiet residential street in this Inland Empire city.

A photo shows two nurses attending to 17-month-old Aaron Martinez while his mother, Adriana Pinedo, holds him.
Adriana Pinedo holds her son, Aaron Martinez, during a visit with hospice nurses Raul Diaz (left) and Shannon Stiles. Pinedo describes the weekly hospice visits from nurses, therapists, social workers, and a chaplain as “our lifeline.”

One of the main criteria for hospice care, established by Medicare largely for seniors but also applied to children, is a diagnosis of six months or less to live. Yet over the course of 17 months, Aaron’s medical team has repeatedly recertified his hospice eligibility.

Under a provision of the 2010 Affordable Care Act, children enrolled in Medicaid or the Children’s Health Insurance Program are allowed, unlike adults, to be in hospice while continuing to receive curative or life-extending care. Commercial insurers are not required to cover this “concurrent care,” but many now do.

More than a decade since its inception, concurrent care is widely credited with improving the quality of life for many terminally ill children, easing stress on the family and, in some cases, sustaining hope for a cure. But the arrangement can contribute to a painful dilemma for parents like Adriana and Hector, who are torn between their fierce commitment to their son and the futility of knowing that his condition leaves him with no future worth hoping for.

“We could lose a life, but if he continues to live this way, we’ll lose three,” said Adriana. “There’s no quality of life for him or for us.”

Aaron’s doctors now say he could conceivably live for years. His body hasn’t stopped growing since he was born. He’s in the 96th percentile for height for his age, and his weight is about average.

His parents have talked about “graduating” him from hospice. But he is never stable for long, and they welcome the visits from their hospice team. The seizures, sometimes 30 a day, are a persistent assault on his brain and, as he grows, the medications intended to control them must be changed or the doses recalibrated. He is at continual risk of gastrointestinal problems and potentially deadly fluid buildup in his lungs.

Adriana, who works from home for a nonprofit public health organization, spends much of her time with Aaron, while Hector works as a landscaper. She has chosen to live in the moment, she said, because otherwise her mind wanders to a future in which either “he could die — or he won’t, and I’ll end up changing the diapers of a 40-year-old man.” Either of those, she said, “are going to suck.”

While cancer is one of the major illnesses afflicting children in hospice, many others, like Aaron, have rare congenital defects, severe neurological impairments, or uncommon metabolic deficiencies. 

“We have diseases that families tell us are one of 10 cases in the world,” said Dr. Glen Komatsu, medical director of Torrance-based TrinityKids Care, which provides home hospice services to Aaron and more than 70 other kids in Los Angeles and Orange counties.

A photo shows Aaron Martinez sleeping in a crib.
Aaron Martinez sleeps in the bedroom he shares with his mother and father in Pomona, California.

In the years leading up to the ACA’s implementation, pediatric health advocates lobbied hard for the concurrent care provision. Without the possibility of life-extending care or hope for a cure, many parents refused to put their terminally ill kids in hospice, thinking it was tantamount to giving up on them. That meant the whole family missed out on the support hospice can provide, not just pain relief and comfort for the dying child, but emotional and spiritual care for parents and siblings under extreme duress.

TrinityKids Care, run by the large national Catholic health system Providence, doesn’t just send nurses, social workers, and chaplains into homes. For patients able to participate, and their siblings, it also offers art and science projects, exercise classes, movies, and music. During the pandemic, these activities have been conducted via Zoom, and volunteers deliver needed supplies to the children’s homes.

The ability to get treatments that prolong their lives is a major reason children in concurrent care are more likely than adults to outlive the six-months-to-live diagnosis required for hospice.

“Concurrent care, by its very intention, very clearly is going to extend their lives, and by extending their lives they’re no longer going to be hospice-eligible if you use the six-month life expectancy criteria,” said Dr. David Steinhorn, a pediatric intensive care physician in Virginia, who has helped develop numerous children’s hospice programs across the U.S.

Another factor is that kids, even sick ones, are simply more robust than many older people.

“Sick kids are often otherwise healthy, except for one organ,” said Dr. Debra Lotstein, chief of the division of comfort and palliative care at Children’s Hospital Los Angeles. “They may have cancer in their body, but their hearts are good and their lungs are good, compared to a 90-year-old who at baseline is just not as resilient.”

All of Aaron Martinez’s vital organs, except for his brain, seem to be working. “There have been times when we’ve brought him in, and the nurse looks at the chart and looks at him, and she can’t believe it’s that child,” said his father, Hector.

A photo shows a nurse giving 17-month-old Aaron Martinez medicine via an oral syringe.
Hospice nurse Shannon Stiles gently administers Aaron Martinez an oral medication. Many hospice organizations are reluctant to take children, whose medical and emotional needs are often intense and complex.

When kids live past the six-month life expectancy, they must be recertified to stay in hospice. In many cases, Steinhorn said, he is willing to recertify his pediatric patients indefinitely.

Even with doctors advocating for them, it’s not always easy for children to get into hospice care. Most hospices care primarily for adults and are reluctant to take kids.

“The hospice will say, ‘We don’t have the capacity to treat children. Our nurses aren’t trained. It’s different. We just can’t do it,’” said Lori Butterworth, co-founder of the Children’s Hospice and Palliative Care Coalition of California in Watsonville. “The other reason is not wanting to, because it’s existentially devastating and sad and hard.”

Finances also play a role. Home hospice care is paid at a per diem rate set by Medicare — slightly over $200 a day for the first two months, about $161 a day after that — and it is typically the same for kids and adults. Children, particularly those with rare conditions, often require more intensive and innovative care, so the per diem doesn’t stretch as far.

The concurrent care provision has made taking pediatric patients more viable for hospice organizations, Steinhorn and others said. Under the ACA, many of the expenses for certain medications and medical services can be shifted to the patient’s primary insurance, leaving hospices responsible for pain relief and comfort care.

Even so, the relatively small number of kids who die each year from protracted ailments hardly makes pediatric hospice an appealing line of business in an industry craving growth, especially one in which private equity investors are active and seeking a big payday.

In California, only 21 of 1,336 hospices reported having a specialized pediatric hospice program, and 59 said they served at least one patient under age 21, according to an analysis of 2020 state data by Cordt Kassner, CEO of Hospice Analytics in Colorado Springs, Colorado.

Hospice providers that do cater to children often face a more basic challenge: Even with the possibility of concurrent care, many parents still equate hospice with acceptance of death. That was the case initially for Matt and Reese Sonnen, Los Angeles residents whose daughter, Layla, was born with a seizure disorder that had no name: Her brain had simply failed to develop in the womb, and an MRI showed “fluid taking up space where the brain wasn’t,” her mother said.

When Layla’s team first mentioned hospice, “I was in the car on my phone, and I almost crashed the car,” Reese recalled. “The first thought that came to mind was, ‘It is just the end,’ but we felt she was nowhere near it, because she was strong, she was mighty. She was my little girl. She was going to get through this.”

About three months later, as Layla’s nervous system deteriorated, causing her to writhe in pain, her parents agreed to enroll her in hospice with TrinityKids Care. She died weeks later, not long after her 2nd birthday. She was in her mother’s arms, with Matt close by.

“All of a sudden, Layla breathed out a big rush of air. The nurse looked at me and said, ‘That was her last breath.’ I was literally breathing in her last breath,” Reese recounted. “I never wanted to breathe again, because now I felt I had her in my lungs. Don’t make me laugh, don’t make me exhale.”

Layla’s parents have no regrets about their decision to put her in hospice. “It was the absolute right decision, and in hindsight we should have done it sooner,” Matt said. “She was suffering, and we had blinders on.”

A photo shows Adriana Pinedo sitting at home and feeding her son, Aaron, with a bottle.
Adriana Pinedo spends much of her day alone with her son. She has chosen to live in the moment, she says, because otherwise her mind wanders to a future in which either “he could die — or he won’t, and I’ll end up changing the diapers of a 40-year-old man.”

Adriana Pinedo said she is “infinitely grateful” for hospice, despite the heartache of Aaron’s condition. Sometimes the social worker will stop by, she said, just to say hello and drop off a latte, a small gesture that can feel very uplifting. “They’ve been our lifeline,” she said.

Adriana talks about a friend of hers with a healthy baby, also named Aaron, who is pregnant with her second child. “All the stuff that was on our list, they’re living. And I love them dearly,” Adriana said. “But it’s almost hard to look, because it’s like looking at the stuff that you didn’t get. It’s like Christmas Day, staring through the window at the neighbor’s house, and you’re sitting there in the cold.”

Yet she seems palpably torn between that bleak remorse and the unconditional love parents feel toward their children. At one point, Adriana interrupted herself midsentence and turned to her son, who was in Hector’s arms: “Yes, Papi, you are so stinking cute, and you are still my dream come true.”

Complete Article HERE!

It’s not easy to tell kids about death.

But the stories we spin can help light the dark

Alice Matthews helps palliative patients write their life story, sometimes with a “children’s book” version for their kids.

By Justine Toh

When we think of how we’ll be remembered after death,  it may seem that simple words and basic descriptions don’t do us justice.

But for parents with a terminal illness and those on their deathbed, plain language is sometimes best.

“Dad was an artist. He painted the world that he saw. People loved his drawings.”

How else do you tell your life story — or explain death — to a young child?

Alice Matthews knows something of the challenge of putting a life into a story.

Since 2017, the SBS and ABC journalist has volunteered as a biographer with the Sacred Heart Community Palliative Care Biography Service based at St Vincent’s Hospital in Sydney.

The work involved sitting by the bedsides of the dying and, over a series of sessions, recording their stories.

For Alice, bearing witness to people’s lives, crying along with them, helping them grieve, reflect, and consider their legacy was an enormous privilege.

“We talk a lot in the service about holding space for someone,” she told RN’s Soul Search.

“There is an incredible spirituality in doing that, sitting with somebody, being with them and not really having to say or do anything except that.”

Death: the storybook version

Alice mostly saw elderly clients, part of a group often “shunted and pushed aside” by the wider world.

“What better way to return value to them than to sit and talk about their life and the value of their life which hadn’t disappeared,” she said.

Such clients often met their deaths with acceptance or comfort in their various religious and spiritual beliefs.

Others died “before their time”, as we would say.

If they had young children, Alice would put together a “storybook” version of their dying parent’s longer biography.

Girl reading a book, with LOVE written on her long-sleeved t-shirt
Some of the best-loved children’s books feature themes of loss and death.

For one client, a dad with a young daughter, Alice worked with the family to come up with a child-friendly “circle of life” explanation of death.

“I remember sitting in the room with them as the wife read it to her husband. That was one of the moments where we all sat there in tears,” Alice said.

“I didn’t know how he would react. He wasn’t verbal at that point.

“We waited a moment and then saw that he’d typed: ‘That was beautiful.’

“That was one of those moments where you feel the entire weight of the heartbreak — but also the relief.”

Once upon a time

Another writer who understands this struggle to give language to death is author Chloe Hooper.

Chloe’s partner Don Watson, the historian, author, and speechwriter, was diagnosed with an aggressive form of leukaemia in 2018. Things looked grim.

Then there was the uncertainty: how to explain his possible demise to their young sons — Tobias, then six, and Gabriel, three at the time.

Author Chloe Hooper wearing blue turtleneck, and light-pink shirt.
Writing offered some comfort in the face of grief for author Chloe Hooper.

Few age-appropriate titles on the shelf seemed right. So, Chloe embarked on a quest to find the perfect book.

“The right story can help us find a path through the forest. It can help us take our straw and weave it into gold,” she said.

“Quite quickly, I realised that storytelling and perhaps re-storying this situation would be a way to help us through.

“The electricity and potential of ‘Once upon a time’ might be a way for us to light the dark.”

Chloe’s search for the best words to explain death — recounted in her book Bedtime Story — turned up the innumerable ways in which adults have explained death to children.

Grief and enchantment

Along the way, she made a surprising discovery: beloved children’s authors had suffered significant bereavement in their lives.

Roald Dahl, for one, described himself as “limp with despair” as he began writing Charlie and the Chocolate Factory after losing his seven-year-old daughter.

Dahl wasn’t alone. The Brothers Grimm, Hans Christian Andersen, J R R Tolkien, Frances Hodgson Burnett, C S Lewis, J K Rowling — death had touched them all.

Black and white photo of writer Roald Dahl holding onto his cane, standing in front of shed.
Writer Roald Dahl was familiar with death, both in his personal life and in his children’s books.

Writing couldn’t overcome death, but it seemed a comfort in the face of it.

“It made me realise that an ingredient of enchantment is grief,” Chloe told me, referring to the often magical settings of the stories penned by those writers.

What she was looking for — the perfect story to tell her children about death — “was embedded in all of the stories that surround us.”

Mythic narratives similarly stalked the border between life and death, Chloe noticed.

Descent and return narratives saw characters like the Greek hero Odysseus — and even religious figures like Jesus Christ — descend to the dead before returning to the land of the living.

These stories, and their authors, couldn’t help but stray into spiritual territory.

For Tolkien, fairy tales were ultimately about escaping death. C S Lewis, author of the Narnia series, found himself a Christian after becoming convinced that the story of Jesus Christ’s death and resurrection was what Tolkien called a “true myth”: the fairy tale that came true.

‘Everything will be alright’

Plenty of people — including Chloe Hooper — are agnostic about that.

But every parent knows it’s their job to protect their kids. According to the late sociologist and theologian Peter Berger, “to become a parent is to take on the role of world-builder and world-protector”.

For Berger, this makes parents practically godlike.

Parents represent “the underlying order of the universe that it makes sense to trust,” he writes in A Rumor of Angels: Modern Society and the Rediscovery of the Supernatural.

Take the most basic parenting move: hushing a crying child in the dead of night. For Berger, when a mother rocks her bub, murmuring “Everything will be alright,” she relates to her child the way we imagine a god should relate to their creation.

Even the most ardent skeptic gets that a god’s job is to guarantee order and safety and beat back the encroaching darkness.

This casts new light on the stories we spin about death: from fairy tales to storybook versions of the “circle of life”.

What are these if not our attempts to love those we must eventually leave? Our efforts to weave out of the world’s sadness a life-giving spell?

Perhaps we’d rather not read the stories of our lives that get written on our deathbeds.

But even if such stories are prompted by the most decisive of endings, they pulse with love and concern for the living left behind.

Death doesn’t exactly get the last word because these stories are, in the end, about life.

Complete Article HERE!

How To Explain Death to a Child

It’s best to be honest and straightforward while remaining age-appropriate

When someone dies, it’s hard enough to deal with your own grief. But how on earth are you supposed to help your child through it, as well?

Pediatric psychologist Kate Eshleman, PsyD, talks about how to explain death to a child, including age-appropriate ways to discuss the concept of death and dying, and how to tell when your child needs a little bit of extra help from a mental health professional.

Why is explaining death to your child so hard?

There’s no getting around it: It’s emotionally grueling to tell your child that someone they knew or loved has died, and it’s not a task that any parent looks forward to. Plus, the difficulty is compounded by your own grief, as well as by your concerns about how to break the news, what your child will understand and whether you’ll be able to answer their questions.

“With death, often there’s either a long, drawn-out illness or a sudden, tragic event with no time for us to prepare,” Dr. Eshleman says. “When we’re struggling to cope, we anticipate that it will also be difficult to tell our children. We care about them, and we think they’re going to be upset, and we want to protect them from that.”

How to explain death to your child

Death is a part of life, so it’s important to help your child become accustomed to the idea that people (and pets) sometimes die.

“It’s something all around us and that kids will be exposed to,” Dr. Eshleman says, “but based on their age and development, kids will have varying understandings of what that means, including the permanency of it and associated factors, like whether it’s scary.”

Here’s the truth: Nothing will make it easy to talk to your child about death. But there are some guidelines you can follow that will help you explain what has happened in compassionate, understandable and age-appropriate ways. 

1. Be straightforward in your explanations

You may be inclined to soften the concept of death with euphemisms, but it’s best to be forthright and specific (while remaining age-appropriate).

If you just say that Grandpa is “gone,” for example, kids wonder: Where did he go? When is he coming home? Is it the same as when mom goes to work during the day? “That ambiguousness causes distress,” Dr. Eshleman notes, “so it’s important to use the actual words.”

The same is true of the lead-up to death. Let’s say Grandpa is terminally ill. Instead of just saying, “Grandpa is sick,” instead try, “Grandpa is sick with a kind of cancer. The medicine isn’t working anymore, and his body is tired of fighting. We think he will die soon.”

“You don’t want them to think that every time they or someone they love gets sick, they’re going to die,” Dr. Eshleman says, “so you want to be as specific with that labeling as you can.”

2. Honesty is the best policy

While you shouldn’t go into any gory or distressing details, always try to tell your child the facts while also using terms they can understand. “We always want to tell the truth in a developmentally appropriate way,” Dr. Eshleman says.

Remember that kids also hear information from the outside world, whether it’s online or from a classmate. The last thing you want is for your child to come home from school and tell you, “Johnny on the bus said that when you die, your body goes into the ground, but that’s not what you said!”

By telling your child the truth, even when it’s difficult or painful, you maintain their trust and your authority.

3. Ask and answer questions

Kids are naturally inquisitive and likely to have questions about death. Try to answer them using the guidelines above: honestly and in age-appropriate ways, using factual language and avoiding flowery euphemisms.

You can ask them questions, too. “It’s good to start conversations with open-ended questions,” Dr. Eshleman advises. “You can ask, ‘What do you think is going on with Grandpa?’ or ‘Where do you think Grandpa went?’”

Questions like “Is there anything on your mind?” and “Do you have any concerns?” help you ensure that your child understands what’s happening. It also gives you the chance to clear up any misunderstandings and address their worries.

And if your kid doesn’t want to talk, that’s also OK. “Don’t force them to engage in conversations they’re not ready or able to have, but do offer the opportunities,” Dr. Eshleman says.

4. Prepare them for upcoming rituals

Tell your kids what comes next so they know what to expect, You might say, for example, “We’re going to go to the funeral home. There are going to be a lot of people there. Many people might be crying, and lots of people that you don’t know are going to come and talk to you.”

You can also explain what they’ll see there (for example, flowers, a casket, the body of the deceased) and what people may be doing (for example, crying, hugging, talking, praying) to help them understand what’s to come.

5. Let kids make decisions

Telling kids what’s about to happen also allows them to choose how and whether to participate. Not sure what age is too young to attend a funeral? There’s no right or wrong answer. After you’ve told them what to expect, you can even let them decide for themselves.

“Again, we don’t want to force a child to do anything that they don’t want to do,” Dr. Eshleman emphasizes. “It’s about preparing them in advance and then following their lead.”

The same is true throughout every step of the process. If there’s an open casket, for example, they may not wish to see the body and may even want to stay in another room, or they may want to visit the casket and kiss Grandpa goodbye. Let your child decide for themselves.

6. Meld your faith with the facts

If your family is religious, incorporate your beliefs into the way you talk about death while also clearly and concretely explaining what’s happening.

“You may say, for example, ‘We’re going to go to Grandpa’s funeral, and then they’ll put his body in the ground, which is where it will stay — but his spirit is in heaven,’ or whatever is consistent with your family’s beliefs,” Dr. Eshleman suggests.

7. Try not to project your emotions onto your kids

Have you ever been to a funeral home where adults are crying and hugging while little kids laugh and play nearby? It can feel jarring, but it’s actually an understandable response for children to have.

In the simplest of terms, adults have more life experience than kids do, which means we can’t expect little ones to know or understand everything we do — including social cues and emotional responses.

“As adults, we have certain thoughts, feelings and associations that we often project onto kids,” Dr. Eshleman explains. “Even when everyone else is grieving, kids may not feel the same way. It’s not always a time of sadness for them.”

8. Let them feel their feelings

Speaking of sadness, though, here’s an important reminder: “When something sad happens, it’s appropriate to feel sad,” Dr. Eshleman reiterates. For kids, that can manifest in behaviors like:

It’s important to keep an eye on your kids to make sure these responses don’t continue indefinitely. But don’t put the kibosh on them right away. In the aftermath of a loss, it’s natural for kids to express their sadness.

It can be helpful for kids to see you feeling your feelings, too. It’s OK — and even healthy — to let children witness your emotional responses. Saying, for example, “I’m crying because I’m feeling sad. I loved Grandpa very much, and I’m sad that he’s gone,” shows kids that it’s normal to feel and express a range of emotions.

9. Make them feel safe

When someone dies under tragic or violent circumstances, it can be even harder to make sense of what to tell kids. And there’s the added layer of wanting to ensure that they feel protected from harm.

“The truth is, there are a lot of things we can’t control, from mass shootings to the pandemic, and we can’t always keep our kids safe,” Dr. Eshleman notes, “but it’s important to discuss the ways they are safe and the ways that we continue to try to keep them safe.”

10. Keep talking about their loved one

Talking about the person who died can help both you and your child cope with grief, whether through telling stories, looking at pictures or just continuing to mention them in small ways.

“Let’s say you’re at the grocery store, and you pick up a box of cereal,” Dr. Eshleman posits. “You can say, ‘Oh, this was Grandpa’s favorite kind,’ or, ‘Remember the last time you had your friend over and you had this for breakfast?’”

“Sometimes, people are afraid of bringing up people who have died because they don’t want to make others sad,” she continues, “but it’s OK to feel sad. Continue to talk about loved ones who have died instead of avoiding it.”

11. Ask for help and consider mental health resources

You don’t have to cope alone, and you don’t have to help your kid cope alone, either. If you’re having trouble figuring out what to say or how to deal, ask others for help.

“Never be afraid to run it by your child’s pediatrician or your own primary care doctor or even your friends, just to get their input and feedback,” Dr. Eshleman says.

And if your child seems to be having an especially difficult time after a loss, those same medical professionals can weigh in on how to get them the extra support they need.

At what age should you explain death to your child?

There’s no age too young to tell your child that someone they knew or loved has died. Again, honesty is the best policy. But Dr. Eshleman reiterates how important it is to speak to your kids on their level, in terms they can comprehend.

“It’s very important to meet each child where they are, developmentally,” she says. “Ask the child what they know and what they understand, then follow their lead.”

Ultimately, she adds, kids are incredibly resilient. “If we do our best to support them before, during and after a loss, it’s likely that they are going to come out of it OK.”

Complete Article HERE!

What Comes After Death?

— Clinicians can help young patients integrate existing belief systems to process grief

By Rebecca Morse, PhD, MA

I once attended a funeral during which the guests were invited to take a flower from atop a young mother’s casket as a memento. A little boy, her son, was being held by his father. He had been remarkably quiet throughout the funeral and interment process up to this point. Then, I began watching him, watch them. He was looking from the line of people to the casket, to his father, to the line of people, to the casket, to his father. He was starting to fidget. And suddenly, amid the silence, he asked his father “Daddy! Why are they taking mommy’s flowers? They are the lastest she’ll ever have?!”

The purpose of this story? To emphasize that this little boy, with only a handful of years on this earth, who couldn’t possibly have a full, contextual understanding of death, on some minute yet significant level got it. His mother would never get more flowers. At least, none she would be able to appreciate.

Last month, I wrote about how medical professionals should always provide honest and fact-based information when talking to pediatric patients about dying. Yet the question remains: What comes after death?

Children may not ask questions indicative of an existential crisis. They often ask very practical questions: What happens after we die? What will happen to me after I die? Is there a heaven? We must educate those who work with and around children: kids live in a world where death exists and we don’t help them if we don’t tell them, help scaffold their understanding, and better their ability to process difficult emotions.

Having established that children understand more than we recognize, how do we, as health professionals, discuss what comes next? First, the pragmatic recommendations: When discussing anything with a child, it’s best to ensure that the parents or legal guardians know what you will be sharing and why. Second, it’s critical to be mindful of culture. Depending on the family’s background there may be constraints or considerations integral to their belief system. And although the goal is transparency and honesty, to establish a trusting relationship with the child, it doesn’t help if the healthcare professionals and guardians are at odds with one another.

It can also be helpful to ask the child what they know already. What have they learned from their family? What does the child think? Children are remarkable observers. They “science” the world around them; correlation does imply causation to them. So, knowing and being able to understand their existing framework or cognitive schema(s) will help guide you in what to say. Even a child as young as 3 or 4 years old can make correlational connections, as did the young child in my story.

In my thanatology courses on children and death, I often require students to watch the movie “Ponette.” It’s a perfect example of what not to do. As each adult and older child gives Ponette different responses after her mother dies, she now must navigate conflicting narratives. And none of it makes sense to Ponette, who is engaging in a very healthy grief response: seeking proximity to her deceased mother and wanting to find ways to communicate with her spirit.

When discussing the afterlife and what comes next with kids, if you know the family’s belief or faith you can work with, not against, what the child has already internalized as their working model for their assumptive world. It’s not our place to undermine the child’s trust in their parents or guardians, or to question what the family has taught the child.

So, what might this look like in a clinical setting?

Step 1: Be honest about what you don’t know first-hand. Unless you are Frankenstein’s monster, it’s safe to assume you haven’t been dead yourself or returned from the grave. It’s okay to tell a child that you don’t know. In terms of sharing what you believe, there may be limitations on what you may or may not share based on professional ethical or legal guidelines, in addition to the need to respect the legal and moral rights of the parents.

Step 2: Ask. This is a good opportunity to ask the child what they believe. A child doesn’t need us to have all the answers. Children need a secure attachment base, and to know they can trust the adults in their world. Regardless of the child’s faith of origin (meaning their caregiver’s or cultural belief system that they are still internalizing), they need consistency in messaging, and their caregivers serve as a primary attachment figure. This can be challenging when the child or family has a different belief system than your own. This is where spiritual cultural humility is imperative; never undermine faith just because you don’t share it (e.g., thanatologists dealing with difference). By finding out what the client feels is salient, we can help them process their emotions around it.

Step 3: Help the child learn to label their emotions. Research has demonstrated that when parents have a more extensive vocabulary for emotion-related words, their children are more advanced in both their social and emotional development. Lev Vygotsky, an early developmentalist, was particularly interested in how we can structure learning in children; he posited that a child’s ability to learn and reach their potential is not limited as much by their own abilities, as it is by the ability of the “teacher” or more expert peer to “scaffold” learning. When children can have their emotion-related expressive language scaffolded (meaning built up or supported by a more experienced person), they show better emotional self-regulation. One final tip: children process through play, so don’t be surprised if they engage in imaginary playacting or games to practice what they are learning and to develop self-regulation. It’s perfectly normal if one moment they are crying or distressed and then minutes later they are laughing and silly. Children may also practice social scripts around loss through make-believe interactions with imaginary friends — this is healthy and adaptive as they are learning to adapt to their new world.

Talking with children about death is one of the most challenging things grown-ups must do. I know many parents who would much rather discuss sex than death and dying. Oftentimes, it may fall on healthcare professionals to provide support. Similar to discussing dying with a child, when discussing what comes after death it’s important to keep in mind the child’s cognitive ability, offer honesty titrated in language they can understand, and remember that grief may manifest itself in different ways such as upset tummies, headaches, irritability, and changes in eating and sleeping patterns.

Moral of the story? The best thing we can do to help children deal with death is to lean into those difficult discussions, work within their existing understanding, and allow them to process at their own pace.

Complete Article HERE!

4 Simple Ways Parents Can Survive The Death Of A Child

By John Cappello

There are many forms of grief that you will face in your life. Some are more difficult to fathom than others. The tough ones like a failed relationship or the loss of a job are rough enough, but there is one loss that is considered the most challenging of all.

The loss of a child.

The loss of a child is not an experience that you expect to endure because it is such an unnatural occurrence. A child is part of your legacy and, to many, becoming a parent is the highest form of achievement that you can accomplish in your life. When a child is lost it affects your very core.

The sense of damage is often unbearable.

To Move Forward, Find A Way To Cope

It does not matter how the child was lost. The hurt of the loss never really goes away. There can be a sense of failure that surrounds this kind of loss and healing from it may simply be impossible.

The solution to moving on from this tragedy is to learn how to cope with it.

1. Face the shock of premature death

Premature death is shocking and keeping it together is not easy. The mental, physical and spiritual pain from the loss of your offspring can create a cycle of other events that can stifle the strongest individuals.

It can create chaos in other areas of your life that had been relatively stable.

A spiral of other unpleasantries can occur if you are not careful. There are no set answers for coping with this problem, but an individual strategy can be created to help.

Since there is no formula for handling this kind of tragedy, you must employ whatever positive behavior you can produce to soothe your pain.

2. Practice the virtue of commitment

The topic of the loss of a child is not easy to discuss but it is necessary because it is a form of grief that is life-altering. Friends or close colleagues are often told to “mind their own business” but this kind of behavior is not helpful to you or them because they are suffering from the same loss.

The others who are hurting may not suffer the same degree of pain, but they are attempting to process the loss as well.

It may sound trite to speak of virtues at this time, but this is a moment when they can matter the most. The virtue of commitment is one of the first that is exhibited by many parents who have lost a child.

This virtue is very important because re-committing yourself to your spouse, significant other, closest family, and friends is essential in the healing process.

You can nurture each other through your pain.

The touch of another loved one — hugging you or holding your hand — is a life link to coping. Re-committing to your spouse or significant other validates the bond that each of you has and the one that was there when you created or adopted your child. Devotion, cuddling, and intimacy allow you some respite and are unique moments that only the two of you can share.

It is your partner who understands your feelings the most and this is not the time to push them away. Your other friends and family are there for you and you are there for them. Ironically, the bond you have with those closest to you becomes stronger during this difficult situation.

This kind of tragedy can bring out problems in a relationship and force those issues to the forefront. 

Many couples separate after a child is lost because other problems that were not pressing are now front and center. It is another heartbreak that results from losing a child, but it may be necessary for an individual to cope if the relationship is not strong enough to survive.

Seeking and giving acknowledgment to others after losing a child is monumental in carrying on. If you do not have anyone to who you can turn at this moment, then seeking help from a therapist or an outreach program is a necessity for your well-being. Emotional support is critical because it is needed at this time.

Some isolation and privacy are expected after your loss but there is a point when isolation becomes negative and accepting the love, support, and nurturing others have for you is a good thing. It will make you feel wanted and that your loss is not discounted in any way. A balance between isolation and socializing with loved ones can prevent negativity.

3. Seek perspective

The act of taking care of yourself is paramount with any form of grief but this type of grief is most likely shared by others. You are the most important person who needs the love and nurturing of others at this time, but it is you who must learn to persevere. You may not be used to accepting help, but it may be one of the things that assist you in your self-care.

It is your act of self-love and other virtues that will help you cope. You may never be able to overcome all your grief from your loss but learning to function positively is a necessity. Being magnanimous in this loss and gaining perspective will hopefully come to you at some point. These attributes are essential in keeping a positive outlook on your future.

A sense of guilt and feeling that you did something wrong may surround your loss. Parents who suffer this loss often feel they did not protect their child enough, but this is just a sign of a good parent grieving. Forgiving yourself if you have a sense of failure is a necessity for your ability to cope with this loss.

Your child lives on in the Spirit World and your relationship with them continues in spirit. It is not the situation that is the most desirable, but it is your belief in it that can bring you some peace of mind. A spiritual perspective is necessary during extreme situations because it is a higher power that will give you the fortitude that you need.

Prayer, meditation, and memorializing your child can bring a sense of peace. The ability to find or develop positive skills to manage is essential for coping. Expressing your emotions is healthy but negative actions or approaches will simply create adversity and more difficulties that can damage your life.

4. Know that life is worth living

A loss of a child is devastating but it does not mean that life is not worth living or that you cannot move ahead in the future. It is an unfortunate part of your journey that you cannot ignore. You did not deserve this tragedy, but it occurred, and it has altered your life forever.

Coping with grief is not easy and this type of grief is the most difficult. Re-committing to those who love you and the ones you love is helpful. Seeking professional help and/or support groups is advisable, but it is only you who can determine your path forward. Navigating this uncharted path is an individual one but trying to have a positive perspective is necessary for you to survive.

Your spiritual life is an important ingredient for coping and should be relied upon for perspective.  Memorializing and recalling the joy of having made a child in your life is a good thing. You may never fully recover from your loss but at least you may learn to cope with the tragedy and try to grow from it.

Complete Article HERE!

9 tips to talk to kids about death under any circumstances from natural causes to mass shootings

Children process death in different ways and it’s important to respect their grieving process and let them know you’re there for support.

By

  • When discussing death with kids, experts advise honesty and plain language rather than euphemisms.
  • Aim to tailor the conversation to their age and stick to the facts, avoiding overwhelming details.
  • Kids often need more time to process what happened, so prepare for more conversations later on.

You’ll likely have to tackle the topic of death with your kids at some point, whether that conversation is spurred on by a death in the family, a school shooting in the news, or simple curiosity.

It’s natural to feel a little uneasy approaching this conversation due to your own discomfort and fear around death, or because you’re afraid of upsetting your child, says Reena B. Patel, a licensed educational psychologist and board-certified behavior analyst. Even so, talking to your child about death can help them understand this difficult topic more easily.

What’s more, in the case of publicized tragic events like school shootings, it’s especially important to take the lead in discussing what happened with your child rather than let them find out from the media, says Bethany Cook, a licensed psychologist in private practice.

The news is written and reported in an effort to captivate the viewer, Cook says. In other words, it’s not crafted to your child’s age or level of understanding, and it won’t be able to answer any follow-up questions they have or provide emotional support, she says.

When deciding how to approach the subject of death with a child, Parenting Nerd co-founder Elizabeth Hicks recommends taking their age and emotional maturity into account. If you’re bringing it up because someone your child knows recently died, you should also factor in their relationship with the deceased.

These expert-approved tips can help you talk to your kids about death in a gentle and supportive way.

1. Choose a time and place carefully

Ideally, you want to approach the topic of death in a private and quiet setting, when you and your child have nowhere to be and don’t feel rushed in the conversation.

If your child has a favorite stuffed animal, blanket, or toy they like to carry around or sleep with, you might give it to them to hold for comfort before starting the conversation.

It’s OK to share a loved one’s death with more than one child at the same time if there isn’t a big age difference between them. However, if they aren’t close in age, you may want to have separate conversations so you can tailor your language accordingly.

When sharing the news of a tragic event, such as a school shooting, Cook recommends choosing a private, comfortable space with minimal distractions and presenting the information in chunks.

“The first piece should be geared toward the younger family members,” she says. “Keep it simple, clear, and concise.”

You might start by saying something along the lines of, “Did you hear about something that happened at a school in [XYZ state] today?” If they did, you can ask:

  • “What did you hear?”
  • “How do you feel about it?” “Do you have any questions?”

If they aren’t yet aware, Cook recommends saying something along the lines of, “Someone went into a school with a gun and killed some people.”

Then, give them a chance to ask questions and share their feelings. After you validate those feelings, Cook recommends setting younger children up with an activity, like a movie or engaging toy, in another room so you can continue the conversation with older children.

Adolescents and teens may have more intense emotional reactions to this news, so be prepared to validate their feelings while reassuring them as best as you can that the school staff is trained to keep them safe.

2. Be honest and concrete

While you might feel tempted to withhold news of a death in an attempt to protect your child, Patel says it’s important to be direct and transparent.

Children often know when you aren’t telling the complete truth. Even if you have good intentions, that dishonesty could erode their trust in you.

You don’t need to share all the details of a person’s death with a younger child, who may not even be able to grasp them. When it comes to older children, though, don’t intentionally leave out key facts — even if the facts are potentially upsetting.

Say a relative died of an accidental drug overdose but the official cause of death was heart failure . Hannah Ly, a child therapist in private practice, advises against saying “They had a heart attack” without mentioning the drug use.

“Leaving out facts could lead to emotional distress when they find out the truth as an adult,” she says.

3. Start small and let them take the lead

In order to avoid overwhelming your child with too much information up front, Patel recommends sharing in doses. Start with simple facts about who died and what death means. Then, allow them to take control of the conversation by giving them an opportunity to ask questions.

For instance, if you tell your child a loved one died due to an illness, like cancer, they might ask why a doctor couldn’t make it better. You can respond matter-of-factly by saying “Doctors can’t always fix everything.” Or, if they don’t ask any questions, that’s OK, too.

Remember, they may need to digest the concept of death in bits and pieces, so just know they might come back to you with more questions on another day. Even if they don’t, you might always follow up yourself in a day or two, after they’ve had some time to process the news.

4. Avoid certain euphemisms

You may feel uncomfortable using the words “death” or “dead,” but Patel advises against using euphemisms to soften the blow. This kind of language can cause misunderstandings and confusion and ultimately do more harm.

For example, if you say the person “went on a long journey,” your child may then be retraumatized when they realize the person will never actually come back. Or, if you say they “went to sleep,” Ly says your child may develop anxiety at bedtime and become afraid they might die in their sleep.

Ly advises focusing on the basic facts of what happened. Say a loved one died naturally due to age. You might explain to a younger child that after many years of life, your body gets so tired that eventually your heart stops beating, your brain stops thinking, and you stop breathing.

5. Allow space for every emotion

Keep in mind that children can experience grief in widely varying ways, just like adults. They may:

  • Express anger, sadness, or confusion
  • Cling closer to you or isolate themselves
  • Need to talk about it a lot to process it, or become quieter and more withdrawn
  • Seem unaffected by the loss

According to Patel, there is no right or wrong way for them to grieve. Ideally, you want your child to understand no emotion is off-limits so they feel safe and supported in expressing themselves however they need to.

Explain that they can come and talk to you any time. When they do share with you, make sure to validate their feelings by saying things like:

  • “It sounds like you’re really upset, and that’s totally normal.”
  • “Of course you’re sad — lots of people feel that way when they have to say goodbye to someone.”

“Let them know it’s OK to cry, and it’s also OK if they need alone time,” Patel says.

If their grief is affecting other areas of their life, such as their performance at school, Ly advises seeking guidance from a mental health professional.

You might start by mentioning the changes you’ve noticed in a curious and non-judgmental way, and asking your child why they think they might be struggling. You can also talk to their teachers to get their perspectives and observations, Cook says.

6. Feel free to express your own grief

You may worry that expressing your own emotions around death will make things worse for your child — but in reality, experts say it’s much better to show your grief than stifle your emotions in an effort to protect them.

You can normalize grief and mourning for your child by openly expressing your emotions, Patel says. It also helps to model healthy coping skills, like journaling, connecting with loved ones, and practicing good self-care.

Children tend to model the behavior they pick up on from the adults in their lives. If they notice you’re comfortable discussing death, and your feelings around it, they’re more likely to do the same.

Conversely, avoiding discussing the death or your feelings about it can send a message that talking about death is somehow bad or harmful. They might then avoid the topic, too — which Ly says may prevent them from fully processing their emotions not only in response to that particular death but others down the road.

7. Keep their age in mind

While it’s important to speak honestly with your child about death, it can be challenging to do so while steering clear of unnecessary details that may traumatize them.

Experts recommend considering your child’s age to find a balance. Here’s how each age group typically perceives and understands death:

Preschool (ages 3-5)

At this age, children may still think of death as temporary or reversible. They may have trouble understanding that when someone dies, they don’t come back. A 2018 study found that media representations of death can often contribute to these unrealistic ideas about death. For instance, an analysis found that 31.6% of the deaths in 57 Disney and Pixar films were portrayed as reversible.

According to Cook, it’s OK if your child isn’t able to grasp the finality of death just yet. You can continue to reinforce the fact that it’s permanent through examples — like how once a tree dies, it doesn’t grow back.

Elementary school (ages 5-9)

At this stage, your child may be coming to grips with the idea that everything and everyone dies eventually, and that death is permanent. They may start expressing concern about their parents or friends dying and begin asking a lot more questions about death in general.

“Magical thinking” at this age can cause them to question whether something they said or did caused the person’s death, or whether they can say or do anything to bring them back.

You can reassure them the person’s death was not their fault without dismissing their feelings.

Middle childhood (ages 9-12)

Once they reach this age range, kids often start to acknowledge that death applies to them, too, so they may have more philosophical questions about life and death. They might be more inclined to dig into “why” death happens, especially when it comes to tragic events like murder and suicide.

Certain events can threaten their sense of safety in the world, which makes it important to reassure them you’ll always do your best to keep them safe. It can also help to offer them plenty of choices in everyday life so they can maintain a sense of control in an unpredictable world. For example, you might:

  • Give them three options for how they’d like to spend their Saturday afternoon.
  • Let them pick between a few different outfits for school.
  • Encourage them to select which book they’d like to read at bedtime.

You can also offer multiple options for how to commemorate the deceased person so they can say goodbye in the way they’d like to.

Teens (ages 13-18)

At this point, your child likely has a strong understanding of what death means, so you can focus your conversations around empathizing with and validating their feelings — which may range from sadness or fear to anger and numbness.

Cook advises continually checking in with them to remind them that you’re there to listen, without pressuring them to talk if they don’t want to.

“Follow their lead,” Ly says. “Normalizing the grieving process and giving them space is important.”

If your teen is unwilling to share their feelings with you, but you sense they may need some emotional support, Ly suggests offering to help them connect with a counselor.

8. Shape the conversation according to how the person died

How a person died will play a part in:

  • What you tell your child
  • How much you should share
  • The way you choose to discuss the topic

A sudden death

For example, if a person died suddenly due to a heart attack or car accident, Patel says your child may be in shock and have a lot of questions since they didn’t have the chance to say goodbye.

A natural death

A death due to age can lead to a larger discussion about the circle of life, Patel says. She says you can feel free to use metaphors in nature to help young children understand death — like pointing out how a flower starts as a seed, gets bigger and bigger until it stops growing, starts wilting, and eventually stops living.

Once your child begins to recognize that all plants and animals die, too, they may have an easier time transferring this understanding to people.

A death due to illness

On the other hand, if the person died due to an illness, whether Alzheimer’s or COVID-19, you might explain they had a disease that makes your body stop working as it should. Ly says you can use similar wording to simplify death related to mental health conditions, too.

A death due to suicide

When telling a child about a death by suicide, it helps to answer questions honestly but focus more on your child’s feelings, rather than the details.

It’s essential to:

  • Offer reassurance that nothing your child did or said caused the loved one’s death
  • Stick to the facts
  • Encourage questions
  • Prepare to have multiple conversations about suicide — not just in the days after you share the news, but in the weeks and months to come

If a relative who had depression died by suicide, you might tell a young child, “Their depression made them so sad they didn’t want to feel anything anymore, and so they decided to stop their body from working.”

You could also emphasize to older children that depression is a mental health condition, not a choice or personal failing.

For more guidance on talking about suicide with children and teens, visit the American Foundation for Suicide Prevention.

A violent death

If you find yourself needing to explain a murder, school shooting, or other violent death, keep it simple and only use language they’d understand. For instance, if they ask why the shooting happened, you might say, “People who are hurt and angry sometimes hurt other people.”

9. Other helpful strategies

Death can bring up a lot of feelings like fear, uncertainty, and vulnerability for your child. Some strategies experts recommend for comforting them include:

Make a memory box

Patel advises helping your child to put together a bereavement box filled with special tokens that remind them of the person who died.

This activity can promote positive memories about the person and help them process their grief at the same time. On days when they’re thinking about the deceased person, they can pull out their memory box to help them cope.

Items to add might include:

  • Photographs
  • Cards written by that person
  • A sample of their cologne or perfume
  • Personal items of theirs like jewelry or a passport
  • Keepsakes like tickets from travel or events your child attended with the person

Write a goodbye letter

If your child feels sad they never got to say goodbye, Hicks says you can encourage them to write a letter to the deceased. You can tell your child the letter offers the space to say anything they wish they got to say. If they’re not sure how to begin, ask them how that person made them feel, or what they loved most about them.

Another option, according to Hicks, is to give your child a journal and let them know it’s their safe, private space to share whatever they’re feeling.

Keep up routines

Since the unpredictability of death can disrupt a child’s sense of security, it’s a good idea to maintain as much structure and consistency in their life as possible.

Try to keep up with routines when it comes to schoolwork, meal times, play, and other activities.

Lean on other resources when needed

You can find many books about death specifically geared toward children in your bookstore or local library. Some of these may help fill in the gaps you find most challenging to explain.

Ly recommends reading “The Invisible String” and “When Dinosaurs Die” to check whether either option might help you explain loss to your child.

The National Association for the Education of Young Children has also compiled a list of additional books and other helpful resources. Find that here.

Consider professional support

In some cases, your child may benefit from talking with a therapist about their grief.

A small 2013 study examined children and adolescents with prolonged grief disorder, a condition marked by feelings of intense longing and intrusive thoughts about a deceased loved one six months or more after their death.

Researchers found that children who received nine sessions of cognitive-behavioral therapy, a common form of talk therapy, experienced a reduction in symptoms of grief, depression, and post-traumatic stress disorder.

Patel, Ly, and Hicks say a child may be finding it difficult to cope if they have:

  • Trouble falling or staying asleep
  • Increased nightmares
  • Changes in appetite
  • Less interest in their favorite activities, including socializing with friends
  • Persistent worrying about death, especially pertaining to parents and caregivers
  • Frequent angry outbursts or temper tantrums

If you notice these behaviors — or any others that seem to affect your child’s health and well-being — your child may need additional support to begin healing.

A good next step involves connecting with your child’s teacher or guidance counselor for more support. You can also reach out to a therapist or counselor or ask your child’s pediatrician if they can recommend one.

Insider’s takeaway

As a general rule, death is best explained to children in a simple and straightforward way, without misleading euphemisms. Always offer the opportunity for your child to ask questions, and make it a point to validate any feelings they share.

You don’t need to hide your own grief — in fact, expressing it openly tells your child two important things: Their feelings are natural, and it’s OK to express those emotions openly.

Just know talking to your child about death won’t be a one-and-done conversation. You can share information in smaller doses to avoid overwhelming them, but you’ll also want to let them know your door is always open, so to speak, so they can come to you with any questions or fears.

Complete Article HERE!