Schools fall short when it comes to helping students in grief

– here’s how they can improve

Children’s understanding of death expands as they grow and develop.

By

An adolescent experiences the death of his mother after a lengthy illness.

When I ask what services he would like to receive from the school, he initially says he didn’t expect special treatment, would be embarrassed by counseling from the school mental health staff and wouldn’t feel comfortable if many of his teachers asked to talk to him about his grief.

At the same time, the student felt as though the school should somehow take his situation into account.

“I don’t know what the school should do,” the student told me. “But I just lost the person I love most in my life and they act as if nothing happened.”

In my many years as a developmental-behavioral pediatrician who specializes in school crisis and child bereavement, I believe this dilemma – that is, the need to do enough but not to overwhelm the grieving student or the adults who are trying to help – represents a major challenge for America’s schools.

The need for recognition by trusted adults of their loss, a genuine expression of sympathy and an offer of assistance is often what students seek after a major loss – but too often don’t receive.

A common experience

Loss is very common in childhood – 9 out of 10 children experience the death of a close family member or friend and 1 in 20 children experience the death of a parent.

In contrast, teacher preparation to support grieving students is uncommon. In a recent survey conducted by the American Federation of Teachers and the New York Life Foundation, 93 percent of teachers reported that they never received any training on how to support grieving students. They identified this lack of training as the primary barrier that prevented them from reaching out to grieving students in their class and offering the support they knew they needed. Worried that they would do or say the wrong thing and only make matters worse, some educators chose instead to say and do nothing.

In recognition of this problem, I offer a series of insights and recommendations that teachers can adopt to make the school experience less stressful for students who have recently lost a loved one. Although the advice is aimed at educators, surviving parents or caretakers or anyone who cares about how to help bereaved students can use this advice to advocate on their behalf.

The consequences of inaction

Saying nothing says a lot to grieving children. It communicates that adults are either unaware, uninterested or unwilling to help. It leaves children confused about what has happened and how to react. It leaves children unsupported and forces them to grieve alone. Adults should reach out to grieving children and let them know that they are aware and concerned and are available to provide support and assistance.

What not to say

Anything that starts with “at least” should probably be reconsidered – “at least she’s not in pain anymore” or “at least you still have your father” are generally not helpful comments. It suggests that the adult is uncomfortable with the child’s expression of grief and is trying to “cheer up” the grieving child in order to limit the adult’s own discomfort. Don’t encourage children to hide their feelings or reactions, and don’t feel that you have to hide your own emotions. Be genuine and authentic. Tell grieving children that you are sorry about their loss and ask them what they are feeling and how they are doing.

There isn’t anything you can say that is going to make everything right again for a grieving child. So, listen more than you talk. Other guidelines of what not to say – and what to say instead – to grieving children can be found in “The Grieving Student: A Teacher’s Guide.”

Engage peers

Peers want to – and can – be an important source of support to grieving children, but often are unsure what to say or do. Provide them advice on what to say and practical suggestions on how to be helpful. This will help grieving children obtain critical peer support and decrease their sense of isolation. It will also reduce the likelihood that peers will instead ask repetitive and intrusive questions or tease grieving children.

Offer academic accommodations

Grieving children often experience a temporary decrease in learning ability. They may be tired from not being able to sleep, have difficulty concentrating and learning new material, or may be experiencing significant disruptions in their home environment that make it difficult to study or complete homework.

Grieving children should view school as a place of comfort and support, especially at a time of loss. If they are worried about failing, school becomes instead a source of additional distress. Teachers should offer educational support before children demonstrate academic failure. Check in more frequently to make sure that they are learning new material and are able to keep up with the workload.

Talk to other teachers, instructors and coaches and try to help grieving students balance all of their responsibilities. If the student needs to prepare for an important concert, then maybe academic teachers can lessen some of their assignments. Grieving students may need to have their workload decreased or modified temporarily. If a major report seems overwhelming, substitute with shorter and more manageable assignments. If it’s hard for them to stay on task to complete an individual project, consider a group project that might promote peer support.

Be more sensitive

Teachers can also introduce activities with more sensitivity. For example, if you are going to do a project for Mother’s Day, introduce the activity by telling students that you realize some children may not have a mother who is alive or living with them. They can still complete the activity remembering their mother, or can choose to focus on another important female family member. This will also help students whose mothers may be deployed in the military or incarcerated, or away for other reasons.

Help children manage grief triggers

Many things may remind grieving children about the person who died and cause them to temporarily feel a resurgence of their grief. It may be a comment made by a teacher or a peer, such as “I went shopping with my mother this weekend,” or a portion of a classroom lesson, such as a health education lesson that references a similar cause of death.

Holidays such as Thanksgiving or the winter holidays tend to involve spending time with loved ones and may accentuate the sense of loss. Let students know that these triggers may occur and set up a safety plan. Students may be given permission to step out of the classroom briefly if they are feeling upset and worried that they will not be able to contain their emotions. Work out a signal to communicate when this occurs that doesn’t draw attention to the student. Make a plan for where the student will go and who they can talk with. If students know that they will be able to leave, they often feel less overwhelmed and will be more likely to remain in class and stay engaged in the lesson.

For more information

The Coalition to Support Grieving Students offers free learning modules on a wide range of issues related to grieving students, including videos and written summaries. Schools can also learn more about how to help grieving students through the Grief-Sensitive Schools Initiative.

Complete Article HERE!

My sons’ grief at a friend’s death has forced me to see I can’t shelter them forever

One thing never ceases to strike fear into the heart of parents: the idea of our kids dying before us

The idea that someone could be in your life one day and gone the next was incomprehensible to Jo Davies’ sons.

By Jo Davies

I was at the grocery store the other night when my younger sons and I ran into my next-door neighbour toting his six-week-old son.

After cooing over Junior’s beautiful blue eyes and his adorable expressions for a bit, one of my boys asked to touch the little one’s cheek. My neighbor hesitated for a moment and then declined, saying the baby hadn’t yet had his second round of vaccinations.

I was shocked for a moment, then smiled, reminding myself we were dealing with that most nervous of Nellies: the first-time parent.

Whether you have kids or not, you’ve likely heard the stereotype of the hyper-responsible first-time mom or dad jumping to boil the baby’s pacifier the second it touches the floor or rushing to the ER for every uptick in temperature.

Undoubtedly, this initial hyper-vigilance serves a purpose: it’s Mother Nature’s way of ensuring the survival of the species. All parents go through it, and most get over it.

There’s one thing, however, that never ceases to strike fear into the heart of parents: the idea of our kids dying before us.

A few weeks ago, my sons’ classmate died at the age of 15.

He was a nice boy — quiet and respectful and kind. His death was unexpected, shocking and a heartbreaking introduction into the ways of grief not only for my two sons, but their school community as well.

At this point in their young lives, my sons haven’t experienced the death of anyone close to them except for their grandparents. That was obviously upsetting for them, but their father and I were able to help them to rationalize it, because their grandparents were much older than them; they’d lived a good life and left a legacy for which their many friends and family would remember them fondly.

When their friend died, however, it was virtually impossible to come to terms with it.

Despite the best efforts of their teachers and school counsellors, my boys were at a loss. The idea that someone could be in your life one day and gone the next was incomprehensible to them.

I asked myself: knowing what I know about death (my father died suddenly when I was 24), how can I make the death of their friend make sense to them? I came to the conclusion that I can’t.

There is no way to make sense of such a tragic circumstance, to find a silver lining. All I can do is try to help them cope with what’s happened.

To that end, I’ve done my best to read up on teenage grief, so I can be useful to my sons.

I’ve learned that, as with adults, teenage grief is as unique as each individual who experiences it. It can’t be dictated or forced to fit someone else’s conception of what’s appropriate.

I’ve also realized that for teenagers, grieving is just one more complication in an already turbulent period of life. The death of a close friend can cause them to question their own, newly formed identities as young adults; to ask questions they might never have considered before about life and mortality.

What’s been hardest for me in this process is watching my sons come to the realization that life, at its core, is uncertain. There are no guarantees of happy, long lives for the ones you love, even if you wish there were.

Up until now, their teenage brains (with their still-developing sense of consequences) have helped to make them feel invincible, or if not invincible, at least unconcerned with thoughts of dying — which seemed to me to be as it should be. Kids should be able to live their lives without constantly thinking about death and dying.

 

Now they know words like “hearse” and “pallbearer” and “condolences.” They have witnessed the depths of a parent’s grief as they listened to their friend’s mother describe all the ways she will miss him.

They’ve also been surprised by kindness from unexpected quarters; friends they didn’t know cared who gave them a hug or a tissue.

They have learned a lot of things over the past few weeks, as have I.

Mainly, I’ve learned that there was still a part of me that thought I could keep them safe from the harsh realities of life. I can’t, and that hurts.

However, just as I taught all three of my sons to use a spoon, to tie their shoelaces and to say “please” and “thank you,” I can teach them other things that are even more useful.

I can teach them to value each day they have on this earth, to be grateful that they knew their friend, and to be happy they were good friends to him during his short time here.

I’m pretty sure those are lessons worth learning.

Complete Article HERE!

As baby boomers age, ‘we are in for a death boom.’

Grief expert urges support for mourning workers.

Bobbi Manka, right, works with her colleague Jen Gallois, left, at Tyson Fresh Meats on Dec. 11, 2018, in Elgin. Manka’s co-workers helped her following the death of her husband, Dan Manka, in January 2016.

By Alexia Elejalde-Ruiz

Bobbi and Daniel Manka were settling into bed after a night out dancing when Daniel stood up, clutched his chest and gasped, “911.”

Just like that, Bobbi Manka lost her husband of 44 years and gained “a hole in my heart that will never be replaced.”

But she has found comfort where she didn’t know she would: at work.

Grief after the death of a loved one inevitably follows people to work, where employers and co-workers often are unprepared to handle the immediate sorrow or the surges of pain that ambush mourners at milestones like birthdays and holidays.

Some of the shortcomings can be linked to insufficient bereavement leave policies, but often what fails is the human response to a suffering colleague.

“We have become an increasingly death-denying society,” said Amy Florian, CEO of Corgenius, a Hoffman Estates-based organization that trains businesses on how to help grieving clients and employees. “And when we don’t talk about it, we don’t know how to do it well: how to accompany people through grief.”

Florian said employers would be wise to prepare for the impact of grief on business as aging baby boomers, who are staying in the workplace longer, move toward the end of life.

“We are in for a death boom, we are in for a dementia boom,” said Florian, a fellow in thanatology, the study of death and bereavement. “All of these things are going to happen but firms are not prepared for it.”

Being prepared includes understanding that grieving individuals will cope differently, and employers should accommodate their unique needs, Florian said.

Nearly 90 percent of employers say they offer paid bereavement leave — usually three days for an immediate family member — but that’s not nearly enough time for many people, especially when the death is sudden, she said. Employers might want to consider more generous policies as well as expand them to accommodate deaths beyond immediate family, as losing an aunt or friend can be just as devastating if the relationship was close, Florian said.

No federal law requires employers to give workers time off to grieve, though Illinois has a law, which went into effect two years ago, that provides up to 10 working days of unpaid leave for the death of a child at companies with at least 50 employees.

Florian said employers also should not expect grief-stricken employees to function normally when they return to work, as their concentration is shot, their minds are disorganized and they may be prone to making mistakes. Some employees will need additional support for a month or two once they’re back on the job, such as flexible work schedules, more breaks, adjusted expectations and someone to catch errors, with the assurance that their performance reviews won’t suffer, she said.

Educating co-workers on how to best support a grieving colleague can also help. Many people fumble awkwardly as they try to express sympathy, or avoid the topic altogether because they don’t know what to say, Florian said.

“What is often very shocking for people to learn is that ‘I am so sorry’ is not the best thing to say when someone dies,” Florian said. “The focus is all wrong, it’s on the comforter and not the griever.” Better to ask about the person who died — what they were like, how it happened, making sure to use his or her name, she said. If someone doesn’t want to talk about it, they will close the door on the conversation, she said.

Bobbi Manka pokes her head into Scott Leckrone’s office at Tyson Fresh Meats on Dec. 11, 2018 in Elgin. Leckrone, Manka’s boss, and other colleagues provided emotional support to Manka after her husband died in January 2016.

Manka, 64, who lives in Genoa, a town about 65 miles northwest of Chicago, said she was surprised to discover how often people didn’t ask how she was doing after her husband died suddenly of a massive heart attack two years ago.

“They are afraid that they might trigger something and you might start crying,” she said. “Even if I did, it would have been a good thing.”

But Manka, an administrative assistant in the Tyson Foods sales office in Elgin, was pleasantly surprised at how her colleagues stepped up during her crisis, even though she’d worked at the company only two years at the time and no one from the office had met her husband — the kind of guy “who would take his shirt off and give it to anyone,” she said.

Her boss and a colleague not only attended his “celebration of life” but stayed through the event and got to know her family, she said. When her three days of bereavement leave were up and she couldn’t bring herself to return to work, she was given an extra week off unpaid. She was eager to return when she did.

“My world had been rocked so incredibly hard that coming back to work helped me, because the house was so empty,” Manka said. “Work was my safe place for a long time.”

As she struggled to adjust to her new reality, Manka sought counseling from Tyson’s chaplaincy program, a network of 100 chaplains employed by the company to help Tyson workers navigate life challenges. She found solace in the Bible verses she was given and the advice about how to help her children through their grief as she dealt with her own.

Small kindnesses in her office of 12 have made a big difference, she said. On Manka’s first birthday after her husband’s death, her co-workers presented her with a big cake and card, and told her “we want you to know you’re part of the family,” Manka said. On her wedding anniversary, or when anything happens that triggers memories, her boss can detect a shift in her mood and urges her to take a walk and clear her head.

Such accommodations pay off in the long term, Florian said.

“People who felt they were treated compassionately during times of grief are incredibly loyal to their employer,” she said.

Grief last year cost employers an estimated $113.27 billion in reduced productivity and on-the-job errors, a calculation that takes into account not only the deaths of loved ones but also other traumatic losses such as divorce or home foreclosures, according to the Grief Recovery Institute, an organization based in Bend, Ore., that trains therapists and counselors in grief recovery.

That estimate is up from $75 billion the last time the nonprofit released its Grief Index in 2002, a increase driven by inflation as well as changing workforce demographics as the population ages, said Operations Manager Ed Owens.

Yet employers are rarely proactive about addressing grief in the workplace, and typically only seek help when an employee has died and co-workers need support, said David Fireman, executive director of the Center for Grief Recovery and Therapeutic Services in Chicago’s Rogers Park neighborhood.

“If I had my druthers, (grief training) would be a built-in component to employee orientation,” Fireman said.

While the aging population is one source of workplace grief, another is the city’s violence. Fireman’s organization last year counseled students and faculty at the Chicago Waldorf School after a teacher at the school was killed by a stray bullet while she waited at a nearby Red Line station. He continues to be available to them because “grief is a process and there might be delayed reactions,” he said.

GrieveWell, a nonprofit in Ann Arbor, Mich., that provides grief training to employers and peer-to-peer support for grieving adults, is trying to raise the profile of grief as an “unspoken public health issue” with dangerous consequences if it is not addressed, said Amy Milanovich, former executive director.

Unresolved grief, a clinical term that refers to intense mourning that persists for a long time and interferes with daily functioning, has been linked to an increase in heart disease, stroke and cancer, she said.

The workplace has become increasingly important as a source of support as community traditions that used to surround people in mourning have been cut short amid a social expectation to get back to life as usual, she said.

“Everyone around is someone who could be in grief and everyone needs to be someone who can support them,” Milanovich said. In addition to conducting business lunch-and-learns on the topic, GrieveWell offers a deeper training in active listening for employees who want to be the designated ear colleagues turn to in time of need.

ComPsych, a Chicago-based provider of employee assistance programs, has seen a steady increase in crisis counseling calls about bereavement, likely because employers have become more aware of the need for mental health support, spokeswoman Jennifer Hudson said. Employees over 60 are the most likely of all age groups to seek bereavement help, the company’s data show.

Eric Freckman, a certified financial planner in Palatine, said grief training at his firm has led to improved relationships with clients, who often find themselves navigating unfamiliar bank accounts and investments when a spouse or parent passes away. Increasingly, grief strikes even before death as more people live longer with diminished capacity, he said.

People tend to make emotional decisions around money, especially when they’re grieving, so it takes empathy to guide them to the best decision, Freckman said.

“There’s the answer in Excel of what they should do,” he said. “But getting people to actually do that is very difficult.”

Financial adviser Eric Freckman, left, meets with Keith Leust, of Barrington, at the Guillaume & Freckman office on Dec. 27, 2018, in Palatine.

Freckman said he used to be “sort of terrified” of talking with clients about their loved one’s death, and would avoid it by sticking to discussing numbers. But after training with Florian at Corgenius he feels comfortable engaging in conversations about the loss — “How did you find out?” he asks. “What was it like for you?” “Are there phone calls we can make for you?” — and leaving the paperwork to later meetings. Ninety percent of clients want to talk, and the care shown has helped solidify trust, he said.

“We keep track of people’s birthdays, we try to call and let them know we’re thinking about them, that we know it’s a hard day, the first Christmas alone,” he said. “It’s all relatively simple stuff when you think about it.”

The simple stuff can make a big difference, Florian said. She knows from experience.

Florian was 25 and a new mom to a 7-month-old boy when her husband, John, went to a business meeting and never returned. A farm insurance agent, he was killed when his car was struck broadside on a rural Iowa road on a sleety February night.

“I felt like my future had simply evaporated in an instant,” Florian said. “And nobody knew what to say to me.”

Florian, a stay-at-home mom at the time, felt “every breath was different” after that day, as she adjusted to the empty pillow, the coffee for one, the realization that “anyone could die at any time.”

She felt alone as many people avoided talking about her husband after the funeral. She was grateful to those who did, especially when they said his name.

“It’s such a comfort to know that John’s life made a difference, that someone remembers besides me,” she said. “That his death left a void in the world, not just my life.”

Florian noticed the various ways well-meaning people’s support was insufficient. They’d ask if she needed anything, but she felt bad taking advantage of those offers, worried she’d be a burden. More helpful, she said, was when people identified what needed doing and offered to do it, such as shopping for groceries, weeding the garden or babysitting her son.

Florian recalls working with a financial professional who would change the subject when she started to tear up. So she was impressed when another financial planner, on their first meeting, looked at her file and said: “I see that you are widowed. Tell me about John.”

Her experience propelled her to get a graduate degree in pastoral studies and advanced certification in grief counseling, and she taught ministry courses on death and grieving at Loyola University for 11 years.

Decades after John’s death, Florian is remarried, and her sadness lives alongside her joy. She can still be sent into a sobbing fit in the grocery store aisle when she hears a certain song – and that’s OK.

“The point of healing is not to forget,” she said. “The point is to remember.”

Complete Article HERE!

Looking after a dying loved one at home?

Here’s what you need to know.

Caring can be very rewarding for both the carer and the patient.

By

When someone dies at home, everyone in the family is affected. Looking after a relative who is at the end of their life can be enormously rewarding, but carers have many unmet information and support needs. This can take a toll on their physical and emotional health.

Here are some tips if you are looking after someone nearing the end of their life.

1. Look after yourself

Carers looking after someone with a life-threatening illness have higher levels of emotional distress, including depression and anxiety, than the general population. It’s important you look after yourself.

Self-care might mean finding time to take a break from caring by signing up for yoga classes where calming breathing techniques are practised, or seeking counselling or support groups.

Caring can be very rewarding for both the carer and the patient. Research shows caring can make people feel closer to those they’re caring for. Carers often feel proud that they have been able to look after someone in their last years, months or days of life.

It can be a positive experience to think about the rewards of caring, like spending more time together or knowing you’re making a difference to a loved one at a difficult time.

It’s important you look after yourself.

2. Get informed

Caring for a relative at the end of life is likely a new experience. Many carers are learning on the job and often don’t feel practically or emotionally prepared for the task. Research consistently shows carers want to know how to safely carry out practical caring tasks, like moving the person in and out of bed, preparing suitable meals, and giving medication.

Emotional tasks might include listening to the patient’s worries and helping the patient write down their preferences for care and treatments in an advance care plan. When patients have an advance care plan, carers report less stress because key decisions have already been made and documented.

Palliative care services often have support groups or information sessions, which help carers feel more prepared and better informed. Such groups help meet carers’ information needs. They also increase self-efficacy (the belief of being able to personally succeed in caring tasks).

Recently, distance learning has been offered to carers and evidence shows this helps them feel more prepared to carry out their duties.

A carer’s emotional tasks might include listening to the patient’s worries.

3. Ask for help

Many current approaches to supporting people nearing the end of life involve working with whole communities. Known as compassionate communities, these approaches are based on the concept it is not just up to an individual carer, or the health service, to look after people approaching the end of life. Support can be everyone’s responsibility, from pharmacists, librarians and teachers to employers and colleagues.

Apps, such as Care For Me, and websites can help co-ordinate help from friends, family and the community. The website Gather My Crew offers a way for carers to list tasks they need help with, to take some of the pressure off themselves.

4. Talk about it

When someone is critically ill or dying, family members often decide not to share their worries with each other. Psychologists call this protective buffering. People do it to try to protect their family and friends from worrying more.

Although it is well-intended, protective buffering can make people feel less close. It’s OK to share worries with each other. Being able to talk about feelings means being able to deal together with the difficult things like pain or fear.

Talk about your anxieties.

Using the “d” words (death and dying) can be difficult, and is an outright taboo in many cultures. Find language that suits you: be direct (death), or use metaphors (pass away) or less direct phrases (getting sicker) so that you can talk about worries together.

5. It’s OK to think about the future

It’s hard to balance feeling positive and feeling sad about the person approaching the end of their life. Many family members and carers say they feel guilty for thinking about the future or making plans for after the person has died.

But research in bereavement has shown it’s normal and healthy to move between focusing on the here and now, and on the life after the caring role ends. This might be reassuring if you’re the kind of person who doesn’t always want to face emotions head on – distracting yourself by thinking about the future is actually a natural and healthy thing to do.

Complete Article HERE!

7 Inspiring Books to Read When You’re Grieving

By Kelley O’Brien

Books on Loss and Grief

Grief is one of the most human of all emotions. At some point in our lives, it is something we all go through, probably multiple times, and it is never easy. This list of books to read when you are grieving won’t cure you of your grief, but it can help you make sense of it. Some of the books on this list will help help you through the beginning stages of grief, while others will help you make sense of some of the things you are feeling. There is a daily mediation on the list and many different perspectives on grief that are sure to be help you cope through such a difficult journey.

1. Grieving: A Beginner’s Guide

Jerusha Hull McCormack’s Grieving: A Beginner’s Guide is exactly what it sounds like – a good book to read when you are experiencing grief and loss for the first time.

2. It’s OK That You’re Not OK: Meeting Grief and Loss in a Culture That Doesn’t Understand

We live in a society that isn’t comfortable with grief and grieving and Megan Devine’s It’s OK That You’re Not OK is the antidote you need when you’re grieving and the world doesn’t understand. According to Devine, “Grief is simply love in its most wild and painful form. It is a natural and sane response to loss.”

3. Modern Loss: Candid Conversation About Grief. Beginners Welcome.

Rebecca Soffer and Gabrielle Birkner, the founders of the Modern Loss website, bring us this honest take book on grief, letting us know that it’s okay for grief to be messy, complicated, sad, and complicated.

4. Healing After Loss: Daily Meditations For Working Through Grief

Now considered a classic, Martha Whitmore Hickman’s Healing After Loss is a daily meditation that you work through a little bit at a time. It’s an on going recovery book and something to keep with you as you journey through the grieving process.

5. Bearing the Unbearable: Love, Loss, and the Heartbreaking Path of Grief

Joanne Cacciatore’s Bearing the Unbearable is a 52 chapter that “opens a space to process, integrate, and deeply honor our grief.” A bereavement educator, Cacciatore creates a book that is perfect for those grieving, therapists, and anyone else.

6. Tiny Beautiful Things: Advice on Love and Life from Dear Sugar

Known for her memoir Wild, Cheryl Strayed, who experienced the loss of her mother and her marriage, brings forth a lot of advice on grief in Tiny Beautiful Things.

7. Anxiety: The Missing Stage of Grief: A Revolutionary Approach to Understanding and Healing the Impact of Loss

Only a few months old, this new book takes a different approach and delves into an often overlooked aspect of grief: anxiety. Packed with advice on how to cope and strategies to get you through grief.

Complete Article HERE!

Not a season to be jolly:

how to deal with dying during the holidays

By

Dying doesn’t disappear at Christmas. For those who know death will come soon but don’t know exactly when, the festive season, when the air is thick with “joy”, can be particularly unsettling.

As a psychotherapist working in palliative care, I often see distressed patients in the lead up to Christmas. Patients can find decorations and carols being played in shopping centres particularly triggering, reminding them this may be their last Christmas.

The dying person may often face an inner struggle. They may want to be involved in activities but may not have the physical and emotional capacity to deal with the heightened stress and stimulation. Some may prefer to sit quietly and watch proceedings without necessarily being amongst the action, but still feeling like they are a part of things.

Regardless of the the type of life-threatening illness, and whether an infant, child, adolescent, young, middle or older aged person is dying, both the patient and their family members may experience deep distress. You may feel the impending death, and your family the anticipated loss. These gloomy or morbid feelings might clash with the celebrations of Christmas.

Whether it’s you or a loved one facing dying at this time of year, there are some practical tips available that draw from a wealth of research and experience.

If you are the one dying

Where possible, plan ahead how you want to spend your Christmas festive period so you don’t place additional pressure on yourself. Think about the most comfortable arrangements for you. Where and with whom do you want to spend Christmas Day? Which is the best time of day for you to manage different activities? Let people close to you know your thoughts.

The process of dying is unique to each individual. It may be quick or slow, spread over weeks or days. Palliative care specialist at Stanford University, Dr James Hallenbeck wrote:

For those who do die gradually, there’s often a final, rapid slide that happens in roughly the last few days of life — a phase known as ‘active dying’. A person may begin to lose their senses and desires. First hunger and then thirst are lost. Speech is lost next, followed by vision. The last senses to go are usually hearing and touch.

We have an ideal perception around death, that a dying person wants to be surrounded by family in their final hours. But some people in the active phase of dying may actually prefer to be alone. And while this may be difficult for family members to hear, you can give yourself permission to ask for whatever you would like.

Studies indicate some dying people may feel they’re a burden to their family. Other people have difficulty saying “no” because they don’t want to disappoint or hurt others, or they may fear conflict. Know your limitations and don’t push beyond these to simply please others.

Many dying people feel they may be a burden to their families.

Have kind consideration for yourself. Remember you are a person before you’re a patient. And remember it’s OK to say “no” and forgo invitations.

If you’re caring for a loved one who is dying

Essential care demands such as helping the person you are caring for to feed, go to the toilet, and clean themselves, will not disappear at Christmas. If your loved one is dying at home, they may require unrelenting attention.

Be realistic with your expectations. This can be a different and simpler Christmas than others. Allow for spontaneity. Try not to be a martyr and delegate and ask others to help. Doing so enables others to feel they’re included and contributing in special ways.

Listen to the person who is dying. Let them speak if and when they can. Gauge their mood and be guided by them. There is value in being present with the dying person without talking.

Heightened noise and activity, which often go hand in hand with the holiday season, can create distress for a terminally ill person. Ask family and friends to roster their visits over the different days of Christmas so as not to tire, overwhelm or stress the dying person.

People can think children don’t understand death and wouldn’t be able to cope with the concept, so often they may protect them by hiding it. But children are attuned to the family emotional dynamics. They know something is happening and they need their feelings validated. It can be helpful to get children involved in taking care of someone who is dying.

Research shows children do manage themselves well in the face of dying, when adults support them to deal with their responses.

Expect things can change quite suddenly. Have a backup plan ready. Keep emergency contact details readily on hand always.

When dying is happening at Christmas, it’s best to allow all feelings to be expressed rather than simply putting on a brave or smiling face. Feelings are a natural response to suffering and what may be a stressful situation.

It’s mostly important to remember not to hide your needs and feelings but to speak and communicate with your loved ones. Especially when dying may be imminent.

Complete Article HERE!

When the family pet dies, children deserve the chance to grieve

If you think telling your child Fido, Fluffy or Feathers has “gone to live on a farm” is a good strategy when the family pet dies, think again.

Involving your children in your pet’s death helps them grieve.

By Kellie Scott

You’re likely missing an opportunity to help them grieve and learn about death, no matter their age, according to the experts.

But what you tell them and how involved they should be is dependent on developmental stage and personality.

Being prepared is an essential part of helping your child through the pet grieving process.

We spoke to a child psychologist, vet and mum-of-two who experienced the loss of a family pet for advice.

Why lying about a pet’s death won’t help

“Pet death is a very big opportunity to learn how to talk about death and how to cope with future death, like extended family, for example,” says Elizabeth Seeley-Wait, clinical psychologist and principal of a children’s psychology clinic.

Children who ask the most questions are usually worriers.

Dr Seeley-Wait says the modelling a parent shows around processing and coping with the death will go “a long way for their children”.

“Everyone is different in their coping style, but what parents at least want is to be honest about what is going on, and as open as they can be in the process of feeling sad and going through those emotions over time.”

After all, she says, children will often catch you in a lie.

“And if not, they will figure it out later and feel pretty uncomfortable with that.”

What to do when your pet dies

Whether your pet dies naturally, in an accident or is euthanased, kids will have questions.

How you answer those questions will depend on their developmental stage and personality, says Dr Seeley-Wait.

“The younger the child, the more simple terms you should use, and you probably want to be more general,” she says.

When children reach the pre-teen and teenage years, naturally they are going to want more information, warns Dr Seeley-Wait.

“Parents should use their best instincts on that, because they will have a sense of whether their child can handle details.”

She says the children that ask a lot of questions tend to be worriers.

“Kids ask a lot of questions, but they also ask questions they can’t handle the answers to.”

What should be consistent through all the ages, she says, is children being involved in some way to grieve properly.

When Kasey Drayton decided to put down her 16-year-old dog Max, her daughter and son, aged nine and 11 at the time, knew it was coming.

“He had been sick for some time, so we were hoping he would pass away naturally, but that didn’t happen,” she says.

“We explained he was possibly in pain, and it was the kindest thing to do.

“There was a bit of resistance in that they didn’t want to lose him, but once they understood it was better for him, they were fine.”

How to decide if your child should attend the pet’s euthanasia

The younger they are, the less they need to see, recommends Dr Seeley-Wait.

“To be honest, there would be some teenagers who don’t really need to see that.”

Sydney vet Sandra Nguyen says in her observations, including children in the euthanasia can help them process the death.

Being prepared is an essential part of helping your child through the pet grieving process.

“I feel it’s hard for a kid to understand that their pet has gone to the hospital and won’t come back,” she says.

“I’m relatively comfortable for kids to be there if we are putting the pet down — not all vets are the same.”

Kasey included her children in Max’s passing, something she says was a beautiful experience.

“On the day, we explained the vet will come here and it will be quite quick,” she says.

“We all took turns in holding him and saying goodbye. Tears were flowing.

When children are present for a euthanasia, Dr Nguyen keeps her language around the process as simple as possible.

She explains the euthanasia process as an injection that is an overdose of anaesthetic.

“I do tend to use pretty frank language, but I soften my voice,” she says.

“A friend of mine who is a childcare worker said not to say ‘put to sleep’ as kids can then associate sleep with dying.”

Dr Nguyen also prepares parents for how children might react.

“I’ve seen kids absolutely sobbing … but as they are leaving the pet hospital they will turn to Mum and Dad and ask for a new puppy,” she says.

“The parent can get quite upset that the child doesn’t seem to be mourning the loss.”

But ultimately, Dr Nguyen says having your child attend a euthanasia is a case-by-case situation.

“Some parents don’t want their kids’ last memories to be of the pet dying, and that is the same with adults — some people decide not to be there for the euthanasia themselves.”

How to deal with the aftermath of a pet dying

No-one grieves the same way, explains Dr Seeley.

In Kasey’s experience, her two children dealt with Max’s death differently.

“My daughter put a little shrine up in the bedroom and kept his collar and his old dog toy,” she says.

“She still refers to him and keeps his spirit alive, and that was her way of grieving.

“My son grieved quite differently. They both felt it acutely, but very different.”

Rituals like burying the pet or planting a tree are worth making time for, Dr Seeley-Wait says.

“Do something that commemorates the life of the pet,” she says.

Max has a headstone in the backyard of Kasey’s property.

“Those moments are pretty special and memorable. And at least really model to the child that you should take a moment out of your busy lives to commemorate the passing of someone important.

“Talk, remember their pet, share stories, and let them feel a part of the process of the ritual of letting a loved one go.”

In Kasey’s home, Max lives on.

His body was cremated, and his ashes are in an urn in the backyard with a plaque.

“We still very much talk about him. That sort of helps.”

Complete Article HERE!