Tag: Death And Dying

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This year, Rosh Hashanah is a time of mourning

By Elliot Kukla

Yesterday, the sun did not rise in my Bay Area home. My toddler who usually wakes at dawn, slept until 9am and woke up confused, pointing to a dark umber colored sky, obliterated by clouds of smoke from wildfires billowing all over the West Coast. Even the hummingbirds and bees in my backyard were disoriented.

This fall, we are not approaching an ordinary New Year. I will celebrate Rosh Hashanah in my living room, connected by video conference technology to my community, as California burns, hurricanes threaten the southeast, and the entire country faces a lethal virus. Everything is changing. We can no longer even depend on the sky to be blue.

We have all faced so much loss in the year that passed, but have we taken time to grieve?

Some of the losses of the past year have been obvious and clear: Precious people have died, countless homes and habitats have burnt down, and jobs have been lost. Other losses are more amorphous. We don’t know yet what we will get back of the world of 2019: Will our kids ever get to play freely again? Will we have predictable seasons in the future?

I am a rabbi who offers spiritual care for grieving and dying. I have learned from my clients that grief is essential; without naming the loss we are unable to draw together and comfort each other and we remain isolated in our suffering. There is a cavernous absence of public grieving for the momentous losses we all are facing in 2020.

Just consider the scale of resources given to grieving the 3,000 lives lost in 9/11, versus the 190,000 people (and counting) who have died in the COVID-19 pandemic in this country. Where are the large national memorial services, the plans for monuments, the presidential condolence visits? Much of this disparity is linked to who is dying (at least in the public imagination), and the prevailing belief that “only” old, sick, and disabled people die of COVID-19.

Mourning is humanizing, and its absence cracks open the door to atrocities.

My Jewish ancestors were snatched off the street by SS officers and buried in mass graves; my queer ancestors were denied funerals out of fear and bigotry as they died of AIDS. My disabled ancestors were warehoused in institutions, and often buried without names on their graves. My trans ancestors are left murdered in alleys, their cases growing cold, as I write this.

Despite this lack of official lamentation, they found ways to mourn and be mourned by each other. Grief has always been a way for disenfranchised people to claim our value.

After surviving the Holocaust in Belgium, my great-grandmother Rivka moved to England. Before she died, she took my father out to the coal heap behind their home: “Swear on this mountain,” she said to him, “that you will mourn for me.” To this day, I feel bound by this oath made by my nine-year-old father long before I was born, to grieve for this woman I never met, whose face looks so much like mine.

My friend, Stacey Park Milbern, died on May 19th, 2020, her 33rd birthday. She did not die from COVID-19, but from battling for care in the beleaguered medical system as a disabled activist and a person of color in an era of pandemic. I attended her funeral from my living room. I picked white geraniums and purple thyme from my garden and held my partner close. The internet was flooded with what Stacey taught us.

Disabled activist Alice Wong wrote an obituary on loving Stacey and the radical world of love and care she had built. Wong’s post was filled with Stacey’s own words on her legacy: “I do not know a lot about spirituality or what happens when we die, but my crip queer Korean life makes me believe that our earthly bodyminds is but a fraction, and not considering our ancestors is electing only to see a glimpse of who we are.”

Reading Stacey’s words and Wong’s tribute, I felt my own sense of self-love as a disabled person, restored by mourning for Stacey, at the same time as aching against the unfairness of it all.

Rosh Hashanah is the beginning of the new year, but it is also a time to say good-bye to the year that past. Our ancestors, like us, lived in times of chaos and change. Tears are a central High Holy Day theme. All the traditional Torah and Haftarah readings for Rosh HaShana speak of weeping.

The Shofar itself is a symbol of tears. Our sages teach that the ram’s horn we blow on Rosh Hashanah must be kakuf (bent) to reflect our own bodies bent over in grief; while shevarim (the broken blasts of the shofar) are meant to echo the sound of our own tears, they are always surrounded by tekiah (whole sounds). This teaches us that even though our heart has been broken it has the capacity to be whole again and, in fact, more complete for having encompassed brokenness.

Grief is transformative: When we name the immensity of loss, we also claim the depth of our capacity for love.

Complete Article ↪HERE↩!

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A dad, brother and sister —

Woman who lost three relatives to suicide focuses on helping others with sudden loss

by Alexandra Heck

It’s a level of loss many would struggle to comprehend.

Jane Brown has lost three members of her family to suicide; her father when she was 29, her brother more than 20 years ago, and more recently her sister.

“There are stages in grief,” said Brown, who now offers support for others who have lost loved ones to suicide. “I didn’t always feel how I feel today.”

Brown is part of the Support After Suicide team with a program called Here4Hope, a partnership between the Canadian Mental Health Association of Waterloo Wellington, the County of Wellington and Wellington OPP.

It’s a program to help families, friends, colleagues and caregivers grieving from the often, sudden loss.

“When a community member dies there are so many that can be touched,” said Cecilia Marie Roberts, suicide prevention lead with CMHA Waterloo Wellington.

She says that Here4Hope is the first of its kind, because it pairs bereaved individuals with a police officer who can act as a liaison on the investigation, mental health support, and the guidance of someone who has similar lived experiences.

She said what follows from a suicide is often a traumatic and complex grieving process, and many may be afraid to talk about it or reach for help.

The program is a three-year pilot project funded by the Ministry of the Solicitor General, aiming to stabilize those in initial shock and work with them in the days and months following.

Both Brown and Roberts say that everyone grieves differently, and that with a traumatic event, there really is no correct order or timeline for how someone may work through the stages of loss.

In the early days, the team helps families with many of the practical questions.

The liaison officer can help answer questions about their loved one’s personal effects, the coroner’s timelines, questions about an investigation.

“There’s definitely support for our officers as well,” said Wellington County OPP Detachment Commander Insp. Paul Richardson.

He said that when someone dies in the community outside of hospital, officers are on scene.

They see what has happened. They are often the ones who speak with family.

He said the program gives officers comfort in knowing that there’s support for those that they meet in these situations.

“They have seen first-hand the pain and the anguish families feel,” said Roberts.  

Questions about writing an obituary, funeral arrangements, speaking with the media and explaining the situation to children are all daunting tasks that the team can give gentle guidance on.

During the next six to eight months, their support changes shape.

“That’s when the anniversaries start happening,” said Roberts, explaining that the first Christmas, birthday, back-to-school, have a tremendous effect. “Those first anniversaries can be so painful.”

Roberts says that life is never the same after losing a loved one to suicide. Instead, things shift and change.

“You move on to a new normal,” she said.

Over and over again, Roberts has heard from clients about the importance of having someone to relate to, someone who has faced a similar experience.

“I think the biggest thing that I offer is hope,” Brown said, noting that she never knows how someone is feeling, but can share how she felt when she was faced with similar circumstances.

“I’m not going to judge them,” she said, explaining her role is primarily to listen.

She shares ideas for coping and stresses the importance of having a strong support network.

Brown wants anyone in Wellington County to know that there are resources available if they are grieving the loss of someone to suicide.

“There’s help out there,” she said.

Complete Article ↪HERE↩!

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Learning to talk about death and dying should start early in doctors’ careers

Hilary thinks people can talk about their end of life wishes more easily with someone who is not family

By Junaid Nabi

When I started medical school, I fully expected to learn how the nervous system works, why heart attacks happen and what to do to stop them, and how the immune system sometimes turns against the body and causes autoimmune diseases. One of the things I needed to learn but didn’t was how to talk with people about death and dying.

To fill that gap, I enrolled in a course at Harvard Medical School on communication strategies during end-of-life care. It was designed to help budding physicians understand how spirituality, end-of-life care, and medicine interact. What I learned surprised me.

I found out that I wasn’t alone in feeling that I was ill-prepared for having effective end-of-life conversations. Physicians in general tend to be particularly limited in their ability to discuss issues such as how long patients will survive, what dying is like, or whether spirituality plays a role in their patients’ last moments.

At first glance, physicians’ poor understanding of death and the process of dying is baffling, since they are supposed to be custodians of health across the lifespan. Look deeper, though, and it may reflect less the attitudes of physicians themselves and more the system that nurtures them. After all, we train vigorously on how to delay the onset of death, and are judged on how well we do that, but many of us get little training on how to confront death.

At one of the seminars that are part of the course, a young man was asked about how he felt during the final days of his mother’s struggle with cancer. “Pain is not suffering if it has a meaning; if it doesn’t, pain and suffering are the same thing,” he said.

That juxtaposition of pain and suffering struck me as an important reminder of the vital role physician communication plays from a patient’s point of view. I realized that a transparent communication strategy can ease suffering and make pain more bearable.

In the process of my coursework, I also realized that significant communication barriers exist between physicians and patients to discussing end-of-life care. When physicians aren’t trained about how to approach patients and their families regarding end-of-life decisions, it’s difficult, if not impossible, to provide the care they want and need.

In one survey, nearly half of the medical students and residents who responded reported being underprepared to address patient concerns and fears at the end of life. About the same percentage said that “dying patients were not considered good teaching cases.” In other words, patients on palliative care with no need of further interventions were seen as offering little in the way of imparting clinical knowledge — even though they might have been wonderful cases for learning more about death and dying.

It’s still unclear whether such limitations arise from personal difficulty talking about this sensitive topic, an inadequate medical curriculum, or a lack of training during residency on how to communicate with terminally ill patients.

When a robust rapport between patient and physician is lacking, or when a physician hasn’t taken enough time to lay out all the options, hospitals tend to follow the “standard” protocol: patients — often at the insistence of family members — are connected to several intravenous lines and an intubation tube, or put on life-support machines, all because the patient or the family never had a clear conversation with the medical team about the severity of the disease and its progression.

That’s not how physicians prefer to die. In a famous essay, an experienced physician wrote that most doctors would prefer to die at home, with less aggressive care than most people receive at the ends of their lives. They understand that such efforts are often futile and take away from the precious time that could be spent in the company of family and friends.

Intensive management of patients with poor prognosis can result in severe emotional damage to patients and their family members. They also have significant policy implications: On average, 25 percent of Medicare payments go to patients in the last year of life, with one-third of that spent in the last month, often on clinical services with negligible benefits.

Physicians certainly share some of the blame for these gaps in communication. But we need to be aware of the role health care systems play in shaping end-of-life interactions. Over-treatment is often encouraged, and with little guidance or feedback on how to navigate end-of-life care, physicians can feel vulnerable to malpractice lawsuits. Due to ever-changing regulations, most interns, residents, and attending physicians are forced to spend more and more time typing into their patients’ electronic health records and less time sitting with their patients, talking with them and understanding what they want and need at the ends of their lives. The issue of resource allocation may also play a role. Medical centers often suffer from a shortage of physicians, and struggle to balance comprehensive teaching with quality patient care.

One way of addressing these deficiencies is to incorporate into the medical school curriculum required courses in which students are provided space and time to reflect upon the limitations they face when engaging with patients with terminal diseases. Some schools have already started this process, albeit as elective courses. Senior physicians also need to play more active roles as mentors, guiding younger doctors on how to approach these complicated situations.

In a book written as he was dying from lung cancer, Dr. Paul Kalanithi said this: “Doctors invade the body in every way imaginable. They see people at their most vulnerable, their most sacred, their most private.”

Physicians have a responsibility to initiate and maintain an open channel of communication with each patient, understand and address the values that he or she holds dear, and talk frankly about the prognosis of his or her disease. If they lack the skills to talk openly about dying and death, one of the most sacred and private transitions, they do their patients a disservice and possibly prevent them from receiving the best possible end-of-life care.

Complete Article ↪HERE↩!

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‘Confirmation of Death’©️

Dr Cathy Welch

The argument about who can or should be responsible for confirmation of death has escalated and evolved over the past few years, alongside changing opinions and legislation regarding CPR and end of life care planning, etc.

But the rise of the Covid-19 crisis has taken the issue to another level. And so, the argument rages on about who owns the rights to use the title ‘Confirmation of Death’©️.

Should death be a medical diagnosis? Are nurses capable of diagnosing death?

And now arise the questions ‘does it have to be a healthcare professional?’; ‘does the healthcare professional have to be there in person?’; and ‘can undertakers confirm death?’

The law has not significantly changed – it still remains that any competent person can confirm death. It‘s only by convention that ‘person’ has been historically replaced (to varying extent by postcode lottery) with ‘healthcare professional’.

Unfortunately, Pulse’s article ‘DHSC says GPs can provide ‘remote clinical support’ for death verification’ earlier this year continues to use language that perpetuates the unnecessary dogma that this is ultimately a medical role.

Within Dr David Church’s relatively recent blog ‘The stormy night that shaped my views on death verification’, and the following responses, all I see are attempts to justify the status quo based purely on anecdote and modern medical cultural convention. We all want to believe that the days of healthcare policy being based on anecdote are gone, but in reality this is all based on personal bias, hearsay, and myth.

Let’s stop trying to insist that ‘confirmation of death’ is some kind of healthcare copyright issue

So, in the discussions and comments, out come the historical tales of live burials – should we then advocate having a bell system installed in all graves again, as in the 19th Century? And the hypothermic resurrections from the dead – should then every cold body be warmed up, as in the Resus Council hypothermia guidelines (not dead until warm and dead)? Good luck convincing all the hospitals and mortuaries to warm all bodies to normal temperatures before confirming death – they’d be stinking fly pits!

Yes, errors do happen, but extremely rarely. Healthcare-only verification of death is a modern phenomena, driven by persisting attempts to use medical ‘knowledge’ to run away from the inevitable. It’s time to grow up and stop using rare ‘errors’ in verification to cling to current imperfect, unsustainable and inhumane dogmatic ‘rules’ governing ownership of death. How will western society finally grow some cultural wisdom and accept that death is a normal part of life? That death is not failure, not an error, but is an absolute fact of existence, with a 100% lifetime prevalence?

It won’t, as long as the medical/healthcare world continues to grasp at and peddle the concept that death is a medical diagnosis, and can only be confirmed by someone with a five-year degree and however-many years’ apprenticeship. As long as the Grand Guild of Medical Magicians continues to promote the myths that life and death are under our mysterious control, people will continue to live in the shadows of mortal fear, beholden to us to rescue them, and so keep expressing the very same unrealistic expectations that GP mages complain about every day.

My opinion on confirmation of death… the bodies of those who have died will all be dealt with by either an undertaker (mostly), or a pathology morgue. Undertakers are the experts in management of death – handling, dressing, caring for and disposing of the bodies of the deceased. Surely then, they are best placed to be trained in recognition and confirmation of death in the community, as a standard part of their normal procedures?

Death is not a medical ‘condition’ or ‘diagnosis’ to warrant its control by medical/healthcare workers, any more than birth or taxes. Hand back normality to the people. Then, we may find other unrealistic expectations ‘imposed’ on us from our patients start to dissolve away too, because we‘ve been the ones clinging to their ‘need’ for us all the time.

Let’s stop trying to insist that ‘confirmation of death’ is some kind of healthcare copyright issue.

Complete Article ↪HERE↩!

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Death Doula: We Are Segregated, Even After We Die


Lupe Tejada-Diaz works as a death doula and helps communities of color through the holistic and legal aspects of death.

By Dylan Allswang

In the midst of the coronavirus pandemic, one of the major issues for our country is the disproportionate effect COVID-19 is having on communities of color. Both infection rates and death rates are much higher in these communities than in white communities. 

This is causing an increased need for healthcare, especially hospice care.

We talked to 24-year-old Lupe Tejada-Diaz who works in Washington state as an end-of-life care specialist and a death doula (a non-medical person trained to care for someone holistically at the end of life). She discussed why at such a young age she decided on this career, being an advocate for patients in hospitals especially during the pandemic and undoing the stigma around death as a taboo topic.

This interview was edited for clarity and length.

DYLAN ALLSWANG: Can you describe what the job of being a death doula entails for people who may not be familiar with that?

Lupe Tejada-Diaz: A death doula is somebody who handles the nonmedical aspect of dying. We counsel people through what they want their death to look like. We help them plan and — if they would like — on the day of their death. And after, we help their families deal with all the bureaucratic things that go into it.

DA: Who are some of your usual clients?

LTD: I work specifically with people of color, indigenous people, LGBTQ communities and low-income communities. I do a lot of community education. So I work at senior centers and community areas that ask me to come in and talk about accessible care options.

DA: This is a pretty unique career path. Why did you choose to be a death doula?

LTD: I saw a need in my community that wasn’t being met. In America, death is still really segregated. And a lot of people don’t think about when we [people of color] go into a white-owned funeral home, they don’t know how to do our hair; they don’t know how makeup works on our skin tone.

I wanted people to see that there are different options. Also that you don’t always have to pay hundreds of thousands of dollars to have a good death. When you die in America, you have to kind of undo the life you had. If you have debts, they need to be settled and sorted and your assets have to go through the system called the probate system.

In order to do that, you need to have all kinds of paperwork, different death certificates, different powers of attorney and it’s really difficult for families who are grieving to call 100 different companies and be like, “Oh yeah, so and so died.” So that’s where I come in and help do that kind of tough stuff for them because death in America is unfortunately a super long and arduous legal process.

DA: Communities of color are more likely to distrust medical institutions. How does that play into your line of work?

LTD: So in a lot of the American health care systems, people of color specifically aren’t treated the same way that their white counterparts are. They are kind of brushed aside. Their concerns are not addressed. 

I think that with the coronavirus, now more than ever, we are seeing that people of color are dying at disproportionate rates to white people. And the people working in death are also really tired because even in the middle of a pandemic, we still want to honor this wish that our cultures have.

I think that having someone who speaks the same language or looks like you or from the same kind of background, really helps you feel that sense of security that you normally wouldn’t get in hospitals or clinics. You feel like someone is on your side to kind of help you battle through that. So there’s more trust.

DA: How are you working with clients during the pandemic?

LTD: So we’re doing a lot of virtual communication, Zoom and FaceTime. But I’m also still doing a lot of the legal work I do. But unfortunately, the people that are taken into the hospital, I’m unable to be an advocate for them because it’s kind of out of our hands at this point. People are scared. People are worried that they’re not going to be able to have the traditional funeral burial services that they wanted their whole lives.

Specifically the Indigenous community, we have gone through epidemics and pandemics, not quite to this size, but the kind that wiped out our entire tribe and our entire society. So we have a sense of knowing that it will pass, but there is still that fear. We all just have to do our part to stop the spread and to be mindful of our neighbors as we possibly can be.

DA: Why do you think death is such a taboo topic?

LTD: I think that the main goal for a lot of death doulas is to spread awareness that it’s OK to talk about death. Talking about it isn’t going to bring death. There’s a lot of superstitions along those lines. And I just want everyone to know that it’s not necessarily something scary. It can be something beautiful.

We don’t have to rely on our doctors and hospitals to deal with death if it’s something that we can deal with at home. There’s a place for medicine and there’s a place for home care. And by marrying that together, I think it would really help the landscape of the American mentality for future generations.

Complete Article ↪HERE↩!

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How California doctors are fixing how we die

Doctors change life-ending drugs to ease the final hours

Dr. Lonny Shavelson

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Modern medicine excels in ways to save a beating heart.

Yet hardly anything is known about how to humanely stop one.

Frustrated by the dearth of information about how to aid dying, Berkeley’s Dr. Lonny Shavelson is gathering data to guide other physicians through this new, important and sorrowful clinical frontier. Legalized in 2015, California’s End of Life Option Act allows doctors to prescribe life-ending drugs to terminally ill patients.

“We’re doing a medical procedure. And whatever is done in medicine should be done well, and consistently,” said Shavelson, 68, a UC San Francisco-educated former Emergency Room physician.

“Now we can tell patients: ‘We’re giving you the best protocol we have,’ ” said Shavelson, whose Bay Area End of Life Options medical practice has overseen 232 deaths. “And we’re getting better and better.”

When Californians passed the medical aid-in-dying law – inspired by Oakland’s Brittany Maynard, San Mateo’s Jennifer Glass and others who sought to end their suffering from cancer – voters assumed it promised them a neat Shakespearean-styled ending, like Romeo’s quick poisoning in Verona. That was the goal, but it didn’t always happen.

A little-known secret, not publicized by advocates of aid-in-dying, was that while most deaths were speedy, others were very slow. Some patients lingered for six or nine hours; a few, more than three days. No one knew why, or what needed to change.

“The public thinks that you take a pill and you’re done,” said Dr. Gary Pasternak, chief medical officer of Mission Hospice in San Mateo. “But it’s more complicated than that.”

So Shavelson, in collaboration with Washington-based retired anesthesiologist Dr. Carol Parrot, set out to compile data to help doctors help their patients. At a UC Berkeley-based conference last February, they co-founded the American Clinicians Academy on Medical Aid in Dying. The Academy’s 240 clinicians are now contributing and sharing their own experiences.

Dr. Lonny Shavelson, of Bay Area End of Life Options, looks over data at his home office in Berkeley, Calif., on Tuesday, Feb. 18, 2020. Shavelson is leading a data collection project to learn what medications most quickly and gently bring the person to their requested death under the 2016 End of Life Options Act.

To each deathbed, seated with grieving family members, Shavelson brings a clipboard with drug names and dosage levels.

As minutes tick by, he measures falling oxygen levels, slowing cardiac rhythms and fading respiration. He tracks outcomes while providing care.

The pharmacologic findings, shared with clinicians nationwide, are dramatically reducing the incidence of long, lingering and wrenching deaths.

“It’s really helpful to have someone actually studying the utility of what it is we’re doing,” said Pasternak. “So much of what we’re doing has arisen empirically. He’s collected such great data.”

“Patients want a medication that is effective. They want a swift, peaceful death,” he said.

Using the initial drug regimen in place when the law was passed, 34% of all patients took longer than two hours to die; one man died after 11 hours. A second regimen reduced that to 20%. With the current protocol, fewer than 10% of patients take longer than two hours to die, and most patients die in 1.1 hours, on average.

The protracted deaths didn’t create suffering for patients; they are in a deep coma. But the lengthy vigils can be agonizing for loved ones.

“After two hours, people were starting to get concerned, and restless,” Shavelson said. They wonder what’s happening. People start walking around the room, going into the kitchen. It disrupts the meditative mood. Between two and four hours – that’s not ideal. Anything over four hours we consider to be problematic.”

“I was looking at what was happening and thinking: ‘This isn’t as good as it’s been hyped up to be,’ ” he said.

There’s no repository of information to help doctors in states that have passed aid-in-dying laws, representing 22% of the U.S. population. The U.S. National Institutes of Health won’t fund the research. Medical schools don’t teach it. Hospitals don’t oversee it. Without that official support, medical journals won’t publish any findings.

Traditional medical research is conducted at universities and medical schools, “and they won’t touch the topic,” said Shavelson. “They’ve completely abrogated their responsibility to patients who are dying … bowing out of their traditional role of teaching, research and providing quality care. It’s taboo. There’s still a stigma.”

When aid-in-dying was first passed in Oregon in 1997, patients were given secobarbital, sold under the brand name Seconal. It induces deep sleep, then a coma that is so deep that the brain no longer drives respiration.

But that drug wasn’t consistently quick. Then it became prohibitively expensive, finally unavailable.

To replace Seconal, the doctors invented a three-drug cocktail — a painkiller, sedative and a heart-slowing agent — based on their experiences with overdose deaths. They later added another cardiac drug. But problems remained.

While sitting at the bedsides of several six-hour deaths, Shavelson pondered what was going wrong. He speculated that one cardiac drug was rendered ineffective by the large quantities of the other drugs. So he separated that out and gave it earlier, so it had time to act.

When some delays persisted, he replaced one of the heart-slowing drugs for a heart-damaging drug.

Based on newly compiled data from Academy clinicians, the formula is about to be improved again, pending confirmation of results.

Shavelson and Parrot have identified which patients are more likely to linger, and can recommend adjustments. People with gastrointestinal cancer, for example, don’t absorb the drugs as well. Former opiate users often have resistance to some of the drugs. Young people and athletes tend to have stronger hearts and can survive longer with low respiration rates.

“We’re learning. Hypothesis, data and confirmation. This is what science is,” he said. “Our job is to stop the heart; that’s what they want us to do.

“We haven’t made it less sad. It’s still death. There’s tears and crying,” he said. “But it’s a better ending.”

Complete Article ↪HERE↩!

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Talking to your child about death

You need not worry excessively about what to say. According to one study, children just want to “hear the truth expressed in kind words.”

By

Death is often a sore subject and one that adults like to avoid talking about. But because it is inevitable, at some point we are going to have to talk to our children about it.

Sometimes their own curiosity may force us to broach the subject, like when your six-year-old child innocently asks if you’re going to die someday. What would your response be? Would you try to invent something in order to spare them any worry or would you tell them the truth in a way that they would understand? While most parents find it difficult to talk about death and dying with their children, the best way to go is by telling them the truth in a way they best comprehend.

In fact, children do think about death. Some even play games in which someone pretends to die. Therefore, death should not be considered a taboo subject, and you should welcome any questions your child may have about it. By occasionally talking openly about death, you help your child learn how to cope with the loss of a loved one.

Talking about death will not cause your child to have morbid thoughts. Rather, it will help him or her alleviate their fears. However, you may need to correct some misunderstandings. For example, some experts say that many children under the age of six do not view death as final. In their games, a child will be “dead” one moment and “alive” the next.

When they get a little older, however, children begin to grasp the seriousness of death—a fact that may cause them to have questions, concerns, or even fears, especially if a loved one has died. Therefore, it is vital that you discuss the subject. Several mental-health experts believe that a child will develop anxieties related to death if he or she feels that they are not allowed to talk about this subject at home.

Here are some tips to guide you when the subject pops up:

Take advantage of opportunities to talk about death: If your child sees a dead bird on the side of the road or if a beloved pet dies, use simple questions to encourage him to talk. For example, you could ask: “Does a dead animal suffer? Is it cold or hungry? How do you know that an animal or a person is dead?”

Do not hide the truth: When an acquaintance or a relative has died, avoid using confusing euphemisms such as “He has gone away.” Your child might wrongly conclude that the deceased will soon return home. Instead, use simple and direct words. For example, you might say: “When Grandma died, her body stopped working. We can’t talk to her, but we will never forget her.”

Reassure your child: He or she might think that their actions or thoughts caused someone’s death. Instead of just saying that they are not responsible for what happened, you could ask, “What makes you think that it is your fault?” Listen carefully, without belittling their feelings. Also, since a young child might think that death is contagious, assure them that it is not so.

Draw out your child: Talk freely about loved ones who have died, including relatives whom your child has never met. You might evoke fond memories of an aunt, an uncle, or a grandparent and relate amusing anecdotes. When you openly discuss such people, you help your child understand that they need not avoid talking or thinking about them. At the same time, do not force your child to talk. You can always broach the subject later, when you feel the time is right.

You need not worry excessively about what to say. According to one study, children just want to “hear the truth expressed in kind words.” Be assured that a child will usually not ask a question unless he or she is ready to hear the answer.

Complete Article ↪HERE↩!