“ There is always rain around me.” Supporting Children with Seriously Ill Parents
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Transcript of “ There is always rain around me.” Supporting Children with Seriously Ill Parents
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“There is always rain around me.”
Supporting Children with Seriously Ill Parents
Kathleen Brown, NP and Thuy Pham, MD Santa Clara Valley Medical Center
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Anna aged 7 when her dad died
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Mrs. N’s Story
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Does Tommy understand the concepts of death?
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Losing a Parent by Age 15 in USA
Beginning of 20th Century Middle of 20th Century 1998
25%
10%
4%
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Definitions
Grief
Mourning
Bereavement
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Concepts of Death
Irreversibility Finality
Universality Causality
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Factors to Consider…
Developmental level
Cognitive skills
Personality characteristics
Religious and spiritual beliefs
Teaching by parents/significant
others
Media input
Previous experience with death
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Factors to Consider…
Developmental level
Cognitive skills
Personality characteristics
Religious and spiritual beliefs
Teaching by parents/significant
others
Media input
Previous experience with death
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Infants to age 2 years
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0-2yr: Predominant Concepts of Death
None
However…– May sense that something is wrong– Acutely aware of loss and separation– Perceive others emotions, especially significant adults– Sensitive to changes in the schedule
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0-2yr: Interventions
• Provide maximal physical comfort– Familiar persons– Transitional objects (favorite toys)– Consistency
• Use simple physical communication
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True/False: Young children do not grieve.
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>2 to 6 years
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>2-6yr: Predominant Concepts of Death
• Believes death is temporary and reversible (like sleep)
• Does not personalize death
• Believes death can be caused by thoughts
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>2-6yr: Interventions
Minimize separation from parents
Correct perceptions of illness as punishment
Evaluate for sense of guilt
Use precise language (dying, dead)
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True/False: Children need to understand and make sense of their experience in order to help them
learn that dying and death are part of life.
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>6 to 12 years
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>6-12yr: Predominant Concepts of Death
Adult concepts of death
Death can be
personal
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>6-12yr: Interventions
Evaluate child’s fear of abandonment Be truthful Provide concrete
details if requestedMaintain access to
peers
Allow child to participate in
decision making
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True/False: Adults know better whether or not to allow a child to participate in funerals or other post-
death rituals.