Understanding Grief and Loss in Children Grief and Loss in Children... Part A: Understanding Grief...

download Understanding Grief and Loss in Children Grief and Loss in Children... Part A: Understanding Grief and

of 33

  • date post

    25-Apr-2020
  • Category

    Documents

  • view

    0
  • download

    0

Embed Size (px)

Transcript of Understanding Grief and Loss in Children Grief and Loss in Children... Part A: Understanding Grief...

  • Part A: Section A.2

    1Part A: Understanding Grief and Loss in Children and Their Families

    Understanding Grief and Loss in Children

  • Objectives

    1.1 Describe the overarching process of grief and loss,

    including:

    a. ranges of grief reactions: denial, anger, bargaining, depression,

    acceptance

    b. difference between “normal” and “complicated” grief

    1.2. Explain how the child’s concept of death develops

    from toddlerhood through adolescence

    Part A: Understanding Grief and Loss in Children and Their Families 2

  • Objectives (continued)

    1.3. Demonstrate knowledge of the stages of acquisition of

    information that occur in children with life threatening

    illnesses, including:

    a. What children understand and know as their disease

    progresses.

    b. How to assist children’s understanding in discussions of

    medical information.

    Part A: Understanding Grief and Loss in Children and Their Families 3

  • Term Definitions

    o Grief: a normal process in response to loss

    o Bereavement: the state of having suffered a loss

    o Mourning: the public expression of grief

    o Complicated grief: persistent separation distress lasting

    more than 6 months and interfering with daily functioning

    Part A: Understanding Grief and Loss in Children and Their Families 4

  • Components of Grief

    o Denial: “This isn’t happening.”

    o Anger: “It’s not fair!”

    o Bargaining: “If I just behave better, things will be

    different.”

    o Depression: “Everything sucks, what’s the point?”

    o Acceptance: “I miss Shaggy, but things will be okay.”

    Part A: Understanding Grief and Loss in Children and Their Families 5

  • Part A: Understanding Grief and Loss in Children and Their Families 6

    Activity: Loss Exercise

    Each participant takes 5 pieces of paper and writes down

    something of personal value on each piece. (Can be a

    person, pet, object, skill, opportunity, etc.) Then each

    participant finds a partner. They then each take three pieces

    of paper away from their partner.

  • Expressions of Childhood Grief

    o Sadness

    o Guilt

    o Fear

    o Numbness

    o Withdrawal

    o Disbelief

    Part A: Understanding Grief and Loss in Children and Their Families 7

    o Explosive emotions

    o Regression

    o Acting out behavior

    o "Big Man” or "Big

    Woman" Syndrome

    o Physical symptom

  • Grief in Children

    o How a child experiences grief will depend on their

    developmental stage and personality

    o Context of the relationship is also a key element

    o Other important elements are

    o Nature of the death

    o Prior experiences with death or loss

    o Availability of family/social support

    o Behavior, attitudes and responsiveness of parents and other

    support individuals in their environment

    Part A: Understanding Grief and Loss in Children and Their Families 8

  • Pediatric Bereavement

    o Children have several “tasks” to accomplish during

    bereavement:

    o Accepting the loss

    o Experiencing the pain and other emotions associated with loss

    o Adjusting to a new situation/environment

    o Finding ways to memorialize/remember the individual

    who is gone

    Part A: Understanding Grief and Loss in Children and Their Families 9

  • Complicated Grief

    o Invasive and debilitating grief symptoms lasting more

    than 6-12 months

    o Can include:

    o Yearning for deceased

    o Difficulty accepting death

    o Inability to trust

    o Excessive anger

    o Intense loneliness

    o Frequent pre-occupying thoughts about deceased

    Part A: Understanding Grief and Loss in Children and Their Families 10

  • Complicated Grief Risk Factors

    o Deep attachment to deceased person

    o Child, spouse, parent, sibling

    o Unexpected death

    o Traumatic death

    o Prior experience with traumatic loss

    Part A: Understanding Grief and Loss in Children and Their Families 11

  • Part A: Understanding Grief and Loss in Children and Their Families 12

    Reflection

    PBS “It’s my life” on “Dealing with Death” (6:39)

    http://www.youtube.com/watch?v=WHUewQtLgNs&feature=r

    elated

  • Part A: Understanding Grief and Loss in Children and Their Families 13

    Reflection

    o What grief responses do the children identify in the video?

    o What additional losses to the children identify?

    o What coping mechanisms do the children identify?

  • Changing Face of Death

    Part A: Understanding Grief and Loss in Children and Their Families 14

    Before 1900s

    • Intergenerational family units

    • Limited effective medical interventions

    • Common to experience births and deaths in the home

    20th

    Century

    • Hospitals and medical technology advance

    • Resuscitation (CPR) developed in 1960

    2000s

    • Emphasis on youth and health

    • Death as a medical failure

    • Death occurring in medical facilities > home

  • Adult Understanding of Death

    o Irreversibility

    o Death is permanent.

    o Nonfunctionality

    o All life-defining functions cease at the time of death.

    o Universality

    o All living things die, including self.

    o Causality

    o There are physical reasons someone dies.

    Part A: Understanding Grief and Loss in Children and Their Families 15

  • Understanding of Death

    Part A: Understanding Grief and Loss in Children and Their Families 16

    Age Developmental Stage (Piaget)

    Perception or Concern

    Anticipated Response

    < 2 years Sensorimotor Sense separation and the emotions of others

    Withdrawal Irritability

    2 – 6 years Preoperational Dead = “Not Alive” Death as Temporary

    Wonder about what the dead “do” Magical thinking (I am the cause)

    6 – 10 years Concrete operational

    Morbid interest in death Others die  I die

    Exaggerated behavioral reactions to the idea of death and dead things

    Adolescence Formal operational

    Adult concepts Existential implications

    “But not me” Death as an adversary

  • Part A: Understanding Grief and Loss in Children and Their Families 17

    Reflection

    PBS “Sesame Street” Big Bird learns about death

    (Mr. Hooper dies) (4:33)

    http://www.youtube.com/watch?v=9NjFbz6vGU8&feature=rel

    ated

  • Part A: Understanding Grief and Loss in Children and Their Families 18

    Reflection

    o Where is Big Bird in his developmental understanding

    of death?

    o How do the adults help support his understanding?

    o How could you use this with parents or patients?

  • Part A: Understanding Grief and Loss in Children and Their Families 19

    Reflection

    GENERATIONS; The Final Farewell, in a Child’s Eyes, in

    New York Times October 29, 2006

  • Part A: Understanding Grief and Loss in Children and Their Families 20

    Reflection

    o What are your personal experiences with talking about

    death?

    o What are your personal experiences being told about a

    death?

    o What are your fears around talking about death with

    children?

  • Part A: Understanding Grief and Loss in Children and Their Families 21

    Activity

    Role play explaining the death of a grandparent to a child

    aged 3, 8, and 14 years old.

  • Part A: Understanding Grief and Loss in Children and Their Families 22

    Understanding of Death –

    Impact of Experience

  • Stages in a Sick Child’s Acquisition of

    Information about His/Her Illness

    Stage 1

    o Child’s Information

    o “It” is a serious illness

    o Not all children will know the name of the disease

    o Experience Required for Passage to This Stage

    o Parents informed of the diagnosis

    o Child’s Self-Concept at This Stage

    o I was previously well but now I am seriously ill

    Part A: Understanding Grief and Loss in Children and Their Families 23

  • Stages in a Sick Child’s Acquisition of

    Information about His/Her Illness

    Stage 2

    o Child’s Information

    o The names of the drugs used in treatment, how they are given and

    their side effects

    o Experience Required for Passage to This Stage

    o Parents informed the child is in remission

    o Child is speaking to other children at clinic

    o Child’s Self-Concept at This Stage

    o I am seriously ill but I will get better

    Part A: Understanding Grief and Loss in Children and Their Families 24

  • Stages in a Sick Child’s Acquisition of

    Information about His/Her Illness

    Stage 3

    o Child’s Information

    o Purposes of procedures and treatments; relationship between

    procedures and specific symptoms