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Title: Children s Grief Training Author: Bethany Gardner Last modified by: testuser Created Date: 1/28/2010 9:52:05 PM Document presentation format – PowerPoint PPT presentation

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Title: Children

Concrete tools for Healthcare Professionals who
provide pre-bereavement support for families with
Heather J Neal BRIDGES A Center for Grieving
Children Mary Bridge Childrens Hospital and
Health Center February 20, 2015
Early Loss Reflection
  • Think of an early loss experience in your own
    life. It may not have been a death.
  • Can you remember feelings associated with the
    loss? What were some of these feelings?
  • Was there someone or something that helped you
    feel supported at the time of the loss?

Types of Incidents
  • New Diagnosis of a serious illness
  • Impending death in a hospital
  • Choosing to go home to die
  • Sudden, traumatic events
  • Removal of life support
  • Other

General Factors
  • Children grieve as part of a family
  • Children re-grieve
  • Children are often repetitive in their grief
  • Young children are concrete thinkers
  • Children may focus on causation
  • Children may also focus on contagion

Tasks of Grief William Worden
  1. To accept the reality of the loss
  2. To work through the pain of grief
  3. To adjust to an environment in which the deceased
    is missing
  4. To find an enduring connection with the deceased
    in the midst of embarking on a new life

The Six Reconciliation Needs of Mourning
Children Alan D. Wolfelt, PhD
  1. Acknowledge the reality of the death.
  2. Move toward the pain of the loss while being
    nurtured physically, emotionally, and
  3. Convert the relationship with the person who has
    died from one of presence to one of memory.
  4. Develop a new self-identity based on a life
    without the person who died.
  5. Relate the experience of the death to a context
    of meaning.
  6. Experience a continued supportive adult presence
    in future years.

Recommendations for Supporting Children
  1. Process the circumstances or event within the
    context of his/her developmental ability.
  2. Understand the concept of death and grief
  3. Understand feelings and behaviors associated with
    normal grief responses
  4. Identify and practice healthy ways of coping
  5. Honoring the relationship and establishing
    continuing bonds
  6. Identifying and accessing support systems

Childrens Needs
  • Ages 2 4
  • Comfort Reassurance that they will be cared for
  • and that their basic needs will be met
  • Honest information
  • A regular schedule
  • Ages 4 7
  • Clear, honest answers with words they use and
  • Ages 7 11
  • Encourage expression of feelings
  • Offer physical outlets for grief expression
  • Be available, but also allow alone time
  • Ages 12 18
  • Encourage expression of feelings
  • Listen
  • Be available
  • Dont try to take away their grief

Assessment Considerations
  • What is the patients comfort level with the
    child knowing details about the disease,
    prognosis, etc.?
  • What is the culture in the family regarding
    illness, speaking openly, sharing difficult
    things with children?
  • What is the childs history with death - other
    family members, friends pets?
  • What are the family and childs coping responses
    related to illness, death?

Assessment Considerations
  • What has the child been told about the disease?
  • If the patient is not living in the same home as
    the child, when was the last time the child saw
    the family member?
  • What does the child know about the disease?
  • Has the child attended conferences with the
  • Has the child accompanied the patient to chemo or
    radiation treatments?
  • Has the child visited the patient in the
  • Has the child assisted with any care giving?

When the family doesnt want to share with their
  • Always consider the culture of the family,
    including ethnic and spiritual beliefs and
  • Educate that the child may overhear conversations
    and imagine things that are worse than the truth.
  • Children may also be picking up on the emotional
    atmosphere in the home and the changes in
    lifestyle that have occurred as the family has
    adjusted to the illness.

Frequently Asked Questions
  • Protecting children from painful realities
  • Age consideration Is my child too young to
  • How to initiate conversations about difficult
    topics such as terminal prognosis, impending
    death, or a death which has occurred.

Visiting the hospital and saying goodbye
  • Children should be given choices which include
  • Assurance that there is no right or wrong choice
  • Information about what to expect, using concrete
    medical language
  • Information about life expectancy
  • Information about other opportunities to see
    their loved ones physical body

Primary Components of Communicating Medical
Information to Children
  • Inform the child
  • Allow some choice and control
  • Tell the truth using correct medical language.
  • Answer questions the child has.
  • Reassure the child that their needs will continue
    to be met.
  • Causation and contagion.

  • Additional Questions
  • Discussion