Presentation on theme: "Concrete tools for Healthcare Professionals who provide pre-bereavement support for families with children Heather J Neal BRIDGES: A Center for Grieving."— Presentation transcript:
1Concrete tools for Healthcare Professionals who provide pre-bereavement support for families with childrenHeather J NealBRIDGES: A Center for Grieving ChildrenMary Bridge Children’s Hospital and HealthCenterFebruary 20, 2015
2Early Loss ReflectionThink 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?
3Types of Incidents New Diagnosis of a serious illness Impending death in a hospitalChoosing to go home to dieSudden, traumatic eventsRemoval of life supportOther
4General Factors Children grieve as part of a family Children re-grieve Children are often repetitive in their griefYoung children are concrete thinkersChildren may focus on causationChildren may also focus on contagion
5Tasks of Grief William Worden To accept the reality of the lossTo work through the pain of griefTo adjust to an environment in which the deceased is missingTo find an enduring connection with the deceased in the midst of embarking on a new life
6The Six Reconciliation Needs of Mourning Children Alan D. Wolfelt, PhD Acknowledge the reality of the death.Move toward the pain of the loss while being nurtured physically, emotionally, and spiritually.Convert the relationship with the person who has died from one of presence to one of memory.Develop a new self-identity based on a life without the person who died.Relate the experience of the death to a context of meaning.Experience a continued supportive adult presence in future years.
7Recommendations for Supporting Children Process the circumstances or event within the context of his/her developmental ability.Understand the concept of “death” and “grief”Understand feelings and behaviors associated with normal grief responsesIdentify and practice healthy ways of copingHonoring the relationship and establishing continuing bondsIdentifying and accessing support systems
8Children’s Needs Ages 2 – 4 Comfort; Reassurance that they will be cared forand that their basic needs will be metHonest informationA regular scheduleAges 4 – 7Clear, honest answers with words they use and understand.Ages 7 – 11Encourage expression of feelingsOffer physical outlets for grief expressionBe available, but also allow alone timeAges 12 – 18ListenBe availableDon’t try to take away their grief
9Assessment Considerations What is the patient’s 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 child’s history with death - other family members, friends & pets?What are the family and child’s coping responses related to illness, death?
10Assessment 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 doctor?Has the child accompanied the patient to chemo or radiation treatments?Has the child visited the patient in the hospital?Has the child assisted with any care giving?
11When the family doesn’t want to share with their children… Always consider the culture of the family, including ethnic and spiritual beliefs and practices.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.
12Frequently Asked Questions Protecting children from painful realitiesAge consideration: “Is my child too young to understand?”How to initiate conversations about difficult topics such as terminal prognosis, impending death, or a death which has occurred.
13Visiting the hospital and saying goodbye Children should be given choices which include:Assurance that there is no right or wrong choiceInformation about what to expect, using concrete medical languageInformation about life expectancyInformation about other opportunities to see their loved one’s physical body
14Primary Components of Communicating Medical Information to Children Inform the childAllow some choice and controlTell 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.