Supporting Children and Adolescents When a Dying Family Member Is In a Medical Facility

When you’re faced with telling a child that a member of the family is in the hospital and may die soon, that can be confusing and overwhelming. It is surely not an easy task,  especially when compounded by the likelihood that physical visits may not be possible. Whether this is the case, as is with recent COVID-19 related hospitalizations and deaths, children will need the support of parents and caregivers in order to process the situation. This needed support begins with the information they receive from you.

There are some helpful things to consider before your discussion and information-sharing with your child or teen.

Begin the conversation. Talking with children and teens about this kind of situation is not easy, but there’s the possibility that your child already knows that something is ‘out of the ordinary’. Don’t put off the conversation, hoping for a ‘perfect’ time to talk about what’s going on. There is never a perfect time. It is just important that they are informed and that the best decisions are made about how they wish to be involved in the process.

Use honest, clear and open language. Be honest and give clear and accurate information using words your children can understand. You want to avoid using words like’ not getting better’, ‘won’t be here much longer’ or ‘passing on’. These phrases can be confusing, especially to younger children. It may be difficult to say, but use the word ‘dying’. It helps children understand what is happening. Rather than saying ‘daddy is really sick’, name the illness so children can differentiate between someone getting sick with a cold and sick with COVID-19 or cancer.

If a family member is hospitalized due to an accident or other sudden event, share that in clear and developmentally appropriate language. Young children need concrete, basic information about what they can expect to happen and when. Teens may need and want more details, especially as the family member’s death approaches. Being honest and open models for children that they can talk honestly and trust you to tell them the truth, even when things are hard to talk about.

Acknowledge and normalize their feelings and thoughts. Listen without interrupting or minimizing whatever they think or feel. Let them know that it’s normal to have a lot of different feelings and thoughts when a loved one is dying. You can help children and teens learn to express their experiences by naming your own thoughts and emotions.

Model being okay with not knowing. Children and teens will ask questions that you won’t have the answers to. That’s okay. Appreciate their questions and tell them that you don’t know the answers. Then assure them that if you find out more, you will let them know. This teaches them that it’s important to ask questions, even questions that we may not have the answer to.

Just like adults, children benefit from feeling included and being given the opportunity to be involved in decisions. Ask them if they would like to do or say something now that they know. They may want to verbally share their thoughts and feelings with the person who is dying. Others may want to make a card or drawing, write a letter or leave a treasured item with the person[a stuffed animal…]

If the person is unable to have visitors or the child chooses not to visit, there are other ways to communicate. If a family member, social worker or medical professional can be at the bedside, they can read the child’s or teen’s letter, share their picture or facilitate a phone call or video chat. If your child or teen doesn’t know what to say, write or draw, here are some prompts that might get them started:

  • I will not forget….
  • I love you…
  • I’m glad you’ve been my….
  • One thing I’ve learned from you is….
  • I wish….

Remind children that their messages matter. In this time of the COVID-19 global health crisis and physical distancing requirements, families might face the heartbreaking inability to be with the person who is dying. You can acknowledge how painful and unfair that feels and work to create rituals in your own home that help children and teens feel connected while also saying or doing what feels right for them before the person dies, even from afar. Some ideas include:

  • Sharing stories about the person. You can do this with your immediate family or invite others to join via video chat. You may want to record the stories.
  • Preparing a meal together and eat the person’s favorite foods.
  • Creating a playlist of the favorite songs the person likes or just reminds you or other family members of them.
  • Creating a place in your house with pictures and other items connected to the person who is dying. Let the children know that there is a place they can go to think about them or talk to them as if they were there. By all means, allow the children to contribute items, as well.

It’s important for children and teens to have the opportunity to honor the person and to choose if and how they want to engage in activities and conversations with and for the person before
they die. If they choose not to, let children and teens know that this is okay and there will be ways for them to do so in the future, even after the person has died, if they want to participate. Your continuing love and support is what holds most importance in helping children through most life events in healthy ways.

 

Your Children Must Understand 4 Basic Concepts To Experience Grief in Healthy Ways

It is said that: ‘on the day we are born, we begin to die’. Take that as you wish, but death is a tragic event nonetheless.

What do we say to a child when a parent dies? As adult children when a parent passes away, it is life-altering. For growing children, the impact will vary. Grief is what is typically experienced after a loved one dies. Grief is a process, and the grieving process for children must be closely monitored, beginning with that first discussion.

When a parent dies, the surviving parent faces many new responsibilities of caring for the children alone. Coping with your own grief and feelings of loss, you must now help your children do the same in healthy ways.

Because children and teens understand death differently from adults, their reactions may be different. They may say or do things that are puzzling to you. Whatever their reaction, you don’t want to rush them through their grief, or expect adult reactions before they are capable of thinking as adults.

Talking with your children about a death is particularly difficult when you are dealing with your own grief. Children will often ask the same questions as an adult will: “How could something this unfair happen?”

Your love and support are critical at this time. They learn how to deal with grief by watching you. It is important to know that if you are feeling too overwhelmed to speak with your child at this time, have someone else explain it to them and/or help you with the discussion.

When you are ready, you can still have these same conversations with your child. They probably will need to have the discussion more than once, anyway, and it will matter to them because it comes from you.

Everyone must understand four basic concepts of death in order to fully grieve and come to terms with what has happened. This is not to be confused with the six stages of grief. As adults, we struggle with death. Don’t assume what your child already knows based on their age alone. Instead, ask them what they understand about death, and then you’ll know what they need to learn.

  1. Death is irreversible. It isn’t like the cartoons when characters die and then come back. Children who don’t understand this may believe it is temporary. If children don’t understand the permanency of death, they won’t be able to mourn. Mourning is painful and requires people t adjust their connections to the person who has died. The essential first step is that your child understands that death is permanent.
  2. All life functions end at the time of death. Very young children view all things as live, like that mean old rock that ‘tripped’ them. We tend to reinforce this when we say to them that their doll is ‘hungry’ or has to go ‘pee-pee’.Or, we use the expression that the car ‘died’ as an explanation for coming home late.                       Sometimes, we tell children that their loved one will be ‘watching over them’. That is confusing to children who don’t totally understand death. It may be frightening to young children. A child may know that a person can’t move after they die, but think that’s because the coffin is too small. They may know that people can’t see after they have died. Your child might believe that is because it’s dark underground.                                                             When children understand what life functions are, they can also understand they end at death. Only living things have a beating heart or need to breathe or feel pain.
  3.    Everything that is alive eventually dies. Children may believe that nothing ever dies. We often reassure them that we will always be there to take care of them. We tell them not to worry about them dying, wanting to shield them from the grief. Children may think that everyone close to them may leave them and die, too, when someone close to them dies.                        Children struggle to make sense of death. They may assume that a parent has died because of something bad they did or didn’t do or bad thoughts they may have had. This leads to feelings of shame and guilt, and they may not want to talk about death. That would expose their bad feelings, in their mind.                                             When you talk to your children about death, let them know that you are well and are doing everything you can to stay healthy and safe. Tell them that you hope to be around for a long time, until they are adults. This is different from telling children that you or they would never die.
  4. There are physical reasons that people die. This is not to be confused with the cause of death. Children must understand why their loved one has died. If they don’t, they are more likely to come up with explanations that cause guilt or shame.            The overarching goal is to help children  understand what has happened. Offer a brief explanation, using simple and direct language. Take your cues from your children, and allow them to ask for further explanations. You can leave out the graphic details and you should leave them out, especially if the death was violent.

 

 

******Many condolences go out to the family and friends of the globally-beloved Kobe Bryant, a basketball legend, and his lovely daughter, Gianna-both gone too soon.

To the family: Stay strong. You still have a purpose here. God Bless You and God Bless us ALL!

 

How to Best Support Someone Who Is Experiencing a Loss

pexels-photo-951290.jpegLoss is a certainty of life at some point[s] in our lives. It can be experienced through a divorce, life-threatening illness, job retirement, or addiction. Loss is very personally experienced, yet it is a common phenomenon with centrally shared feelings. Support can make the difference in whether we summon the courage to fight our way back into ‘life’.

We may want to reach out and lend a hand in showing our support for those who have experienced a loss. Sometimes, it can be confusing as to the best way to do just that. What do we say, how do we act, how can we help? Well each individual is different and experiences loss differently. Often, loss occurs in stages as does grief-the process of grieving and mourning an absence. We must be mindful that, as we seek the best ways to demonstrate our supportive aim, we can’t actually mourn for someone else’s loss. That’s too personally felt. We simply can’t really grieve for someone else who is impacted by a loss. We can, however, be empathic, sensitive and compassionate to that other person. Exactly how?

There are some general do’s and don’t’s regarding helping people cope with a loss in their lives. Use this to help guide your efforts.

Do

  • Express your condolences. A simple, sincere “I’m so sorry for your loss,” a soft hand on a shoulder or a caring hug are usually perfect.
  • Be present. Stay in touch even when others begin to disappear.
  • Show you genuinely care through kind words and actions. It’s OK to also show that you care with your tears of sorrow.
  • Be a safe harbor for others to express their feelings. Allow them to grieve without fear of being judged, analyzed, fixed, cured, saved or healed.
  • Use your listening skills. Listen patiently, and ask open-ended questions to see how they’re doing, what they need and/or how you can be helpful.
  • Give them multiple options for what you could do to help. By doing so, they’ll know you’re serious. Listen intently, and do what they ask.
  • Give grieving individuals every opportunity to talk about those who have passed. If given the chance, you can also tell stories acknowledging the lives of the people they lost — the special qualities they possessed and their loving relationship with those they left behind.
  • When they bring up the loss, respond in a way that shows them you were listening, and that you genuinely care.
  • Give grieving individuals every opportunity to talk about those who have passed. If given the chance, you can also tell stories acknowledging the lives of the people they lost — the special qualities they possessed and their loving relationship with those they left behind.
  • When they bring up the loss, respond in a way that shows them you were listening, and that you genuinely care.
  • Ask their preferences. Ask them how they would like your support on special dates such as birthdays, “angel-versaries” (days of their passing) or holidays.
  • Show genuine concern, kindness, understanding, patience, empathy and compassion. This is a time to put your ego on the shelf and be of service to others.
  • Stay humble, flexible, relaxed and at ease when you’re with those who are grieving.
  • Assist them in getting the support they need. This may include professional help from grief counselors or coaches — or even psychiatrists, if necessary. Assure them it’s not only OK, it’s smart.
  • Encourage them to ease back in. In the case of grieving colleagues, encourage them to ease their way back into work a few hours at a time until they can handle longer stretches of sustained activity. (Also, tell them that taking a leave of absence is OK and may be necessary. Most companies have bereavement policies that allow time off, and many employers will make special arrangements when asked.) When they are back, support them to set up a “back-up” or “buddy” system in case they have a meltdown or need to step back and take a break.
  • Invite them (without the least bit of pressure) to join you for lunch coffee, or a walk.

 DON’T:

  • Don’t assume you know how they feel or what they want.
  • Don’t put a psychological, religious or spiritual spin on their losses.
  • Don’t use clichés — for example, “The glass is half-full.” Just be positive and supportive.
  • Refrain from anything that might be interpreted as a “Hurry up.” Don’t tell them, “You’ll get over it,” “Time heals all wounds” or “In time, you will have closure” or any similar types of advice.
  • Don’t give unsolicited advice or play “shrink” with them.
  • Don’t compare your loss to theirs.
  • Don’t suggest a quick fix to take away the pain.
  • Don’t take it personally if they’re not responding to you in the way you’d hoped. Remember, it’s not about you!
  • Don’t be insensitive. Don’t allow your own feelings of helplessness, impatience or intolerance of their continuing sorrow to cause you to say something insensitive.
  • Don’t ask how they’re doing or pose any other casual question. Tell them they (and their families) continue to be in your thoughts and prayers.
  • Don’t control the conversation. Let them take the lead on what they wish to talk about; and ask respectful, open-ended questions to draw them out.
  • Don’t avoid, gloss over, act cute, change the subject or pretend that nothing has happened — or if you do, that nothing was said.
  • Don’t smother them with too much caregiving attention. 
  • Don’t ignore your own triggers. Don’t hide, deny, repress, avoid, displace, dumb down or “medicate” the feelings of sorrow, anger, or guilt that may have been triggered by their losses.
  • Don’t make executive decisions about what they need without consulting them. Ask them what they would like to have happen.

 

The biggest don’t of all encompasses all of the other don’ts: DON’T ever say this:  “Just forget about it and move on!”, “That’s life!” or any words to that effect. It may be minimal or insignificant to you, but we can not and should not assume the same for another person. Be sensitive! Be supportive!

School Shootings or School Shootouts: Our Only Choices?

 

anthem

From the ridiculous to the sublime! First thought about having teachers carry weapons, guns, in our public schools, is that the imagery alone conjures up escalated numbers of school shootings, as though that is impossible once someone starts shooting innocent children and educators. School shootings are now becoming shootouts??? Scary thought!

I know, I know! The ‘hot’ topic of the day isn’t global warming, refugees or immigration. It is the most recent school shooting in Florida. Once again 17 lives were interrupted and many more lives are forever impacted. Among those lives lost, will be the lingering memories, and for many, certainly traumatic stress producing. Children, families, teachers, neighbors, friends, and many more people are the collateral damage produced by these horrible occurrences. ACEs don’t fully cover the range of help and support needed in this community, not to mention the families and communities where shootings have taken place before this one.

bored danger
It would seem to me that the bystander effect has taken control for long enough. Is it that everyone is still waiting for the next person to act in the best interest of the children and everyone else who happen to be in close proximity to an active shooter? I do not mean that teachers are standing in fear while awaiting the next teacher to step out of the shadows and kill or critically injure the active shooter. I don’t mean that any staff member must step out from safety and confront the perpetrator of this crime/cry for help, either.
First, could it possibly be that the shooter is making his/her final cry for help, recognition, support, guidance? Is it that, in the end game for this person, that their hope is that they too, are killed and thus their personal pain and suffering ends, along with the others? If you indulge me for a moment, suppose this is true. The latest shooter, as the others, felt unsupported, bullied, unaffirmed, undervalued, etc., for so long that this latest act was a retaliatory one in which it becomes clear that the recognition will be received. People will finally pay attention to them-‘see’ them, and also ‘feel’ the pain he or she felt for a long time.

Do we consider these as possibilities that are taken into account and consideration as we, not only help a community heal and process the tragedy, but as we plan to prevent another to be repeated by a different student in a different school, town, or wherever. What if signs of distress were present for so long, and not one person, even if recognized, said or did anything to help this young person when it wasn’t an unavoidable situation. Actually, it is never unavoidable, but always avoidable. For the individuals who are chronically suffering inside, all it takes is for one person to step up. Ask questions, refer, counsel, follow up- to make a difference between the day before the shooting when no one had a clue, and the day of and after when people’s lives have been uprooted and forever altered.

street fight

There is still an issue and ongoing debate about gun control in this country, and shouldn’t stop until it makes clear sense, the policies we attach surrounding access and to whom we permit that access. Also to be determined, under which clear and without loophole or ambiguity, conditions is usage excusable, allowed, or deemed ‘righteous’ under the law. There remains an issue central to our concerns in order to prevent these events. Seeking solutions that address how we react to these events should first emerge from the mindset in which an ounce of prevention is worth a pound of cure’. We must begin to pay closer attention to youth and their families as well.

Children can’t be expected to learn or thrive in environmental conditions that are stressful, inadequately poised, or which aren’t conducive to classroom learning and achievement. We understand that children have basic needs which must be met. In the immediate, we understand that they have developmental , physical, emotional, psychological needs which must exist on a level by which students may best acquire resilience and access outside supplemental supports regarding those needs. Is that not where schools step in?

With the number of hours children spend away from home, their primary environments, it only makes sense that we charge schools with undertaking the responsibility of advocacy in the absence of parents and caregivers. No, our role is not to parent, but support children and their parents ability to provide and support skills learned in school. We support the education process of children, and learning, not an isolated independent process, is optimized under certain conditions. It is at school that we provide and maintain those conditions-safe, supportive, healthy, challenging, and individually culturally responsive.

girl-stress

We have youth demonstrating a range of emotions and expressing them in extremely insensitive, harmful manners.  In incidents such as Parkland, not only is a statement being made to teachers, but students, parents and all associated with this environment, for it is apparent that there was great disappointment experienced by this youth within this setting. Anger is demonstrated against students, because not one supported, acknowledged or stood up for the student, and everyone else, whose job it was to provide those tools and skills that are critical to their healthy development. They, youth engaging in these acts, do realize the importance of the school environment, so why aren’t we?

writing
Instead, we limit funding, when education investing produces the best ROI possible. And, we are and should be investing in our future, our children’s future and the future of everyone else’s children. Instead, we limit school facilities, like building space, gymnasiums, playgrounds. These are critical to development. Instead we  mandate parents to send their children to learn in settings that are structurally unsound and unhealthy, e.g., lead running through it’s water supply. Instead of showing a clear commitment to the future of society, and ensuring quality public education and experiences for every child in public education systems, we limit books, guided by a narrow curriculum, materials no longer valuable or relevant to prepare children for their future economic, life and career demands.

We omit cultural competence, social-emotional skills, as an essential component of the general curriculum. We say one thing but demonstrate differently. Children are supposed to learn in environments with access and opportunity more readily available than out in the ‘real’ world. They are supposed to learn with state of the art technology and be fed the most healthful meals. That which children don’t have at home should be supplemented by the school. That demonstrates a commitment to ensuring bright futures for children and ourselves. Even in the best of communities, we still see these disturbing occurrences like school shootings, mass murders, and this must inform us that there is still something very deficient in the school environments themselves.

In that building, a Utopia must exist for children, even though we know that is not representative of the real world. However, in order to ensure that all children have bright futures and are productive members of a better society, they must have access to the very best that is available. If chaos is allowed to exist in schools, then we are preparing them for a chaotic society. We aren’t showing them what they can be, do, and achieve. We still limit access to possibilities, a very important factor of engagement and achievement AND healthy development.

We still teach children the same values taught when the law of the land accepted, recognized, supported and practiced inequality, discrimination, segregation, and separate but equal, knowing that was inherently wrong and an excuse to continue to discriminate and limit life possibilities for children of color, the economically disadvantaged. In relation to this shooting in a school, arming teachers would fail on every count and simply turns active shooters into school shootouts producing unnecessary collateral damage.

Comprehensively, we must train better, teacher more inclusively, and that includes mental health integrated into the curriculum, too. We must increase mental health professionals in every school, even those in the suburbs, because that’s where these events occur-all white communities. The increase of counselors, social workers and school psychologists should be grade-age specific, in the way content areas are taught under the curriculum-scope and sequence. Aren’t your children worth it?

If you believe that my children aren’t worth the added expense or greater investment, remember, we don’t and won’t exist in bubbles. In the future, my child may work for your child, may rob and shoot your child, may rape your daughter[pardon the explicit, but keeping it real as possible, because what we see is very real.]

If education unlocks the doors to a better, more peaceful, tolerant future in a global society, then in order to ensure that every student learner is given all the comprehensive supports needed to be solutions, not problems for society, then we must put our money where our mouths are. If we teach children to be upstanders, compassionate, and life-long learners, we must demonstrate it while offering ample opportunities to practice these principles. We must be compassionate, commit to life-long-learning and show upstander behaviors to others. We will set the climate and reflect a culture in which we affirm and recognize as well as encourage and empathize with others.

There must be a system of practices in place whereby students receive ample supports and opportunities to have access to safe places, staff who are guaranteed to listen and help build coping, resilience, and also advocate in their best interest. In order to do these things, we must advocate in the larger society for our policies to allocate funding in areas which demonstrate our commitment to the future and solutions-before they become problems.
Unfortunately, there will always be an anomaly, a random act of gross unkindness in this world, schools, and such, but being more proactive is a better solution than being reactive and/or by making politically-correct suggestions and gestures. I understand that some people are fearful of a more brown future population, and the loss of implied and inexplicable entitlement and privilege. Some are, at the core, fearful of power, illegally and unethically earned, and they fear losing it to those who legally or ethically earn it through aptitude and opportunity alone. They fear that someone will open a door and provide opportunity and access to someone ‘different’ and that is a real grounded fear, but doesn’t have to be. It speaks to us more than the other persons.
The solutions: I am unable to pinpoint the best, most economically sound decisions to be made that will effectively address the nation’s new fascination with tragedies like Parkland, Florida, but it is very clear that we must reorganize, reframe, reallocate and reenvision school settings and the framework of public education in order that we practice what years of research data has informed us. The ‘whole’ child approach cannot be adopted and fulfilled in schools until we train and staff professionals, multidisciplinary teams, similar to the way we employ pedagogues. The scales are tilted so far that children are failing and falling through the cracks of a system in which they are simply test scores and mere faces.

Proactive and most positive productive efforts to mitigate and interrupt potential incidents at our schools involves arming professionals, complementary to one another, with skills, tools, and sufficient staff to address the needs and strengths of students more individually and comprehensively. Not a new wealth of skills, tools and competencies, but a comprehensive wealth of competencies must be taught in school settings to respectfully, but proactively empower students and their families. We, as educators should look to non-violent evidence-based promising practices which will better enable them to achieve comprehensive wellness and live full lives as productive contributors to a global society.

Last thought to America, with all honesty and much respect, in those school settings when you hear tell of mass shootings as gun related crimes, it’s specifically not in those schools with marginalized populations. Gun related events occur with much less collateral damage in settings with majority ‘of color’ students no matter the economic circumstance. Why? Blacks, poorer groups and Latinx students are far more likely to be frisked, searched, subject to metal detectors at school, arrested and jailed for mere knife possession more often than guns. Legal possession is not the M.O. of this facet of gun-toting America. They are far less likely to be granted a license to legally possess one. Hence, the black market also thrives in the poorer areas. But, where are they getting them from? Unscrupulous white gun shops in different states with less strict regulations.

Certainly, semi-automatic weaponry is not the norm of access either. In viewing the stats, I would say that those opposing gun control should rethink their views on the issue. It is ALWAYS a caucasian kid who commits these deeds against their communities and fellow citizenry. Given this thought, it still does not negate the necessity to teach pro-social skills and social emotional skills in these communities. Trust me, it is definitely needed. However, this topic deserves consideration in more detailed discussion.

Share your thoughts, because I am certain that everyone has a unique view!