A CHILD S JOURNEY THROUGH THE GRIEVING PROCESS

Transcription

1 A CHILD S JOURNEY THROUGH THE GRIEVING PROCESS Presented by Good Shepherd Hospice Bereavement Department Diane McNamara, LCSW-R Carolyn Lisi-Haas, LCSW-R Goals for today Gain a greater understanding of a Child s journey through the grieving process Characteristics of child grief and how it manifests Tasks of grief Normal vs. traumatic grief Best Responses Connections Program 1

2 CHILDREN AND GRIEF STATISTICS 1 in 5 children will experience the death of someone close to them by age 18 (Kenneth Doka, Editor of OMEGA, Journal of Death and Dying) In a poll of 1,000 high school juniors and seniors, 90% indicated that they had experienced the death of a loved one.(nahic.ucsf.edu/downloads/mortality.pdf) One out of every 1,500 secondary school students dies each year (nahic.ucsf.edu/downloads/mortality.pdf) 1 out of every 20 children aged 15 and younger will suffer the loss of one or both parents. These statistics don t count for the number of children who have lost a parental figure, such as a grandparent or other relative who has provided care (Owens, D. Recognizing the Needs of Bereaved Children in Palliative Care Journal of Hospice & Palliative Nursing. 2008;10:1) It is estimated that 73,000 children die every year in the US. Of those children, 83% have surviving siblings. (Torbic, H. Children and Grief: But what about the children? Home Healthcare Nurse. 2011;29(2);67-79) National Alliance for Grieving Children 3 FACTORS THAT AFFECT THE CHARACTERISTICS OF GRIEF Who died Relationship with the person who died Where the grieving child is in his or her life cycle Person s past life experience Death surround Personality of the bereaved Support Religious, personal and cultural beliefs 2

3 DIFFERENCES IN CHILDREN S GRIEF RELATING TO THE NATURE OF THE DEATH ILLNESS ACCIDENT MURDER SUICIDE Drug/Alcohol Factors that increase the risk for depression and substance use: Depression during the first 9 months of loss History of depression Losing a mother Blaming others Low self esteem Negative coping Depression should be treated immediately after the loss to improve outcomes 3

4 PTSD fear is foremost in PTSD PTSD includes sleep disturbance, traumatic grief does not always. Traumatic grief is precursor for the onset of depression and PTSD Hypervigilance- searching, looking for them Preoccupation with the deceased Functional impairment TASKS OF GRIEF To understand that the person is dead Grieving To Commemorate To Go On 8 4

5 GRIEVING CHILDREN DON T NEED TO BE FIXED CHILDREN KNOW AND UNDERSTAND MORE THAN WE GIVE THEM CREDIT FOR 5

6 ADULTS GET IN THE WAY CHARACTERISTICS OF CHILDREN S GRIEF Children grieve in spurts (meltdowns) Children grieve from the specific to the more general Children are physical in their grief Children grieve in the context of their family Children revisit the loss through each developmental stage 1 2 6

7 HOW GRIEF IMPACTS CHILDREN Physical Emotional Cognitive Spiritual 1 3 7

8 GRIEF AND DEVELOPMENT Language Capacity Communication Style Primary Needs Primary Relationships CHILD AND ADOLESCENT GRIEF Awareness of how children and adolescents experience death is essential in helping them cope with their grief The grieving process can be challenging because much of it depends upon developmental stage cognitive and emotional Children grieve in the context of their families very important to know about family dynamics children and teens will cope only as well as the adults around them Moving in and out of grief is natural for younger children, symptoms of grief may come and go, varying in intensity 8

9 PRE SCHOOL AGED (3-5) CHILDREN AGED (6-11) PRE-ADOLESCENT (11-14) ADOLESCENT (14-18) PHYSIOLOGICAL REACTIONS THAT CAN T BE CONTROLLED Grieving adolescents are under more stress than those who have not experienced the death of someone significant. Because stress increases cortisol levels, the grieving adolescent is at a greater risk to develop avoidant coping, psychological distress, and maladaptive grief (Kaplow Et al., 2010, p.237). 9

10 THE ADOLESCENT IS: Striving for greater independence, but is still reliant upon the family and yearning for friends and popularity and has an increased awareness and consideration for social and cultural traditions as well as independence and self reliance. THREADS OF COMMONALITY THAT THE IMPACT OF GRIEF HAS ON ADOLESCENTS: role changes, stress, changes in relationships and social activities, being forced to take on new and unfamiliar responsibilities, changes in life patterns and daily routines as well as profound sadness that can lead to depression, changes in the perception of identify, loneliness and physical health implications. 10

11 BREAKING DOWN THE BARRIERS Acknowledge your own fear of death and the resulting avoidance of uncomfortable realities Understand what grieving children need: what words to use and how to act Realize that it is demanding and difficult to be with a child whose pain we can t fix or take away WHEN TO BE CONCERNED Depression can be a result of complicated or extended grief. It is expected that there will be changes in behavior, however if extreme changes are noted, never hesitate to seek professional consultation

12 GRIEVING CHILDREN WANT YOU TO KNOW Grieving children want to be told the truth Grieving Children want to be reassured that someone will care for them Grieving children want you to know that their grief is long lasting Children often cope with grief through play Grieving children want you to know that they will always miss the person who died Often, grieving children want to share their story and talk about the person who has died Every child grieves differently Grieving children often feel guilty Even thought a grieving child might be acting out, what they are really feeling is intense emotions of grief If you are not sure what a grieving child wants, just ask them!! 2 3 WHEN TO SEEK PROFESSIONAL HELP Child or teen threatens to harm themselves or others Persistent preoccupation with details of the events Constant fear of someone they love getting hurt or dying 12

13 SUPPORTING A GRIEVING CHILD Life will never be the same again- life can be good again Provide a safe and supportive environment Practice supportive unconditional listening Help children find their own ways of expressing themselves Provide opportunities to honor and remember their loved one Empower and reassure Remember holidays and special occasions may be difficult 26 TALKING TO CHILDREN ABOUT DEATH 13

14 LESSONS LEARNED Children are the experts in their own grief Grief is not an illness to be cured Children will sometimes appear as though they are unaffected by loss. This outward behavior can be deceiving. Remember that children grieve differently than adult and can be crying one minute and happily playing the next. -Be open to these changes in feelings and behaviors Duration and intensity of grief will vary from child to child 2 7 REMEMBER Compassion Hugs Honor all feelings Model feelings Listen Be honest Safe supportive environment Assess for traumatic grief and refer for counseling when needed 14

15 WHAT TO SAY WHAT NOT TO SAY 15

16 Good Shepherd Hospice Connections Program Bob Sweeney s Camp Hope Anything that s human in mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting and less scary. The people we trust with that important talk can help us know that we are not alone. ~Fred Rogers 16

17 REFERENCES AND RESOURCE SECTION Doughy Center, The National Center for Grieving Children and Families Cultural Guidelines for Working with Families who have experienced sudden or unexpected death. Terrorism and Disaster Center, University of Missouri National Alliance For Grieving Children