Helping Children (and families) Cope With Death

Dear Family Volley,

I have just been diagnosed with cancer.  It's very treatable with an excellent prognosis, however, my young children will have to see me go through various treatments, be away from me more (I'm a stay at home mom) and have a lot of disruption.  They are 1 and 3.  How much and how should we explain to them what is going on?

 Thanks!

Holly

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Dear Family Volley,

I hate to ask such a “overwhelming” question… but we are dealing with my very sudden and shocking discovery of my husband’s mother with a brain tumor. Her mother (my husband’s grandmother) is still alive – so we thought we would easily have 20+ years with her. His mom is only 72yrs… Better yet maybe my question is How do I support my two young girls and my husband through all of this sadness, stress, and soon to be loss, while trying to deal with it myself? How do we support two very sad girls?

5 years ago I lost my grandmother to a brain tumor as well. So I understand it all. But how do I explain this all to my 2 little girls (7 1/2 and 10). We finally sat them down. They both are incredibly intelligent and I think they understand that this will mean death… but it is affecting them greatly.

We live in FL on the West coast and Grandma San lives in Maine. She was given 2-4 months. She just finished a round of radiation and we just heard that she lost most of her hair. We will be heading up there next Thursday (4/8) until the 20^th. Kind of a way to give all of us – but mostly our daughters some time with her and possibly a goodbye. We have a book. But it’s just not helping. My eldest is definitely stressing and constantly thinking about it. She even started to sleepwalk again due to her worries. Our youngest – well she is aware and we believe she is internalizing it. But not really understanding it all.

So “Grandma San” has not passed away yet… but we know it will happen sooner rather than later. We are all devastated.

I’ve been relying on my parents/wonderful friends to help support me – because it is just too much for my husband – as he is trying so hard to deal with it all himself. I also need someone who is unbiased to help…

Thank you so much. Truly. Any insight would be phenomenal!

Always,

Kymmie 

West coast, Florida

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Dear Holly and Kymmie,

I am so sorry for what you and your families are dealing with. Our thoughts and prayers are with you as you are coping with these challenges.

Every person, every child copes with stress from death and illness differently. When children are very young, you can be more limited with what you tell them. You never want to lie, or deceive. In your case Holly, you are able to talk more about the affects that the treatments will have on you and less on the cancer. Explain that you are sick and that you will be given medicine to get better, but the medicine makes your hair fall out. Assure them it will grow back and that it doesn't hurt. Explain to them what you will do until your hair grows back so they know how you will make things "normal". There is usually not a need to tell them what "could" happen, or how bad it "could" be. 

It is important to recognize how the stress is affecting them. Some children become more violent or disobedient, some become very quiet and withdrawn, there will most likely be some behavioral repercussions because of the stress. Be very patient as these changes manifest themselves. Think about how hard it is to deal with these things as an adult, then think what that must be like to their little bodies and inexperienced brains.

Now... Some general guidelines to help children deal with the stress of death and illness. (These principles can apply to any stress, new sibling, moving, starting school, anything).

• Create a low stress environment: it is important during these trying times to do all you can to keep as much stress out of your home as you can. Little things like getting behind on the laundry, or letting rooms get out of order or cluttered. If emotionally or physically this isn't possible, don't hesitate to ask for help. Even if it is just for a short time. Assess what everyday things bring stress and anxiety into your home and try to safeguard yourself from those things by thinking ahead and being prepared. If there are unnecessary activities in your family's lives, think about eliminating them until things get back to normal. 
• Stick to a schedule: This could be one of the most important things you can do to help children, and your self, deal with stress. Keep things consistent. If you have always had spaghetti on Monday's, keep doing that. If you always go for walks on Sunday's, try to keep going on those walks. Do all you can to keep the everyday normal. When there is a schedule and things are routine, kids know what to expect. They feel safe and secure when their lives are predictable. Don't we all? It is the unknown that makes children scared and uneasy. Try to keep things as normal as you can. 
• Model responsible stress management: I am sure there are days and moments when you don't know how you are going to keep it all together. When you would like to yell and scream and express frustration by throwing something. In front of your children you need to practice responsible stress management. Stay calm, demonstrate thoughtful actions and words. Children will be upset by outbursts, yelling and violence. Children will watch very closely to see how you are handling things. They will mimic a lot of your actions. Understand that these experiences will happen to them again. Your good example now, will teach them how to handle stress as they grow older. Save the the outbursts for the times when you are alone, or with your spouse. Then you can let all of the anger and frustration out.
• Act as a buffer between your children and the stressful event: You are there to protect your child and help them through the coping process. Give them opportunities to talk about their concerns, but don't be pushy or meddlesome. If they feel like crying, let them, if there is anger, let them express it. Give emotional support by activity listening. You can best help by listening without judging, evaluating, or ordering them to feel differently. 
• Teach children to relax: Relaxation can help children deal with stress. Teach them to breath deeply, and help them do some very basic stretches. One of the most successful is the "rubberband stretch". Have the child take slow breaths and stretch their arms straight out to the sides as far as they can, like a rubber band, then bring the rubber bands back to hang limply by their sides. (This also works with children who are angry for whatever reason).
• Teach coping skills: If you find that your children are expressing a lot of anger, help them harness the anger by giving them something constructive and physical (hammering nails in a new bird house, let them punch a punching bag, have them pitch baseballs into a net). If they are sullen and sad, get them involved in a new hobby to help bring a smile to their faces, do something funny, make them laugh. If they don't know how to communicate their feelings, teach them communication skills. 
• Do things together as a family: Do what ever activities you can together. When a loved one is lost we don't really want to get out and do anything. It is necessary to feel the grief and the pain, but research shows that families who loose a loved one, get over the loss faster when they get out and do active things. Take walks, play games, go to the park. Doing things together will help in the healing process.
• Take time to remember your loved one: Help your children do activities that will help them remember their loved one. Put together a scrapbook with pictures and quotes from your children about that loved one. Have your children put something in their rooms that reminds them of the happy memories they have with that person. Teach them a hobby that their loved one did.
• You must grieve also: Take time for your own grieving, so that you are healthy and can help your children. Remember the oxygen mask? It applies here also. Go on dates with your husband, breathe fresh air, keep engaged in your hobbies. Have some quiet time each day to meditate and cope. 

Band together as a family. Be there for one another. Show extra love and extra patience. Strengthen your families through the loss or trial and it will bond you together and bless your relationships. 

Have any of your dealt with death or illness with your children? Any tips you want to add? How did your family cope?

Family Volley