Breaking the news
There is never a good time to tell a child their mum or dad isn’t going to get better.
But as Lisa Barkley, a clinical psychologist at Great Ormond Street Hospital, explains: “Children who are kept in the picture tend to have a more positive recovery.
“It is best to deliver the news slowly and in small chunks. First ask your child questions to find out what they know about the situation already. They may have overheard you talking and already had ‘fantasies’ about what is happening and feel confused or worried.”
Choosing the words
As hard as it may sound you need to use concrete words like ‘death’ and ‘die’.
“Try not to use euphemisms like ‘mummy’s gone to sleep’ because it can confuse a child,” advises Lisa.
“Avoid specifics about how much time their mum and dad has got left,” continues Lisa. “You can’t always predict this and you don’t want to mislead them by getting it wrong.”
Being honest
When faced with a devastated child who needs comfort and reassurance what can you do if there is none to give?
“You need to be honest; don’t tell a child what you think he or she wants to hear,” advises Lisa. “It’s not helpful to say that everything is going to be ok when you know it isn’t.”
The grieving process
“It’s normal for young children to start grieving before their parent dies,” explains Lisa.
Children aren’t ‘mini adults’ and the way that they grieve can be very different from adults, says Lisa.
They might:
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be very matter-of-fact and literal
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withdrawn one minute and having fun the next
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show anger at their parents because their world is changing
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want to comfort their parent at other times
“It’s also common for children to worry that their parent’s illness or death might be their fault. Constant reassurance that it’s not is very important,” adds Lisa.
Security and routine
Children benefit from a sense of security and routine while they’re coming to terms with how their world is changing.
But when a parent is terminally ill it’s inevitable there will be changes. Explain why, and talk to your children about it. Try to keep the routine as consistent as possible from that point on.
Extra support
Extra support from other family members will give you and your partner space and time. It can also become a comforting, familiar presence in your children’s lives.
“For a lot of children this will be the first time they’ve experienced death and they will be looking around them for support. They may not know how to respond but having people around them will help,” assures Lisa.
Outside home, school can be a welcome relief for a child, providing much needed security, routine and a break.
Needless to say, good communication between school and home is essential to ensure everyone is aware of how your child is managing.
Sharing memories
A therapeutic way for children to prepare for their parent’s death is to focus on sharing memories together, and on building new ones for the future.
Many families make memory boxes together or write letters or cards for future milestones in their children’s lives.
“We’ve come to understand that people have ongoing bonds with family and friends long after they’ve died,” explains Lisa. “It’s not always about saying good bye – some people might want to ‘talk’ to their loved one after they’ve died and feel they have an ongoing relationship with them.
“There is no hard and fast rule about what you should be doing,” emphasizes Lisa. “It must be something that you and your family are comfortable with.
Living in the now
If it’s too difficult to think about the future, focus on the present and trying to have fun as a family. Macmillan Cancer Support recommends ‘laughter’ as one of the best medicines.
When Sue Rouse was diagnosed with Melanoma she wanted to share as much quality time as possible with her eight-year-old son, Tim.
“Sue wanted to do all the things that she knew Tim enjoyed, like going to Centre Parks. She loved seeing Tim having fun,” remembers Tim’s dad, John.
At the time Tim didn’t talk much about what was happening. It’s important to respect that a child might feel this way.
“You’ve got to know your own child and how they would like to handle the situation. If they don’t want to talk about it then don’t force it,” adds John.
Helping a poorly parent
As the illness progresses and it becomes harder to be with the children, it doesn’t mean that they should be shut out from their parent’s world.
The Child Bereavement Trust says: “Children’s self-esteem can be helped greatly by being involved and doing practical things for their ill parent, such as fixing their pillows to help make them comfortable or making a card for them.”
Offering choice
“It is important that children are asked what they think or what they would like to do wherever possible,” adds the Child Bereavement Trust.
“Giving children a choice and being involved in their parent’s care – even small things like rubbing in hand cream, massaging their feet or reading to them – can help children feel included and boost their self-esteem.
“Anything that gives the children in the family some control in a world where so much feels out of control will be helpful to them.”
Children will have different fears, different needs and different ways of coping. It’s up to you to work out what’s best for your family and their future – but there is support available, from charities and hospices, if you need some guidance.
What a child needs
Shelley Gilbert, from the Grief Encounter Project, highlights a child’s key needs when preparing for a parent’s death.
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Honest and clear information in age appropriate language, with time to ask and process questions.
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A safe space to be listened to and heard and to share lonely feelings, possibly with a professional.
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Structure: children need extra safety at this difficult time, a sense of normality and continuity.
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A trusted adult: someone appointed by the dying parent, who they know will offer wise counsel in the future.
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Ways to connect with the dead parent, like a bracelet to kiss (Jade Goody’s way of connecting with her sons) or a memory box.
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Memory making: include fun times too.
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Help to make sense of death: time to talk about challenging existential issues.
