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“There is always rain around me.” Supporting Children with Seriously Ill Parents Kathleen Brown, NP and Thuy Pham, MD Santa Clara Valley Medical Center

“ There is always rain around me.” Supporting Children with Seriously Ill Parents

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“ There is always rain around me.” Supporting Children with Seriously Ill Parents. Kathleen Brown, NP and Thuy Pham, MD Santa Clara Valley Medical Center. Anna aged 7 when her dad died. Mrs. N’s Story. Does Tommy understand the concepts of death?. Losing a Parent by Age 15 in USA. - PowerPoint PPT Presentation

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Page 1: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

“There is always rain around me.”

Supporting Children with Seriously Ill Parents

Kathleen Brown, NP and Thuy Pham, MD Santa Clara Valley Medical Center

Page 2: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Anna aged 7 when her dad died

Page 3: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Mrs. N’s Story

Page 4: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Does Tommy understand the concepts of death?

Page 5: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Losing a Parent by Age 15 in USA

Beginning of 20th Century Middle of 20th Century 1998

25%

10%

4%

Page 6: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Definitions

Grief

Mourning

Bereavement

Page 7: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Concepts of Death

Irreversibility Finality

Universality Causality

Page 8: “ There is always rain around me.” Supporting Children with Seriously Ill Parents
Page 9: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Factors to Consider…

Developmental level

Cognitive skills

Personality characteristics

Religious and spiritual beliefs

Teaching by parents/significant

others

Media input

Previous experience with death

Page 10: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Factors to Consider…

Developmental level

Cognitive skills

Personality characteristics

Religious and spiritual beliefs

Teaching by parents/significant

others

Media input

Previous experience with death

Page 11: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

Infants to age 2 years

Page 12: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

0-2yr: Predominant Concepts of Death

None

However…– May sense that something is wrong– Acutely aware of loss and separation– Perceive others emotions, especially significant adults– Sensitive to changes in the schedule

Page 13: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

0-2yr: Interventions

• Provide maximal physical comfort– Familiar persons– Transitional objects (favorite toys)– Consistency

• Use simple physical communication

Page 14: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

True/False: Young children do not grieve.

Page 15: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

>2 to 6 years

Page 16: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

>2-6yr: Predominant Concepts of Death

• Believes death is temporary and reversible (like sleep)

• Does not personalize death

• Believes death can be caused by thoughts

Page 17: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

>2-6yr: Interventions

Minimize separation from parents

Correct perceptions of illness as punishment

Evaluate for sense of guilt

Use precise language (dying, dead)

Page 18: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

True/False: Children need to understand and make sense of their experience in order to help them

learn that dying and death are part of life.

Page 19: “ There is always rain around me.” Supporting Children with Seriously Ill Parents
Page 20: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

>6 to 12 years

Page 21: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

>6-12yr: Predominant Concepts of Death

Adult concepts of death

Death can be

personal

Page 22: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

>6-12yr: Interventions

Evaluate child’s fear of abandonment Be truthful Provide concrete

details if requestedMaintain access to

peers

Allow child to participate in

decision making

Page 23: “ There is always rain around me.” Supporting Children with Seriously Ill Parents

True/False: Adults know better whether or not to allow a child to participate in funerals or other post-

death rituals.