When a family member has a long or serious illness, it may disrupt family life. Perhaps Mom goes out every evening to visit her sister in hospital, ending the familiar bedtime routine. Or a sibling with a serious illness consumes more of the parents' time and attention. Or if Dad is troubled about sickness in his family overseas, children notice that he's not as ready to play as usual.
Explaining an illness
Children should be told about illness in a way that they will understand: "Aunt Emma has cancer. That's a disease that makes her very sick and weak." This may be enough for your six-year-old, but an eight-year-old will want to know about how cancer acts on the body, and a twelve-year-old may be interested in the details of chemotherapy. Let them know how it might affect their lives: "I'll go to see her every night to cheer her up, so Daddy will put you to bed." Often a family illness will bring out the child's fears about disease. Reassure him that he cannot catch cancer and that he won't have to go to the hospital just because he's ill with a cold. When a family member has a terminal illness, a child might interpret every upset tummy as a sign that he, too, might be ill.
If the family member faces the probability of death within a short period of time, prepare your children for that probability. Otherwise, when the death occurs, they may feel betrayed, as if everyone but them knew what was going to happen. Don't take away their hope that the loved one will recover, but introduce the idea that death might be the end result: "Grandma is in the hospital. She's had a stroke, and we're worried that she might die. The doctors are doing everything they can."
Set up a support system
When you're caring at home for someone who's ill for a long time, seek out all the help you can to keep family life stable for your children. Enlist school friends and neighbours to take them to school or to their swimming lessons. If you can afford it, hire someone to manage the household so that you can concentrate on the family and your sick spouse or child. The children will feel less lost if they can help in some way. Suggest your six-year-old draw a picture for the sick family member. An older child might help by taking water to Daddy in bed or by reading him part of the paper. Your 11-year-old may be able to help more around the house or walk to the corner store for supplies. If someone in your family is dying, nothing you can do will ease the pain of a terminal illness in a parent or sibling, and you may want to get counselling for your children or yourself.
When a loved one dies
Until recently, it was common to hear that children did not grieve, even over the death of a close family member. Although children may react to a death differently from an adult, they do grieve deeply. What adults may feel as a hollow in the heart may feel like a tummy ache to a grieving child. They may lose appetite, have trouble sleeping, be unable to concentrate in school or revert to earlier behaviours like bedwetting or tantrums. Children cannot concentrate on their grief as adults do. They may seem to bounce back, laughing and wanting to play with friends or return to school right after a death. But they will return to do the work of grieving later -- in some cases years later.
How to tell them
People who work with bereaved children recommend you use the words -- death and died -- rather than euphemisms such as passed on or gone to heaven that might be confusing to children. Try to tailor your message to your child's level of understanding. Sit close beside him and touch him as you speak.
First, give a little warning of what you are about to say: "I have some bad news to tell you." Then, say what has happened: "Grandpa died suddenly last night." Third, give a cause of death: "He had a heart attack. That's when the heart stops beating." This will be enough information for most children, as they try to absorb the news. But leave the door open to all the questions that will arise later in your child's mind. "Do you have any questions about Grandpa?" If you feel you cannot handle these questions, direct your child to someone accessible who can: "I am feeling sad today. You can ask Aunt Bea."
Your most immediate question may be whether to take the children to the funeral home with you or whether they should just attend the service, Your answer will emerge out of your culture and family traditions, but don't exclude your children because you fear that they won't understand or that they will be too upset.
Experts are divided over whether children aged six to 12 should see a dead body. Some say viewing a body is traumatic for a child, others that children will not find it frightening with the right preparation. If you have an open casket and set visiting hours, give your child a choice. Many funeral homes have playrooms where children can stay. You should also ask your child whether she wants to attend the funeral service. Describe for her what will happen and what will be expected of her.
Psychologists who work with bereaved families encourage them to include their children in the activities surrounding visits to the funeral home and in the funeral service so that they will witness how adults grieve for and honour the dead. Before she makes a choice, let your daughter know what car she will ride in, how the service will be conducted, and who she will sit with. Explain that people cry or react in different, very personal ways, and it's OK either to cry or not.
Take care of your own emotions by accepting some of the many offers of help from your family and friends at this time. Honour your child's wishes to go back to his normal routine if that's reassuring for him. If you're not ready to resume the daily rounds, you might enlist a neighbour to walk him to school.
Families with open patterns of communication seem to deal better with grief. Don't be afraid to let your child see you cry sometimes. Talk about Grandma and your good memories of her. Keep a picture of her in the living room. Don't be surprised if your child asks when Grandma will visit again. He may have absorbed the information that Grandma is dead, but he may not be mature enough to understand that this means the end of his relationship with her.
A child of six may not see death as final and may imagine the dead person living somewhere else. Children aged seven to 10 may realize that the dead person no longer exists in the familiar body, but may continue to converse with the person as if their relationship could continue. They may see the death as final, but may not think it was inevitable; they're more likely to press for reasons why medicine couldn't save the loved one.
Reassure your child
At this age, children may worry about their own death and may need reassurance that Uncle Harry's leukemia cannot spread to them. They may also ask gruesome questions about what happens to the body -- which is normal, so don't interpret the questions as an unhealthy preoccupation with death. The mature 11- or 12-year-old may have an understanding of death and is more likely than a younger child to think deeply about the afterlife.
Children who have experienced the death of someone very close, such as a sibling or parent, may continue to speak to that person in fantasy games, carrying on the relationship years after the death. They continue the work of grieving well into adulthood, with fresh bouts of sorrow as they reach each new stage of maturity.
Unfortunately, parents who have lost a child or a partner may be "absent" emotionally to the rest of their family because of their own grief. If one parent has died, it's difficult to re-establish familiar routines. The family may have to move and accept a reduced lifestyle with less money. Such children may need extra support. Grief counselling may be available through the school, a hospice, your religious organization, and through all mental health facilities. Groups such as Bereaved Families of Ontario also offer bereavement therapy for children.
Excerpted from Raising Great Kids: Ages 6 to 12 by Christine Langlois. Copyright 1999 by Telemedia Communications Inc. Excerpted, with permission by Ballantine Books. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.