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When a Child Dies Shay M. Crenshaw, M.Div., BCC UNC Hospitals

Children's Developmental Stages and Grief Responses. AGE 0-2

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When a Child Dies Shay M. Crenshaw, M.Div., BCC UNC Hospitals

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    1. When a Child Dies… Shay M. Crenshaw, M.Div., BCC UNC Hospitals

    2. Children’s Developmental Stages and Grief Responses AGE 0-2 “Out of Sight, Out of Mind” Peek-a-boo reinforces idea that people exist even if they can’t be seen Concept of death: “All Gone”

    3. AGES 2 – 7 Death is temporary, reversible, a journey, bodily functions continue, like sleep Dead person lives in a box underground or on a cloud Child thinks his/her thoughts could have caused the death People live to be 150 years old Concept of death: Magical Egocentric, Casual

    4. Ages 7 - 12 Curious about birth, death, sex differences Interested in details of death Begin to realize permanence of death– body functions stop Comprehend thoughts of afterlife Accurate estimate of life span Believe very old, or handicapped people die Concept of death: Curious and Realistic

    5. Ages 13 and up Death is seen as a natural process in life Have difficult time with death because of self-absorption Strong sense of denying one’s own mortality More comfortable discussing death with peers than older adults Death caused by old age or serious illness

    6. Sociocultural Influences on Children’s Understanding of Death Socialization Society Culture Resocialization Tactical socialization Family School and Peers Mass Media Religion

    7. Positive Influences of Childhood Fantasy: Ring Around the Rosie Rock-a-Bye Baby Prayers- “Now I lay me Down to Sleep…” Three Little Pigs Little Red Riding Hood Hansel and Gretel

    8. A Mature Concept of Death Universality Irreversibility Nonfunctionality Causality

    9. Explaining Death to a Terminally Ill Child Use language which is understandable, describe which part of the body is affected, what the treatment will be like, goals of the treatment Let the child explain back to you what they have heard, help clarify confusion or misunderstanding Explain what cause the illness, it is not brought about by magical thinking Allow child to express feelings, talk about similar feelings of family members Assure the child that he/she will be cared for and loved

    10. Psychosocial Needs of Ill and Dying Children: Need to feel loved Sense of security Freedom from pain Freedom from deep-seated feelings of anxiety or guilt Sense of belonging Feeling of self-respect and understanding of self

    11. Common Concerns of Dying Children: Fear of Abandonment Family Survival Personal Responsibility Fear of the Unknown

    12. Principals to Consider for Empathic Support of Children Coping with Death Development Life experiences Individual Personality Communication

    13. Four Task Central to Productive Mourning In Children: Understand and make sense out of what is happening or has happened Express emotional and other strong responses to the present or anticipated loss Commemorate the life that has been lost through some formal or informal remembrance Learn how to go on with living and loving

    14. Phases of Adolescence: Early Adolescence—11 to 14 years—decreased identification with parents, increased identification with peers, fascination with hero figures, growing interest in sexuality, Separation (abandonment) vs. Reunion (safety) Middle Adolescence—14 to 17 years– developing autonomy from parents, experimenting with who they are, second chances, second individualization process, reorganization of values of parents, Independence vs. Dependence

    15. Late Adolescence—17 to 21 years—achieving closure in second individualization process, coping successfully with traumatic events, accepting one’s past and freedom for growth and maturity, resolving one’s sexual identity, closeness vs. distance

    16. Adolescents and Loss Grandparents, Parents, Siblings, Neighbors, Teachers, Friends Celebrities, Cultural Heroes, Pets Love relationships, Friendships, Moving, Offspring

    17. Guidelines for Adult Communication with Adolescents about Death: Take lead in open discussion about whatever adolescent wants to discuss Active listening, attention to spoken and unspoken feelings Accept feelings as real, important and normal Use supportive responses Don’t try to solve the problem, assist adolescent in solving problem Provide frequent opportunities to talk

    18. Bibliography Core, C. A., Nabe, C. M.., & Corr. D. M. (2003). Death Dying, Live and Living. Belmont, CA: Wadsworth Despelder, L. A. (2002). The Last Dance. Boston: McGraw Hill. Fitzsimons, Ann, Erica Rothman, and Beth Seyda. When a Child is Dying, The Supportive Care Handbook. Ford & Earl Associates. Troy. 2002. Goldman, L. (1994). Life & Loss A Guide to Help Grieving Children. Levittown, PA: Accelerated Development Inc. Grollman, E. A. edt. (1995). Bereaved Children and Teens. Boston: Beacon Press. Johnson, J. (1999). Keys To Helping Children Deal With Death and Grief. New York: Barron’s Educational Series, Inc. Rothman, Erica, and Beth Seyda. “When A Child Is Dying.” Compassionate Passages. 2002.

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