On Nov. 19, 2003, Dianne Herivel's beloved 50-year-old husband Dave died of cancer. Despite Herivel's best efforts, the youngest of her three daughters, Rebecca, who was 11 at the time of her father's death, often felt left out of the loop.
To Rebecca, it seemed that her mother did not give her enough specific information about her father's illness and death. And in the end, she regrets that she did not have the opportunity to say goodbye to her father one last time before he passed away. Dianne says she got caught up in the painful process of her husband's dying, and she "thought everything was OK" with Rebecca.
Trying to cope with a terminal illness of a close loved one is already very challenging. When you also have to help a child say goodbye, the process can feel overwhelming. Fortunately, for families with children facing the death of a parent, grandparent, sibling or friend, the Puget Sound region is full of resources to help them through the difficult days ahead.
Mary Hejnal is the Bereavement Specialist at Evergreen Hospice in Kirkland, where she manages the Children's Bereavement Program. They offer a seven-week support group for children ages 6-12 who have experienced the death of a parent or significant caregiver in their life.
Hejnal says that children coping with a loved one's death typically grieve through their behaviors, and it is not unusual for normally well-behaved children to act out, or for outgoing children to get quiet and or overcompensate by trying to be perfect after a loved one has died. It is essential that grieving children "feel safe in their worlds," she says, adding that it helps to maintain a structured routine and provide appropriate information and choices.
For example, she believes that children should be given a choice of whether or not they want to visit a dying loved one, and if children choose they can make a drawing or write a letter instead to be posted by their loved one's bed. If the child does choose to go, he or she should be prepared. Hejnal says parents should specifically describe what the child will see, such as "Grandma will have tubes in her arms and she'll look like she is sleeping."
Cynthia Robson is a medical social worker with Providence's hospice program in Seattle. She agrees with Hejnal that it is very important for parents to be specific when discussing a loved one's terminal illness and possible death. "Truthfulness and accuracy are imperative," she says.
Robson recommends that parents give the illness a name, instead of saying "Grandpa is sick," for example, which may cause children anxiety next time they have a cold or flu. Let children know they did not cause the illness and there is no way they can catch it, and also discuss the finality of death. Don't say, "Grandma is going to sleep," as the child may not want to go to sleep himself after grandma dies.
While this process can be extremely difficult, Robson acknowledges, she also points out that "life has many painful things in store for our kids." When the death of a loved one is handled well by parents, she adds, children have the potential to be more compassionate.
Robson recommends that parents connect with a group just for grieving children or with one of several grief camps offered for children in the area, such as Camp Erin. Camps can provide "a supportive environment where being a grieving kid is normal," she says.
Perhaps the most difficult situation to imagine is being a terminally ill parent of a young child. Danah Peace, a hospice social worker at Providence, says the first step for parents who are terminally ill is to identify the support network for their child.
"Kids want to know 'what's going to happen to me?'" Peace says. Providing opportunities for the child to make choices and participate in the process will help them retain a sense of control, she says. Also make sure the child's school is aware of the situation. "Most schools want to help but can't unless they know what's going on," she adds.
And when it is a child's sibling who is terminally ill, Peace says, it is important to acknowledge that "almost all the family's energy is directed to the sick family member" and children may feel at first jealous, then guilty. Finding a friend or family member who can focus on the surviving child can be helpful.
Dianne Herivel and her daughter have learned many lessons since Dave Herivel's death. Dianne says that she and Rebecca understand now that they "don't grieve on the same time line" over the father's death. Rebecca has participated in a grieving group for kids. She and Dianne have developed key words for times when each is missing Dave, such as "I need space" and "please come now, I'm having some sad feelings."
Rebecca gazes with pride at her mother when she reveals that their experience has had a profound impact on her: Dianne now plans to go back to school and work with grieving families herself in the future.
Kathleen Miller is a Samammish-based freelance writer and mother of two.
Resources for grieving kids
Your local hospice organization is an excellent resource for connecting to counselors, groups and camps for grieving kids.
- Hospice of Seattle, part of the Providence Health System, offers Safe Crossings, a specialized program for children who are facing the death of a loved one. For information, call 206-320-4000.
- Camp Erin is a bereavement camp for children ages 6-17, held in September at Camp Killoqua near Stanwood. The camp, sponsored by the Moyer Foundation, is free but registration is required. Call 425-261-4798.
- On the Eastside, Kirkland's Evergreen Hospital offers grief support, including groups designed to support parents and young children. Evergreen's next seven-week session support group for grieving parents and 6- to 12-year-olds will be held April 5- May 17 and again in September. For more information, call 425 899-1077.
For children ages 6-10
- What About Me? When Brothers and Sisters Get Sick, by Allan Peterkin, MD
- When Dinosaurs Die: A Guide to Understanding Death, by Laurie Krasny Brown
- The Saddest Time, by Norma Simon
For children ages 10 and older
- The Next Place, by Warren Hanson
- A Tiny Boat at Sea: How to Help Children Who Have a Parent Diagnosed with Cancer, by Izetta Smith. This book is highly recommended by local grief counselors and can be purchased through the Dougy Center (see below).
- The Portland-based Dougy Center provides many resources online. Choose "Center Locator" and type in your ZIP code to find a program for grieving children near you.
Originally published in the March, 2005 print edition of ParentMap.