discussion on grief and bereavement in young people doug ennals, rsw inctr annual meeting chennai,...
TRANSCRIPT
Discussion on Grief and
Bereavement in young people
Doug Ennals, RSWINCTR Annual Meeting
Chennai, 2005
CHILDREN and LOSSCHILDREN and LOSS
Every deathEvery deathhas a life of its own…has a life of its own…
We enter the conversation with our own knowledge, experiences and beliefs about death, grief and bereavement
Opportunities for reflection, asking questions, exploring, and creating dialogue in everyday practice
Local KnowledgeLocal Knowledge
Language of LossLanguage of Loss
Bereavement – the state of having experienced loss
Grief – subjective, personal feelings and reactions to loss
Mourning – the private and public processes, rituals and practices to loss
Models of GriefModels of Grief
Many western models have attempted to help understand the processes of bereavement
linear
series of stages
tasks to be completed
re-investing of emotional energy
processes of ‘letting go’ of attachment to the deceased
Historical
Models of GriefModels of Grief
Through continued bonds, people find places for the deceased in their ongoing lives
Grief is a condition of the human spirit
Constructing relationships with the deceased
Ongoing construction of self and relations to the world we live in
Emerging Perspectives
Dual Process ModelDual Process Model
LossOriented
Involves the emotional and
reactive processing of the loss
Restoration Oriented
Dealing with the many life changes and new roles that
are brought about by the death
(Reference: Stroebe and Schut, 1999)
Oscillating between these stressors
PerspectivesPerspectivesMultiple, dynamic processes whereby people find meaning in loss
Moving between the grief and day to day life adjustments
Continual process of coping, adapting, building capacity to move forward
Traumatic grief – survival issues take priority over grief
Political, economic, social, cultural, spiritual and other considerations
(Reference: Parkes, Colin M. Mortality: Virtual Themed Issue, 2003)
PerspectivesPerspectives
(Reference: Parkes, Colin M. Mortality: Virtual Themed Issue, 2003)
“…restoring the fit between the world that
is and the world that should be…”
Children and LossChildren and Loss Death touches the lives of children regularly
What may seem normal or abnormal for adults may be quite the opposite for children
Children’s expressions of grief are both similar and different from adults
Adjusting to the reality of illness, death, and loss is complicated by:
- children’s developing conceptual understanding of death and dying
- lack of or distortion of information they receive
Developmental ConsiderationsDevelopmental Considerations
Think in more connected ways
Live in the moment
Magical thinking… Belief that thoughts and behaviors are cause for events
Anxiousness, distress
Repetitive and physical in their grief
Younger Children
Developmental ConsiderationsDevelopmental Considerations
Developing a better understanding of cause and effect
Detect feelings of others
Building capacity for expressive language
May have many questions and a need for detailed information
Children
Developmental ConsiderationsDevelopmental Considerations
Time of dramatic physiological, cognitive, emotional, spiritual, and social change
Increased sense of self
Quest for knowledge, understanding, awareness of place in the world
Search for meaning and purpose
Increased understanding about significance and realities of dying and the death experience
Adolescence
Social and Cultural ConsiderationsSocial and Cultural Considerations
Child-rearing practices
Nature of attachments
How children acquire their understanding of death
Religious and spiritual beliefs about death and bereavement
Age, gender, family position
Influences
Social and Cultural ConsiderationsSocial and Cultural Considerations
Cause and nature of death - stigmatization?
Roles during illness
Previous loss experiences
Rituals attending death, bereavement and mourning practices
Influences rites of passage, and the norms for ‘appropriate’ grief
Influences
PerspectivesPerspectives
Children’s grief experiences are influenced over time, embedded in developmental, social and cultural
contexts in which all experiences exist
Windows to GriefWindows to GriefEntering into the grief journey with children
requires an embracing of their spirits
Magical, curious, unpredictable, observant, perceptive, spontaneous
Live in metaphor
Need spaces to see, experience, accept, reject, and try on feelings and reactions
Loss of one’s right to be born into a safe world that makes sense
Windows to GriefWindows to GriefCompanioning children on their grief journey
means using theory as a framework and your heart as the guide
No formulas
Observant, flexible, patient
Honest
Courage to stay out of the way
Courage to companion
Prepared to be surprised
Windows to Grief Windows to Grief
Children understand more that they are given credit for
Adults are one of the biggest barriers
Grieving children don’t need to be fixed
Expressions of grief take many paths
Children need, want, and deserve honesty truth, and choices
The best gift is the capacity to listen
Into the Circle of CareInto the Circle of Care
What are my beliefs about grief and bereavement?
What are my beliefs about how children should be involved / not involved in end-of-life care conversations?
What does the team need to know from the patient and family?
What are my comfort levels in sharing information and talking with children?
Who on the team could assist in the process?
Ourselves and the team
Into the Circle of CareInto the Circle of Care
What does the child(ren) already know?
What are the cultural, religious and social practices for this family? How has ritual been practiced?
What is the relationship between the child(ren), patient, family and other caregivers?
What would be helpful?
Invite conversation
Family and caregivers
Into the Circle of CareInto the Circle of Care
Preparation
What to expect
Misconceptions
Expressions of emotion
Providing developmentally appropriate information
Asking children what they understand, how they are making sense of what is happening
With children
What is dead?
Who will take
care of me? Who am I now?
Did I cause it?Am I going to die too?
How will I remember?
ReflectionsReflections
All children are different and their view of the world is unique and shaped by different experiences.
When working with a grieving children, we are witness to a profound journey.
Children as experts
ReflectionsReflections
In our everyday practice, how can we support
children as experts and storytellers of their own
knowledge and loss experiences?
Children as experts
Every deathEvery deathhas a life of its own…has a life of its own…
Thank you…Thank you…