Helping Kids Cope with Loss

Because of the generous support of our community, Hospice of Santa Cruz County hosted our first weekend camp for grieving children, Camp Erin© Santa Cruz, last fall. Nestled in the redwood forest at Mount Hermon Redwood Camp, the weekend was filled with both healing and fun activities for the 40 campers in attendance. Campers brought photos of their special person to include on the memory board. They gathered in small groups and, with the support of trained volunteers and staff, discussed their feelings of grief and loss. Interspersed with these healing activities was a lot of fun – ziplining, swimming, art projects and an adventurous ride on the Geronimo Swing.

Bernice’s Story
As we gear up for our 2015 camp, we continue to check in and connect with our camper alumni. Eleven-year-old Bernice attended Camp Erin Santa Cruz County on the recommendation of her school counselor. After her father’s sudden death in an auto accident in 2010, Bernice had suffered from nightmares. Her mother had worried that Bernice had become withdrawn.

“When something happens, you don’t want to just tell everything to people,” explained young Bernice. Sometimes you keep it in and it can be difficult to open up again.” At Camp Erin, Bernice was in the company of 14 other children who had lost their fathers. For many of the children, this was the first time they had met other people their own age who had experienced a similar loss.

Camp Erin has proved to be an important part of Bernice’s healing journey. “It’s amazing because you have all these people there that are in similar situations, and they understand what’s happened,” explained Bernice. “All of the kids supporting each other and getting to know each other and learning how to interact. It’s a really great environment because people respect what you do and don’t want to do,” she added.

Fourteen Big Buddies attended HSCC grief support training and considered their own losses so that they could best support the campers. “It means so much that the volunteers and staff want to help,” shared Bernice’s mother, Yadira. “They are so well prepared and really care … they have such big hearts.”

Today, Bernice still feels the sadness of losing her father, but she doesn’t feel as alone. “I would have never met all these wonderful people, and I would still feel heavy if I didn’t go to camp,” she told us.
“I would have everything jumbled up inside me and I would feel like I should be closed up and not have people see that side of me,” she added. Yadira agrees that HSCC and Camp Erin has made a difference in Bernice’s healing. “It’s a wonderful experience and very helpful for the children and for the parents,” she said.

HSCC’s Camp Erin is free of charge to all children and teenagers ages 6-17, who have experienced the death of someone close to them.  Our next camp is October 9-11 at Mount Hermon Redwood Camp. Applications are now available on our website www.hospicesantacruz.org/camp-erin. Please help spread the word about Camp Erin.

Camp is available to children and teens in Santa Cruz County, the greater Monterey Bay, Silicon Valley and other areas.

The Recipes of Life - A Volunteer's Journey

Volunteer Visitor Denine Jones

Sometimes an experience in life inspires us to change directions.  Denine Jones had one of those experiences toward the end of her father-in-law’s life. While spending time with him in the hospital, she realized her calling – to become a nurse. As she was helping to honor her father-in-law’s end-of-life wishes, it became clearer that her interest was in hospice care. “I just want to support and empower people who are dying and do what I can to improve their quality of life,” explains Denine.

And that’s exactly what Denine is doing. She has been a Volunteer Visitor for three years, in addition to being a nursing student at San Jose State. “It feels good. It feels like I’m doing exactly what I want to do - empowering people to be autonomous and do the things that are important to them.”

Every Saturday Denine spends four hours visiting with Rita. Their time together is well planned – they bake. Before her illness, Rita was a caterer and her favorite thing to do was bake. As her brain cancer has progressed, Rita has lost the use of her left side and can’t see out of her left eye, making it dangerous for her to do her most cherished activity. “Imagine having all that taken away from you,” says Denine. With this volunteer’s support, Rita is back in charge of her kitchen. “Rita supervises me and tells me what to do. And, she loves serving people – it gives her so much satisfaction to give the gift of food,” she adds. Their delicious creations are offered to visitors and friends who stop by to help with odd jobs and chores.

Rita was reluctant to accept a volunteer visitor at first. “I told them I don’t want a Volunteer Visitor who wants to sit all day. I want someone who wants to bake!” She quickly came to cherish her time with Denine and has shared some of her prized recipes with her volunteer. “She is so willing to learn and do. I sit in my wheelchair in my kitchen and I hover over her,” explains Rita. “We usually make two pies so Denine can be part of it. I like to send one home with her.”

Denine has been inspired by her baking afternoons. Back at home, she is now sharing Rita’s recipes with her 15-year-old daughter. “I’m going to get an old fashioned box to put her recipes in.” Denine’s eyes well up as she speaks about her time with Rita. “It’s wonderful to bake with her and bring home these treats to my family – I feel as if I’m sharing Rita’s legacy.” Their time together is also precious to Rita. “I can’t cook and I can’t bake anymore,” she says tearfully. “It makes me feel good that I can get back into it a little bit and at least I can see my baking get done. It makes me feel like a part of things again,” adds Rita.

And so their Saturday baking days continue. “It’s extremely important for me to bake with Rita. She’s still giving and useful. I feel like it’s a gift for both of us,” shares Denine.

What a beautiful gift the recipes of life are.

__________________________________________________________

Hospice of Santa Cruz County is currently looking for friendly, compassionate men and women to volunteer to give support directly to patients and their families in their homes and in Skilled Nursing Facilities and/or Residential Care Facilities throughout Santa Cruz County.

Hospice volunteers are a remarkable and dedicated group of individuals and an essential part of our team. Volunteers are drawn to hospice for different reasons, yet they share a common desire – to be of service and help others at this precious time of life. Hospice of Santa Cruz County volunteers visit patients, support loved ones during their grief, and assist in our office. They also speak about hospice services in the community, and join together to present exciting fundraising events. Volunteers who do massage therapy are especially needed.

Click to visit Hospice of Santa Cruz County Volunteer page for more details.

5 of the Most Important Questions You Should Have the Answer to

The news is inundated with stories of accidents and unexpected illnesses that effect people every day.  Have you ever thought about what would happen if you were suddenly unable to speak for yourself?  The following are five questions you should have the answer to for not only your peace of mind, but for your family’s peace of mind.

1. Who do you want making decisions for you?
2. What kind of decisions would you want them to make?
3. Would you want to be kept alive on life support or would you prefer comfort care only? Or something in between?
4. Are you comfortable leaving your loved ones to try and figure out what you would want?
5. Are you certain if your loved ones aren’t there that your healthcare provider is aware of your wishes?

If you haven’t completed a directive, you’re not alone. According to a study conducted in late 2011 by the California Healthcare Foundation, while 82% of Californians say it’s important to have end of life care wishes in writing, only 23% say they have done so.  An Advance Healthcare Directive is a very simple form that can be completed quickly and it gives you a chance to make your wishes known.  This way your loved ones don’t have to guess about how to handle tough decisions related to your health. You get the peace of mind that they are following your guidance and they don’t have to worry whether they’ve made the right decisions.

We think this is so important that we’re offering free, 30-minute Advance Healthcare Planning Sessions throughout the county in honor of National Healthcare Decisions Day (April 16). Trained counselors can assist you in updating or completing your Advance Healthcare Directive.   We are also offering two Planning Ahead for Peace of Mind forums to provide information that might be helpful as you are planning for your future or the future of your loved ones.

Planning Ahead for Peace of Mind - Free educational forums featuring experts on: 

• Understanding Wills and Trusts
• Completing Advance Healthcare Directives
• Finding and Choosing the Care You Want
• Funeral planning

Planning Ahead Forums 

• 4/13 7:00 pm - 8:30 pm at St. Philip’s Episcopal Church, 5271 Scotts Valley Dr.
• 4/17 10 am – 12:00 pm at Community Foundation, 7807 Soquel Dr., Aptos

Advance Healthcare Directive Workshops 

• 4/13 Advance Healthcare Directive workshop 2-4 pm Dominican Oaks 3400 Paul Sweet Rd. in Santa Cruz near Dominican Hospital
• 4/14 Advance Healthcare Directive workshop 1-3pm Mountain Community Resource Center, 6134 Highway 9 in Felton
• 4/15 Advance Healthcare Directive workshop 1-3pm Arbor Cove at 84 Blackburn St. in Santa Cruz on the Westside
• 4/16 Advance Healthcare Directive workshop 1:30-4pm Scotts Valley Senior Center at 370 Kings Village Rd. in Scotts Valley
• 4/16 Advance Healthcare Directive workshop for Spanish speakers 10am – noon at Hospice of Santa Cruz County’s Center for Compassionate Care located at 65 Nielson St. #121 in Watsonville, on the campus of the Watsonville Community Hospital.
• 4/17 Advance Healthcare Directive workshop 10am - noon Watsonville Community Hospital Senior Circle located at 75 Nielson St. in Watsonville
• 4/18 Advance Healthcare Directive workshop 10am – noon Community Foundation located at 7807 Soquel Dr. in Aptos

Please call ahead to reserve your spot: 831.430.3078. 

Supporting Children When Someone They Love Has a Serious Illness Part 6 - Explaining the Final Stages of Life

Part 6 of our 6 part blog series sharing coping tips to help support children when someone they love has a serious illness. 

Explaining the Final Stages of Life

The final stages of life can be confusing and scary for children if they do not understand the changes they see happening.  Not all terminally ill people will go through these changes, but talking about them ahead of time can help children be prepared.

Loss of Strength
The disease may weaken the body so much that the person will need lots of rest.  At some point, the person may not have the strength to talk.  Explain that he or she is still able to hear their voice and feel their touch.

Loss of Appetite
The person will slowly lose their appetite until they may not eat anything at all.  It is important to tell children that because of the disease, the person does not feel hungry or need food like they did before.

Pain or discomfort
The person may sometimes have pain or other discomforts from their illness.   Let children know that the care team is doing all they can to keep the person comfortable.

Personality changes
Some people may act differently as the disease weakens their body.  They may be more irritable, sad, or quiet.  Let children know that these changes are caused by the disease and not by anything anyone in the family has said or done.

Confusion
Some diseases cause the ill person to be confused as they get closer to the end of life. They may start saying or doing things that don’t make sense.   This can be very frightening for children.  Explain that the disease is causing the confusion and reassure children that nothing they did or said caused it.

Breathing Changes
It is common during the last few days of life for breathing to change.  There may be pauses between breaths or breathing might sound loud and heavy. There may also be a sound like the person needs to clear his or her throat.  Explain that these breathing patterns are like snoring – uncomfortable to listen to, but the person is not feeling any discomfort from them.

Explain to children that the family will not be calling 911 to prevent the death but will be doing everything to help the person stay comfortable.

When Death is Close at Hand

The transition from life to death is often peaceful. Witnessing this can give children a sense of reality and comfort.  If you feel comfortable being with the person as they are getting closer to dying, ask your children if they would like to join you.  The child should decide; never force them to be there against their will.  Assure children that they do not need to feel guilty if they aren’t there at the moment of death.  If you feel uncomfortable having your children present, you may want to tell them about it later instead.

Don’t promise children they can be present at the time of death. Since many people die when everyone is out of the room, being with them is not always an option.  Gifts of words and art are other ways children can say goodbye.

Age-related Responses to Children at the Time of Death

Warm, loving concern should be shown to children of any age when they learn that the person has died.  Let children know they can say goodbye even if they are not in the same room or house with the person who has died.  

3-5 Preschool children will watch the reactions of the people around them. Their own reactions happen later, when they begin to understand that the person is gone from their life.  Once this happens, they may feel sadness and disappointment or have trouble believing that the person is gone.

6-8 There are many different ways children of this age may respond to the death. They might have no response at first, or cry quietly. They may sob or scream, even if they knew that the death was coming. These responses may last a few minutes to about an hour.  After this, most children usually return to what they were doing before the news.

9-11 Children this age often put on a brave face to help them deal with their strong feelings.  They may look like they are not feeling grief, but this is not the case. They sometimes show anger as a way to cover up their fear, anxiety and sadness.

12-18 Adolescents are able to talk about the fact that their loved one has died and show sadness and cry.  They also become anxious as they face the loss and how it will impact their life.

Remember that being patient with your child is the most helpful way you can support them at this difficult time for everyone.

Supporting Children When Someone They Love Has a Serious Illness Part 5 - Guidelines for Teenagers

Part 5 of our 6 part blog series sharing coping tips to help support children when someone they love has a serious illness. 

The Teen Years 

During the teen years, children are finding their own identity and becoming more independent. They need more privacy and often withdraw from family members.  This process of growing up is harder for them when someone in the family is ill.  They try to balance the family’s needs with their own very different needs. 

Teens may show anger as they become more anxious and fearful about the illness. When much of a parent’s time and attention is focused on the sick person, the teen may feel that they are being abandoned and become resentful. 

As the ill person gets closer to dying, teens often are able to talk about it and cry as they express their sadness.  They may also become very anxious and worry about how the death will affect their lives.  Around this time, they may try harder to behave well and do what is asked of them. 

Teens need as much time as possible to prepare for the death. Let them know when death is near so that there is time for them to have a final conversation and say goodbye, if possible.  If they have been angry and resistant, they may become more cooperative when the death is near, but not always. Sometimes they may become even more angry as a way to protect themselves from their sadness. Teens’ hostility and anger before a death may lead to feelings of guilt after the death.

Guidelines for Children 12 – 14 Years Old 

Teens between the ages of 12-14 can understand the illness and how it will effect their lives, yet it may be hard for them to cope with the feelings that come with it. They may not want to talk about it out of fear that they’ll lose control and cry.  They may act “grown up” as a way to ignore their strong feelings. This can make it seem like they don’t care, which can be upsetting to parents, but this is not the case.   

Teens this age can also be very optimistic that the sick person will get well and they may not want to hear otherwise.  They hold on to their positive outlook by avoiding facts and feelings. This is normal for a young teen and should not be discouraged.

Reactions to expect:

• Not wanting to talk about the illness

• Feeling strong emotions but acting or saying that they are “fine” 

• Holding on to the belief that the patient will get better 

• Tending to argue and be more “difficult” or demanding

• Resenting chores and other demands that take them away from school and friends

• Having trouble with school work, or, sometimes, trying very hard to please adults by being extremely good

• Trouble sleeping 

• Anger

• Sadness

How to help:

Talk with them about the disease

Keep them up-to-date with what is really happening, even if they don’t want to hear it.  Don’t assume that they understand as much about what’s going on as they seem to. Let them know when death is near so that there is time for them to have a final conversation and say goodbye, if possible.  

Give them a chance to talk about their feelings and concerns

It is important to talk with your teen about how they are feeling, even if only briefly and even if they don’t really want to talk. Try to be as open and nonjudgmental as possible when they share their feelings. Sharing your feelings and concerns can help them feel more comfortable sharing their own.  This helps them see that the feelings they have are normal and expected. 

You may say, for example:

“You look kinda sad today.  I’m feeling sad about this too.  How are you doing with all of this?”

“Sometimes talking about what’s going on helps.  I’m here to listen any time that you want to talk about any of this.”

It is also normal for grieving teens to have strong and often negative feelings about the person who is sick.  They can feel frustrated and angry about the illness and may direct their anger towards the person.  Often after having or expressing these emotions, teens can feel guilty.  Help them understand that having a wide range of feelings is normal, and help them figure out ways to cope with their strong feelings.

Be understanding of the teen’s reactions

Remember that if your teen pulls away from you, has lots of ups and downs, or is defensive or self-centered, this is all normal given their age. Teens often find writing, quiet time alone, and time with friends helpful as they deal with a difficult situation. 

Be an advocate for your child

If possible, try to limit the teen’s duties and chores at home, since pulling them away from school and friends can cause them to become angry or difficult.  Understand that they may not do as well in classes at this time. Let their teachers know about the illness. Help them connect with any counseling or support groups offered by the school or local hospice.  Often teens don’t want their classmates to know that they are receiving counseling.  Listen to your teen’s concerns, offer options, and help find creative solutions to this issue.

Guidelines for Children Ages 15 – 18

Teens between the ages of 15-18 can usually understand the realities of the illness and deal with their emotions. Yet at times they still may feel overwhelmed.  Though they can generally talk about what they think and feel, their feelings about the illness may not be clear. 

Teens this age tend to be more practical in their thinking than younger teens. They may also be more considerate.  Because they’re more aware of the possibility of death, they may feel more grief during the illness than a younger child might. 

At this age, teens want to be treated like adults and are trying to rely more on their friends than their family for support.  They’re able to be more concerned about the needs of their family members, though they may resent having to do more. 

Expected Reactions:

• Fears about the future

• Irritability

• Having strong feelings like anger and guilt toward the person who is ill

• Trouble concentrating 

• Being torn or frustrated when having to focus on the needs of the family rather than attend activities or socialize with friends

• Feelings of resentment, anger, and defiance.

How to help:

Talk with the teen about the illness and how it will progress 

Include older teens in family discussions about the illness. It’s helpful if the sick person can talk directly to the teen about the illness as soon as possible. Teens this age can understand personal or spiritual thoughts and feelings, including uncertainties and unknowns, so these can be shared with them as well.  Let them know when death is near so that there is time for them to have a final conversation and say goodbye, if possible.   

Expect that the teen will not perform as well during this time 

Keeping up grades, activities and friendships is very important to most teens. However, during a serious illness, it’s normal for them not to do as well in school, sports, etc. This can be hard for teens and parents who believe that grades will affect future opportunities.  However, some teens actually do better at this time as a gift to their ill parent.  Either way, be understanding of what the teen is going through. 

Recognize how the stress caused by the illness can affect them

Teens this age may feel overwhelmed by the stress from the illness on top of the other pressures they feel in life. Talk with them about ways they might reduce the stress in their lives, dealing with the things that are causing them stress one at a time.

Know that they may be worrying about the future 

Talk with older teens about how future plans will be affected by what is happening. Reassure them in a way that is realistic. Provide a listening ear as they share any fears they may have about their future.

Know that teens may be afraid that they too could become ill 

Let older teens talk to medical professionals if possible to allow them to ask questions about the illness-how it is caused and what to expect. Talking with your teen about the actual chances of them getting sick can help them feel less fearful.

Talk with the teen about ways they can be helpful to the family

Giving the teen helpful tasks can sometimes help them feel less anxious.  Look for opportunities for them to help in ways that they enjoy, such as cooking, shopping, or errands. They may also want to spend time with the patient reading, listening to music together, watching a movie, sharing food, or writing a card or letter.

Understand that the challenges of growing up are even more stressful when a parent is seriously ill

The normal process teens go through to become their own person is harder when a parent is seriously ill.  It can be challenging for them to see a parent be needy. It can also be hard for them to deal with a parent wanting to control their activities and comings and goings more at this time. They might react to this with resentment or anger and then later feel guilty about it. 

Be an advocate for your teen

Consider helping your teen join counseling or support groups that may be offered by the school or local hospice.  They benefit from talking with understanding people who are not directly involved.  They may find that friends who are usually supportive “just don’t get it”.  Speak with teachers and coaches about the illness and about ways they might help support the teen. 

Supporting Children When Someone They Love Has a Serious Illness Part 4 - Guidelines for Children 9-11 Years Old

Part 4 of our 6 part blog series sharing coping tips to help support children when someone they love has a serious illness.

Guidelines for Children from 9 – 11 years old

Children ages 9-11 are able to understand more about the illness than younger children and may ask about the details.  Their desire to know these details may make it seem like they don’t have a lot of feelings about what is happening.  Yet getting facts to help them understand what’s going on is one of the ways that they cope with scary and strong feelings.

Children this age understand that death is final and can feel sad about a future loss.  They wonder how they will be impacted by illness and death and who will do the “daddy” or “grandma” things.  When one parent is terminally ill, the child often fears the death of the other parent and worries about what will happen to them if both parents died.  They tend to hide emotions and it’s easy to think the situation is affecting them less than it is.  They may silently wonder, “Can I catch this?” “Did I do or say something to cause this?” Or they may create their own explanations when they are not given facts about what is happening on a regular basis.  Children this age welcome distractions of school, activities and friends.

Behaviors to expect:

• A lot of interest in understanding the disease, treatment and progress
• Wanting to avoid strong or scary emotions
• Not wanting to talk about or show feelings
• Anger (used to cover fear, anxiety and grief)
• Angry and mistrustful reactions when not given the facts about what is happening
• Strong reactions to stress and normal frustrations in every day life 
• Wanting to stay active with schoolwork, sports and outside activities
• Wanting to help care for the ill loved one

How to help:

Talk openly with the child about the disease
Watch for opportunities to talk about the illness and explain what children are seeing and hearing. Include them in discussions and updates. If children are not given enough information they will listen in doorways or strain to hear whispered phone conversations and may jump to false conclusions.

Talk about the name of the disease, how it affects the sick person, causes, and side effects of treatments.  Children also like learning things from doctors and nurses when possible.  You can try to be optimistic about what to expect but not give false hope that the person will heal from the illness.  So, instead of saying, “Grandma is a fighter, and she will be cured,” it would be better to say, “The doctors and nurses are working hard to help Grandma feel as comfortable as possible.  She may be well enough to come to your birthday party this weekend.”

Encourage children’s natural interest in the illness by reading together and providing time to write or draw.

These are some common questions:
How did she get it?
Can I get it?
How do you know I won’t get it?
What if the medicine doesn’t work?
What will happen to me when she dies?

Reassure children the illness is not their fault. Gently let them know when the person may be close to death.  This will help them to make final visits and say goodbye.

Let children know that what they are feeling is normal
Let them know that the situation is hard for everyone and that the family will deal with it together. Remind them often that your moods are not their fault.  Encourage them to express their thoughts and feelings about all the changes that they are seeing in themselves, in you and in the patient.  When it is time, acknowledge sadness about the possibility of death.

Prepare ahead of time for changes in routine 
Children need time to prepare for changes.  Talk with them ahead of time about upcoming changes in their routine as much as is possible.

Offer children ways to be helpful
Some children this age want to help take care of the sick person as a way to show their love and caring.  Let them help by doing simple things but limit their responsibilities so they don’t feel burdened.  Children can help the patient feel loved by drawing pictures, telling the patient they love him or her, talking quietly, sharing favorite memories, etc.

Be an advocate for children
Help the child stay active with after-school activities and by spending time with their friends.  Let teachers and other supportive school staff know about the illness so they can provide support as needed.  It is not uncommon to see a temporary drop in grades due to changes and stress at home. You may want to ask teachers for homework packets if you know children will be absent from school.

Supporting Children When Someone They Love Has a Serious Illness Part 3 - Guidelines for Children 6-8 Years Old

Part 3 of our 6 part blog series sharing coping tips to help support children when someone they love has a serious illness. 

Guidelines for children 6 – 8 years old

Children between the ages of 6-8 will often feel anxious during a serious illness.  They fear being left and can feel they are the cause of family distress. They often blame themselves for bad things happening. Their actions are often tied to what is happening around them.  They may feel rejected when the person who is ill is less able to be part of usual family activities.

Behaviors to expect:

• Showing many different feelings such as anger, anxiety, sadness, fear, and feeling left out or forgotten
• More conflict between siblings
• More acting out or sulking when separated from parents
• Strong requests that their personal activities not be changed and loud protests when activities are changed
• Concern about how the sick person looks and feels. Concern about changes in the person’s ability to talk or do things with them.
• Becoming more clingy, stubborn or demanding

How to help:

Give the child information about the disease

Name the disease and write it down. Talk about how it changes and how the sick person may look or feel over time. Talk about treatments and causes.  Reassure children that nothing they did caused the disease. Let them know that it cannot be caught from the ill person.  Prepare explanations ahead of time, since children this age tend to ask questions that are very exact and they often include a lot of "why" questions.

“The doctors have told me that your grandpa has Parkinson’s disease and is going to die.”

“Parkinson’s changes the way grandpa’s brain works and it makes him shaky and maybe more tired than before.  It’s not like a cold because grandpa can’t give it to you or anyone through his germs.  This disease isn’t because of anything that you did or said. 

“The doctors will work very hard to make sure your grandpa isn’t in pain.  You will probably have questions about this.  Remember I am here to answer any questions that you have and that I love you very much.”

Talk with them about changes in the person’s illness and treatment

Update the child often.  This helps them feel valued and included.  When they feel close to their family members, they are better able to deal with the stress. When possible, let children talk with the doctors, nurses, and social workers caring for the ill person.

Children this age tend not to ask questions. This can be because they fear upsetting their parent or fear that the answers to their questions will be too scary. They may also worry that they will make the illness get worse by talking about it. Try not to let their lack of questions keep you from talking about it.

“The doctor has told me that the medicine hasn’t worked.  This means that the cancer is growing.”

“I’m hoping that something will happen and the cancer will stop growing on its own, but I’ve heard that this probably won’t happen.”

“Remember that this cancer has nothing to do with anything that you did or said.  I don’t know why I got this and I am really mad and sad about it.” 

“Most of all I want you to know that I love you and I want so much to be alive and see you grow.”

Help children understand that what they are feeling is normal

Talk openly about how the situation is hard for everyone.  If the person who is ill acts differently, explain that this is caused by the illness and not by a lack of love or caring.  Understand that children may still be angry about the changes within the family. Even if they’re not told that the person is dying, they will often fear this and may keep that fear inside.  Let them know that it’s okay to show their feelings. Allow them to see your own feelings and tell them that you will still take good care of them even though you are sad or mad or scared.  If children are struggling in school, let them know that this is normal given what they are going through and that it is temporary.

Prepare ahead of time for changes in routine

Prepare children for any situations where both parents may have to leave the house unexpectedly.  Talk ahead of time about the plan so they know what to expect.

“Your dad and I are going to be spending a lot of time at Grandma and Grandpa’s helping with Grandpa.  We have a plan for when we aren’t able to pick you up from school.  Your Aunt Sue is going to give you rides home from school and to soccer practice.  She loves you very much.  We’ve talked to her and she’s promised to take good care of you, just like she does with her own kids.  We don’t know if this will happen, but we wanted you to know these plans just in case.”

Allow time for play or art

Play is the natural language of children and a healthy way for them to deal with stress.  It allows them to feel a sense of power and control. 

Be an advocate for your child

Talk with teachers and other adults in the child’s life about the illness. Try to be consistent with who cares for the child when you cannot. Try to chose people who relate well with the child. Extra praise can help children’s self-esteem during this stressful time.