Grief and loss

On a chilly Sunday in late February I found myself wandering around the basement of the Toronto General Hospital in search of the ELLICSR centre. Inside, I found a lovely and warm space in which I would spend the next eight hours.

I was at the centre to attend Grief and Loss training as part of the Nanny Angel Network’s volunteer training program. Though I am not a nanny, I was there to see what nannies going through the required training learn. The seminar is hosted by NAN every other month, and is taught by Andrea Warnick. Andrea is a nurse psychotherapist, educator, and thanatologist with twenty years of experience in supporting grieving children and families.

As Andrea introduced herself, she explained that she first began to explore issues surrounding death and dying when working as a nurse. Working on the frontline of healthcare and regularly interacting with bereaved families, Andrea realized that medical personnel were not receiving sufficient training in how to talk to kids about cancer, death, and grief. Though there was a wealth of research surrounding kids and death, from how to talk to kids about death to how to recognize and help with children’s grief, this research was not being put into practice.

It is no surprise, when one considers our general cultural-wide discomfort with the subject of death, that we would be bad at speaking about it with children. Parents understandably want to protect their children from news of a serious illness, and especially from the death of a loved one. They worry about the impact a death, whether of a parent or of a loved one, will have upon their child. With this in mind, they will often avoid speaking to their children about the approaching death, attempting to spare the child from trauma.

Study after study has shown, however, that the opposite is true. The best way to protect children from being negatively impacted by the death of a loved one is to prepare them for it. Instead of not speaking about it with children, discussing it openly and in age appropriate terms helps children psychologically cope with the death of a loved one both during their childhood and as adults. Grief is something that never really leaves us, though we may cope with it differently at different ages.

While Andrea discussed the complexities and difficulties of discussing death with children of all ages, in the end she summed it up in a few central principles. Be honest with your child. Use simple, but correct language –  euphemisms can be confusing, especially if a child is still at an age where they take everything very literally. Foster an environment where they can ask questions. They might not be asking questions only because they are picking up on the fact that the adults don’t want to discuss it. Finally, be prepared to not have all the answers. You aren’t going to mess your child up forever because you didn’t know the answer to one of their questions. Do some research, or wonder at life’s mysteries with them.

Children’s concerns around cancer and death often fall into four central questions – did I cause it? Can I catch it? Can I cure it? And who is going to take care of me? Explaining cancer to a child involves answering these four questions, using real terms, and explaining what is going on in as much detail as the child can comprehend… if the child wants! Ultimately, the level of explanation depends on the kid, and how much they want to know.

After the death of a loved one, children will grieve and mourn just as adults do, though their grieving will look different from an adult’s grief. Play is often part of a child’s grieving, as well as moving between intense sadness and normal happiness. It is important to discuss, encourage, and model the expression of all emotions, in a range of healthy ways. If a child is expressing their grief through inappropriate behaviours, feel free to correct those behaviours, but it is important to distinguish between the emotions and the behaviours ­– the emotions are not the problem. Offer children the chance to talk, but don’t force them to if they don’t want to, and help them develop rituals to stay connected to their deceased loved one.

Ultimately, every person is different, and every child is going to react to illness and death differently. The important thing to remember is that even young children are fully capable of understanding cancer and death – if the adults in their lives explain it to them and are prepared to take the time to engage with them fully on their level. I left the course with a far greater understanding of the importance of creating safe spaces for children and fostering honest conversations with them. The knowledge Nanny Angels gain from this seminar allows them to do just this. If the children they are visiting want to talk to their Nanny Angel about the things they are afraid to discuss with their parents, our volunteers are prepared.

For more information and resources on how to help children cope with grief and loss, check out Andrea Warnick’s website and follow the conversation at #nanGL on twitter, where we regularly post links to resources and community programs designed to help bereaved children.