Trauma Archives - Association for the Wellbeing of Children in Healthcare

Grief in children – resources

26 November, 202019 April, 2017 by AWCH

Grief in children: a handbook for adults

Atle Dyregrov
2nd edition, Jessica Kingsley Publishers, London, 2008. ISBN 9781843106128

“Atle Dyregrov has written about children and death with a calm and clear voice”

Explaining death, grief and loss to children and young people can be incredibly challenging especially for grieving parents and carers. Even health professionals, emergency workers, police and teachers working with children find talking about death, grief and loss with kids hard.

This became clear to me when a nurse asked AWCH for information about how to talk to children in her own family about their parent’s serious illness. She wanted to talk with and prepare children at their level and in a supportive way. This was a critical time in their lives.

Grief in children: a handbook for adults, is an accessible book for parents, carers, family and professionals. It is for people who want to prepare, care for and support children living through grief, loss or trauma when someone is dying or has died. Circumstances covered vary from anticipated to sudden and traumatic death.

Children and adolescents at different age levels have different understandings about death and grief. So how do we help children through their grief journey?

Atle Dyregrov has written about children and death with a calm and clear voice. This is valuable in western culture where people often find it difficult to know how to talk about death. This book gives information about children and how they might think about death based on their age, sex and developmental stage. Useful examples have been drawn from family life experiences. In this second edition, more children’s voices are included with children’s questions and reactions. There is also more material on traumatic deaths. Atle Dyregrov has listened to what children have said about what is helpful and supportive.

To view contents link to the book, Grief in children: a handbook for adults. The chapter Guidelines for taking care of children’s needs, explores open and direct communication. There is information on death following an illness, making the loss real and giving time for understanding to grow. Children need information, adolescents may want to have websites to look at.

The section Handling death in a playgroup and at school, is an inevitable situation for teachers and this book will help to do this well. Find help with mental preparation and planning before a death or other critical event occurs. Atle Dyregrov includes information on terminal illness of a child, although the general focus of the book is on sudden death.

This handbook overviews crisis or grief therapy for children and bereavement groups for children, caring for oneself and peer support.

Grief in children, draws on the author’s experience as a clinical psychologist, author and director of the Center for Crisis Psychology in Bergen, Norway. His extensive experience and research underpins this book, yet the tone is informative and very readable. The case studies bring experience and understanding to the topic. Concerned adults will find a good overview and helpful information for what can be a hard task involving raw emotions.

For children’s healthcare facilities valuing patient and family centered care, Grief in children will be a good addition to the bookshelf. It is also an accessible reference book for early childhood educators, teachers, school counselors, pastoral carers, libraries and families.

If you found this blog informative you might also like to read our blog G is for Grief and Grandma.

More information

Crisis support

Kidshelpline Call 1800 55 1800

Hey teachers there’s also the Kids helpline @ School program

Lifeline Call 13 11 14

Resources and links

Australian Centre for Grief and Bereavement

Australian Child & Adolescent Trauma, Loss and Grief Network

National Centre for Childhood Grief

Parent and carer information

Raising Children Network

Better Health Channel

Kidsmatter

Women’s and Children’s Health Network, SA

AWCH books to borrow…

Do you have a resource that has been helpful? We’d love to hear from you.

Jillian Rattray

AWCH librarian

Email: Jillian@awch.com.au
AWCH Library

A is for anxious parents & children

17 December, 20208 August, 2014 by AWCH

Parents’ emotional response to child’s hospitalization
Helen Gofman, Wilma Buckman, George H. Schade

What was it like for children in hospital in the late 1950’s? This article is from the Pediatric Mental Health Unit, University of California Medical Center. In 1957, understanding of children’s emotional response to hospitalization as well as parents was little understood.

This interesting article looks at parents’ perceptions and what it was like for families with hospitalized children. Parents were interviewed and questions asked included what information was provided by doctors as well as admission procedures. Interestingly, as the study progressed researchers became aware of the impact of separating children from their parents without preparation of any kind and modified their admission procedure. There were one hundred parents who were interviewed at the time of their child’s admission and 68 parents were interviewed again at discharge from hospital.

This is a very touching article, with parent vignettes. Readers can see how difficult it was for both child and parent to be separated, vulnerable and fearful. The article describes the traumatic admission procedure where children were placed in bed in an isolation unit and parents were escorted to a nearby waiting room where they could hear their child crying calling for them but could not see or be with them. The modified procedure led to a more gradual separation. The changed procedure involved a nurse being assigned to the care of the child and parents, accompanying them to a room where the child was no longer isolated. The child shared a room with others of a similar age and the nurse acquainted the child with roommates before assisting parents to put the child in bed. Parents were encouraged to stay until the physician was available.
The article describes visiting hours and the success of a “further extension of visiting hours”, some of the nursing staff were sceptical about the extension.

In the summary section of the article major points made were children and parents needed adequate preparation for hospitalization;

An admission procedure which allowed for a more gradual separation of parent and child;

During hospitalization health personnel needed to focus on both the child’s emotional and physical needs;

Continuing preparation of child and parent throughout hospital procedures and treatment;

At discharge, health professionals provide understanding of findings and implications both orally and in writing for further care of the child at home.

This article has been cited approximately 35 times, Google scholar.

Link to first page of article to read more:
http://archpedi.jamanetwork.com/article.aspx?articleid=498653

View the record in the AWCH catalogue or contact the AWCH Librarian for more information:
http://awch.intersearch.com.au/cgi-bin/koha/opac-detail.pl?biblionumber=13531

Jillian Rattray

AWCH librarian

http://Library.awch.org.au

August 2014

Painful paediatric practice

17 December, 202029 July, 2014 by AWCH

I was out to dinner with my girlfriends last night and at dinner the topic of pain relief in hospital came up. One of my girlfriend’s children had broken his arm and to fix the fracture pins had been placed in his humerus. To have pins removed, my friend took her son to the local paediatric hospital. Before Bob had his pins removed he was offered no pain relief and this is where the story really starts…..

To remove his pins Bob was placed in a chair. His mother was asked to sit next to him. A clown doctor was there to distract the child whilst the pin was being removed. To remove the pin the doctor used pliers, which slipped as the pin did not come out easily. This process caused Bob a great amount of distress…. However, as this was happening, the clown doctor was attempting to put a red nose on the mother – impeding her ability to comfort Bob. In addition, there was still one more pin to be removed. Yet by this time the child was hysterical and distraught.

A comedy of errors, or a sheer lack of planning and consideration for the needs of Bob and his mother?

The reason I wish to share this story is that this type of situation exemplifies why AWCH is still relevant in 2014. In our 40 year history we have made lots of progress in advocating for children and their families as they navigate the health care system. However stories like Bob’s and Betty’s still exist.

Betty is an intelligent and articulate woman. She told me that she placed her trust in the medical staff and that if they said that this procedure did not require any pain relief then Bob would be fine. Once Bob became distressed she felt she had no control over the situation and that all she could do was comfort Bob to the best of her ability at that time.

This happened two weeks ago, and prior to the pin removal Bob was always a happy go lucky child with a ready smile and a cheeky sense of humour. Since the procedure he has been having nightmares, being argumentative at school and is scared to play footy or use him arm too much.

For me this story shows that AWCH is still very relevant today and the work we do is still needed.

Ally Hutton
AWCH President

Thanks to Bob and Betty for sharing their story (real names not used)

Please Don’t Leave Me

20 October, 202012 June, 2013 by AWCH

Film Australia made this film for the Australian Association for the Welfare of Children as an Australian contribution to the International Year of the Child , 1979. The film was the result of a unique cooperation between Government, hospitals and the community.

Please Don’t Leave Me is a social document truthfully reflecting ‘where we were at’ in Australian children’s hospitals in 1979 – the International Year of the Child. The film is without commentary. At the time, Film Australia and AWCH paid tribute to hospitals whose staff courageously agreed to this exposure of their normal routine. Despite their vulnerability they were willing to go ahead, sharing with the film makers the aim of providing insights to all professionals, parents and policy makers concerned with the care of children.

Uncontrived visual and sound effects speak to the observer at an individual level with a strong emotional impact. It is worth noting that one of the camera men in the production team was Dean Semler of cinematographer fame – Mad Max 2, Dances With Wolves, City Slickers and Bruce Almighty to name a few.

Please Don’t Leave Me shows the reality of a child’s hospital experience in 1979. The result is important and at times uncomfortable. It was an important tool for the achievement of AWCH’s national goal – that each hospitalised child’s overwhelming plea ‘I Want Mummy’ should be understood and answered. It was hoped that through insights gained the necessary provisions would be made both in policy and practice so that hospitalised children could be continually supported by their parents. In the cases where this was not possible, it was necessary to ensure a surrogate parent for each individual child.

In AWCH’s 40th year we celebrate its achievements in the introduction of:

increased and flexible visiting hours for parents/carers and siblings of hospitalised children and adolescents
parents staying with their child during hospitalisation with appropriate facilities
recognition of the importance of play/education for a child/young person’s preparation and recovery while in hospital
increased parental involvement in all aspects of a child’s hospital care
Introduction of the AWCH Ward Grandparent Scheme

It is worthwhile watching the outstanding film and reflecting on the last 30+ years advances in how children are cared for in hospital.

The DVD can be borrowed from AWCH Library