Background It was identified that parents didn’t know how to begin conversations about death and dying with their children and they were often overlooked by professionals concerned about getting it wrong. This resulted regularly in patients with young children coming into an inpatient hospice for terminal care with children unprepared for their death, leading to concerns about the longer term effects on the mental health and resilience of these children in the future (Crook & Eliot,1980).
An in-house service to provide bespoke family-centred pre-bereavement support for families where a parent or significant adult had received a terminal diagnosis was developed. It was acknowledged that not all children need complex or long term interventions (Kennedy, McIntyre, Worth et al., 2008). A dedicated children/families support worker was recruited.
Aim To evaluate the service which was piloted over six months.
Method Interventions with children included individual one-to-one support, making worry dolls and memory boxes plus liaison with schools and other services. Adult interventions involved advising and supporting parents about the language and timing of conversations, need for honesty and helping with letter writing and mummy diaries.
Results 50 children were supported during the pilot. Most of the interventions occurred at home whilst the parent was still well. When the time came for admission to the inpatient unit the family were prepared and familiar with the service and the staff. Feedback was exceptionally positive: ‘It was important for us to know that L was there to hold our hand when we need it’. Twenty-four children were discharged from the service and six accepted onward referral to local children’s bereavement services.
Conclusion Parents felt empowered to provide their children with age appropriate, timely information. Children were well adjusted to the death of the adult and there was less need for conventional bereavement services in the period immediately after death.
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