Anticipatory Grief and Bereavement Support

Abstract

1. A diagnosis of a life-threatening condition in a child sets in motion a range of reactions understood as anticipatory grief, that ultimately equip the child and his family to prepare for his dying and death. The case study describes some of the emotional, social and cultural aspects that may accompany such a diagnosis for a child patient, his sibling and parents, and provides suggestions for enabling communication and safe expression of reactions over time. After the death of a child, the resulting grief and bereavement is recognised as a healthy, inevitable process experienced by siblings and parents. Examples of the wide range of reactions and experiences of bereaved children are personified by the patient’s younger sister in the case study. Throughout the chapter practical communication suggestions have been offered to assist the reader integrate alternative ways of assisting children and young people negotiate their way through this painful journey. Anticipatory grief and bereavement support for children demands honesty, reassurance and provision of a space for safe expression of emotions. 2. Anticipatory grief is triggered by disclosure of a diagnosis of a life-threatening condition (LTC) and prepares the child and family for dying and death. 3. Bereavement after a death includes a wide range of emotions, experiences, thoughts, physical symptoms, social and spiritual changes over a long period of time, at differing times and with varying intensities and combinations. 4. Bereaved children and young people need to be listened to with empathy and given permission and facilitation to grieve in their own unique way, assurance that there is no right or wrong way to grieve, and given time and support for them to express their feelings. 5. Grief reactions in children and young people will change over time and maturity and vary according to gender, culture, age, previous losses and experiences, family support, the relationship to the deceased and the nature of the death.