Daniel S. Gottlieb, Psy.D.

לכל זמן ועת לכ לחף תחת השמים.

עת ללדת ועת למות, עת לטעת ועת לעקור נטוע

Everything has an appointed season, and there is a time for every matter under the heaven.

A time to give birth and a time to die; a time to plant and a time to uproot that which is planted.

Kohelet Chapter 3

The natural course of life does not protect us from adversity but prepares us for it and brings it at times that we are best able to face it and cope with it.

But what happens when something occurs outside of its "appointed season?" How do we cope? How do we know what to do? Such are the questions that arise when a young parent is terminally ill and family members must rally to care for the young children, keep their lives going as normally as possible, help them deal with their fears and anxieties and prepare them for the unthinkable yet unavoidable, the impending death of the parent.

When facing the terminal illness of a parent, a child is at once faced with significant changes in his life, both the present and the future. All of a sudden he is deprived the ministering of not only the ill parent but also that of the other parent who must now turn his attention and energy to ill parent. The child, as are the adults, is left scared and confused, particularly if he is dependent on the parents for his day-to-day immediate care. Just at the moment that he most needs his parents to care for him and be there for him, they are least available. In some cases, the child may be expected to help or even comfort the parents. While children may not allow themselves to consciously contemplate the future, on an unconscious level, at least, they begin worrying about things like who will care for them if the parent dies, will he to get sick? Can the other parent also die? The absence of clear answers to these questions may arouse considerable anxiety.

One particular feature of a protracted terminal state, is the ambiguity of it. On the one hand the parent is still alive. He is lying there in plain view. In most cases he can still be spoken to. He may even be able to laugh. But, he's not quite the same parent. He can't help with homework, can't cook and can't play basketball. Psychologist Pauline Boss coined the term "ambiguous loss" to describe this confusing state in which a person finds himself when he has experienced a loss yet the loss is not clear and not complete. When someone dies, we have a prescribed way of reacting and responding. There are rituals connected with the funeral, shiva and mourning period. There are the well know psychological phase outlined by Kubler- Ross of denial ,anger ,bargaining,depression and acceptance. But when a parent is terminally ill, the child cannot begin with the mourning process even though too large extent the parent has stopped functioning as a parent and may have already undergone significant personality changes.

Ho to help children:

1.Maintaing a routine: We all respond well to routine, to familiar things and to predictability. As difficult as it may be, family members need to help kids' lives as on-track as possible - school, friends, food, homework, etc.

Handling our emotions

Preparing a child for the trials of a terminal illness and the distress of death is difficult task for any individual, that much more so for a parent who himself or herself is confronted with the fear and anxiety associated with an impending loss. Parents need to separate their emotions from those of the children. It's O.K. to be honest about how you feel, but it's important to remember that kid's respond differently than adults. Don't expect that will necessarily feel the way adults do or react the way they do. Let kids deal with things in their own way. Help them' talk to them' be there for them but don't expect them to react like you do.

Talking to children: When talking to children, it is important to give them honest and accurate information. Information helps combat the helplessness associated with not knowing. People generally prefer honest talk, even if the news is bad. If you know what's going on you can prepare yourself. You can develop coping mechanisms. Nonetheless, when speaking with kids, one needs to be careful not to give too much information. Information overload leads to confusion. Too much detail leads to anxiety. One needs to tailor talk to children to suit their developmental state. You should never talk down to children but on the other hand one should not tell kids things that are out of the realm of their understanding. A parent may have a need to talk, to vent or to express his fears and frustrations. That's good, but not with the kids. When speaking with children the parent must be available to the child. One usually does well by at first giving children a small bit of general information and then following the lead that they set by their questions. They will usually let you know how much they are able to hear.

The terminal illness and ensuing death of a young parent is always a tragedy that at the moment seems insurmountable. Nonetheless, with the proper support of the family, most children are able to find the resilience needed to overcome the adversity and grow up to be emotionally healthy adults.