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Section 12
Terminally Ill Patients

CEU Question 12 | CEU Test | Table of Contents | Grief
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

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On the last track we discussed the role of step-parents of grieving children.  Aspects of step-parenting that I discussed were the three stages of stepfamily development through grief, how grieving stepfamilies differ, and coping strategies for the step-parents of grieving children. 

On this track we will discuss the terminally ill.  Five points we will consider are whether or not the grieving child wants to visit the terminally ill, preparing the child for the visit, taking a gift, limiting time, and the benefits of involving a child in terminal illness.  As you listen to this track, you can evaluate your client to decide if the information is applicable. 

5 Challenges for the Child Visiting the Terminally Ill

#1 Does the Child Want to Visit the Terminally Ill?
The first point is whether or not the grieving child wants to visit the terminally ill.  Do you agree that visiting an infirmed or terminally ill relative can be traumatic to a child if not handled well? 

In order to help parents decide if the child should visit the terminally ill, I have found that it is productive to simply ask the child if he or she wants to go.  Justin was a 7 year old grieving child whose grandfather was diagnosed with terminal cancer.  Justin’s father Merle wanted to know why Justin didn’t want to visit his grandfather. 

When I asked Justin why he didn’t want to go, he stated, "I’m scared."  After talking to Justin, Merle and I learned that Justin simply did not know what to expect at the hospital.  After discussing what Justin might encounter, he elected to go. 

Think of your Justin.  Does he or she want to visit the terminally ill?  Why or why not?

#2 Preparing the Child for the Visit
If the child wants to visit the terminally ill, the second point is to prepare the child for the visit.  To help Merle prepare Justin to visit his grandfather, I stated, "Let Justin know what is happening to his grandpa.  Tell Justin what kind of medical equipment is being used.  Also, let him know what physical changes he will notice in his grandpa.  Specifically tell Justin that his grandpa is dying of cancer." 

When Merle talked to Justin, Justin asked, "Will he die?"  Merle stated, "He might, but the doctors are doing all they can to help."  I discussed with Merle Justin’s feelings.  Merle stated to Justin, "You might get sad, scared or plain mad.  I know I did when I first saw granddad.  How are feeling right now Justin?"  After Justin told him that he felt scared, Merle asked Justin what would help him feel better. 

Have you found... talking to grieving children about their feelings to be a productive way of preparing a child for a visit to the terminally ill? 

#3 Taking a Gift
In addition to whether or not the child wants to visit the terminally ill and preparing a child for the visit, the third point is taking a gift.  Do you find that by a child taking a gift, the gift can serve as a diversion? 

Clearly, visiting his terminally ill grandfather was difficult for Justin.  Taking a gift gave Justin something to do.  Justin chose to bring his grandfather one of those singing mounted bass because he thought it was funny.  However, the mounted bass also reminded Justin of fishing with his grandfather before his illness. 

It also gave him an alternative subject to talk about.  Merle noticed that the presentation of the mounted bass gave Justin time to take in his surrounding, relax, and feel that he had been helpful.  You may have also experienced that when a grieving child takes a gift to a terminally ill person it provides a way to say goodbye.  Could taking a gift to someone help your grieving client cope with grief? 

#4 Limiting Time
I suggested to Merle that he may want to consider limiting the time of Justin’s visit.  I stated, "Ten to twenty minutes may be long enough for Justin’s first visit.  Perhaps future visits will be less emotional.  Justin may be comfortable staying longer and be less fidgety.  After the visit, you might consider talking to Justin about the visit." 

Merle asked Justin, "How was it?" How do you feel?" and "When do you want to come back?"  Justin talked at length about how he felt and what he saw and heard.  Merle stated, "I think that making sure he wanted to go, and preparing him was a good idea.  He wants to go with me this weekend to see his granddad again." 

Think of your Justin.  Would you consider limiting the time of his or her visits?

#5 Benefits of Involving a Child in Terminal Illness
In addition to if the child wants to visit the terminally ill, preparing a child for the visit, taking a gift and limiting time, the fifth point is the benefits of involving a child in terminal illness.  By preparing Justin in advance and giving him a chance to visit, Merle helped Justin get on with his life when death actually occurred. 

Prior to the death, Merle had stated, "We all hope granddad will get better and I know you hope so, too.  But we all know there is a possibility that he’ll die."  By informing Justin of the seriousness of his grandfather’s illness, Merle provided Justin with the opportunity to begin his grief work before the death occurred. 

Are you treating a child who could benefit from visiting the terminally ill in order to begin grief work early?

On this track we have discussed the terminally ill.  Five points we considered are whether or not the grieving child wants to visit the terminally ill, preparing the child for the visit, taking a gift, limiting time, and the benefits of involving a child in terminal illness.  Would it be beneficial to play this track for the parent of a child who has a relative about to die?

On the next track we will discuss involving children in funerals.  The four topics we will discuss are how funerals help children accept the reality of death, what if the body isn’t presentable, preparing a child for a funeral, and when not to take a child to a funeral.

Peer-Reviewed Journal Article References:
Hanoch, Y. (2007). Terminally ill patients and volunteer support: Is it the right intervention? Health Psychology, 26(5), 537–538. 

Herbst-Damm, K. L., & Kulik, J. A. (2005). Volunteer Support, Marital Status, and the Survival Times of Terminally Ill Patients. Health Psychology, 24(2), 225–229.

Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnout. Psychological Services. Advance online publication.

Oosterhoff, B., Kaplow, J. B., & Layne, C. M. (2018). Links between bereavement due to sudden death and academic functioning: Results from a nationally representative sample of adolescents. School Psychology Quarterly, 33(3), 372–380.

Petren, R. E., Lardier, D. T., Jr., Bible, J., Bermea, A., & van Eeden-Moorefield, B. (2019). Parental relationship stability and parent–adult child relationships in stepfamilies: A test of alternative models. Journal of Family Psychology, 33(2), 143–153. 

Review of Life & loss: A guide to help grieving children (2000). [Review of the book Life & loss: A guide to help grieving children (2nd ed.), by L. Goldman]. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 21(3), 141. 

Online Continuing Education QUESTION 12
What are the five points we discussed regarding the terminally ill? To select and enter your answer go to CEU Test.

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