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CHILDREN'S UNDERSTANDING OF DEATH
EARLY AND MIDDLE CHILDHOOD
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Every source, from Indian Health Service Chartbooks to
your cousin can tell you that death is more frequent on the reservation.
The leading causes of death are heart disease, cancer, accidental injury,
diabetes and chronic liver disease.
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Infant mortality rates for Native Americans as a whole
are 150% the rate of the total U.S. population. The Aberdeen area of the
Indian Health Service (the area in which the Spirit Lake Reservation is
located) shows an infant mortality rate of 2% - many times the U.S. rate,
many times even the high rate for Native Americans.
==== > DID YOU KNOW>>> That of all of the ethnic groups,
tribes, etc. in the United States, the two most at-risk of Sudden Infant
Death Syndrome are two groups of Native Americans, i.e, Native Americans
residing in Washington State and the Lakota Sioux. {Yes, I do know that
Spirit Lake is Dakota, but I still thought it was a disturbing fact.}
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The leading causes of death for Native American men
are heart disease, accidents, malignant neoplasms (cancer), chronic liver
disease, and suicide, in that order.
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Native Americans are three times as likely to die in accidents,
4 times as likely to die of chronic liver disease and 5 times as likely
to die of tuberculosis, compared to the U.S. population as a whole.
(All of these statistics, by the way, come from the IHS
chart book for 1997. Click
here if you are interested in finding any more statistics.)
What does this all mean?
It means that, during early and middle childhood, the average child on
the Spirit Lake Reservation is much more likely to experience death up
close and personal than are children of the same age who are not tribal
members.
I have a personal interest in how death is understood
by and impacts children because, as you may know. my husband died when
my children were eight, nine and twelve years of age. At the time, I found
very little information about parental death (this was before Princess
Diana died, which seemed to spark a brief interest in children's death,
which then died out, pardon the expression).
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When a parent dies... what I know now that I wish
I knew then.
The best book I have read on this topic is Children
and grief by J. William Worden. I highly recommend it. The most important
points from this book, I think were on the mourning process for children
and what adults can do to ease the difficulty for children of experiencing
parental loss. Although his research has focused most on loss of a parent,
he does discuss somewhat other types of losses, such as siblings, and much
of what he has to say would be applicable in this context as well. |
THE MOURNING PROCESS
Worden says that children must accomplish four tasks.
The first is to ACCEPT THE REALITY OF THE LOSS. The
child has to learn to accept the finality of the loss. I remember when
my sister-in-law's father died. Although my niece had it explained to her
that Grandpa had died, was in heaven and so on, still, at three years old,
she had difficulty comprehending this, and from time to time, ask her mother
"When's Grandpa coming back?" According to Worden, when children have not
seen the body, or when the death is sudden and unexpected, it is easier
for them to deny the reality of it. In this case, we did NOT follow Worden's
advice about giving children a choice of attending the funeral or not.
Personally, when my husband died, I was not much prepared to deal with
anything during the first few days. The funeral director, who knew my family
through church, was gently insistent that it was important for all of my
daughters to attend the funeral, even my nine-year-old, who, literally,
had to be dragged there kicking and screaming. Now, at the mature age of
thirteen, I asked Jennifer if she thought that was wrong of us to make
her go, and she said, "It was all right. I didn't want to go to the funeral
home more than the funeral." (Trust me, she was shrieking that she wasn't
going to go.) In Worden's study, the great majority of children attend
the funeral, and most of those who did not were very young.
The second is to EXPERIENCE THE PAIN OR EMOTIONAL ASPECTS
OF THE LOSS. Worden says that if children see adults who are not dysfunctional
with grief, it is easier for them to express their own feelings. He also
says that children are better off if adults are not depressed. While that
may be true, I am not sure it is a realistic expectation to put on a parent
who has just lost a spouse (or a child). I am sure there were days that
I was not very functional - some days I just sat in my living room and
cried. My husband had died. I still consider that a very normal response.
Another normal response is to be angry. I never really experienced that
very much, but I know it is a very common response in both children and
adults. Jennifer was mad at her father, she was mad at God.
I think, like the third
task, this is something that happens over time. I agree with Worden, too,
that young children are particularly vulnerable. My youngest, who was eight
when her father died, seemed to be doing okay at first, but a year or so
later, when we moved back to California, she started to become depressed
and withdrawn, a total personality change for her. I think, when she was
still in North Dakota, her very close circle of friends and activities
helped to keep her busy and protected from having to deal too much with
her father's death. As she got older, and the finality of it set in, as
she said "that I will never have a dad", she became much sadder than she
had been a year before.
The third is to ADJUST TO AN ENVIRONMENT IN WHICH THE
DECEASED IS MISSING. I think this is very hard, especially at first. We
had a lot of invitations to people's homes the first Thanksgiving after
Ron died, and at Christmas time. I decided to stay in North Dakota and
"get it over with". Get what over with? Not having him there to carve
the turkey, cut down the Christmas tree, help decorate the house, etc.
I was rather surprised by Worden's findings that death of a mother affects
the children much more than death of a father, because I was thinking that
there is usually a big change in the family income when the father dies,
children have to move, and so on. However, as he pointed out, children
are often closer emotionally to their mother and she interacts with them
more on a daily basis. She is the one who knows what they like for breakfast,
where their shoes are likely to be found, what time band practice is, the
phone number for another mother who could pick them up from the basketball
game, and a million other little details.
I also totally agreed
with Worden's finding that adjustment here is a process and not a one-time
event. I know that there were times when our youngest daughter, who was
quite a good swimmer, would do well in a meet and be thinking "I can't
wait to show Dad my ribbons," only to remember that Dad was not going to
be there when she got home.
The fourth task is to RELOCATE THE DEAD PERSON IN ONE'S
LIFE. Worden says (and I agree) that it is NOT best to forget the person
and move on. It is important for children to remember the parent, but to
go on living. My children each have some momentos of their father, pictures
of him, toys he gave them, a flag the Veterans of Foreign Wars presented
to the family, a star quilt. These are things that are very special to
them because they symbolize his life, what was important to him, and that
people remembered him.
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What Can I Do?
Worden says that, "Three things a child needs after
the death of a parent are support, nurturance and continuity," but providing
these may be difficult for the parent who is dealing with his or her own
grief.
Provide or arrange social
support for the child. When my daughter did not want to attend the
funeral, someone must have mentioned it to the school principal (Sister
Dorothy), who promptly called the homes of four of my daughter's friends
that she always hung around with in school and asked their parents if they
could come to the funeral and sit with Jennifer. They sat in their own
pew in front of us and all cried together. In general, when I think of
the number of people who helped our family in diverse ways during this
period, I feel truly blessed.
BE THERE FOR THE CHILD TO
TALK ABOUT THE DECEASED PARENT Some children may not want to talk
about their parent right away. Other children may want to talk but, in
Worden's study, they often were worried about burdening the surviving parent.
Having other adults around who support a child emotionally, who are willing
to let him or her talk about their dead parent, and about other concerns
they have, are related to better adjustment. It reminds me of a story I
heard once about a little girl who went to visit an elderly neighbor who
had lost his wife. When her parents asked her what she had to say to someone
so much older, she replied, "I didn't say anything. I just sat on his lap
and helped him cry." Sometimes having someone to help you cry can be good.
SEND MONEY. MAKE DINNER.
I know this sounds callous, and I was quite surprised by how many people
in the first few days after my husband's death sent me checks. In retrospect,
I realized these were mostly people who had experienced a death themselves.
The more stresses a family has, the more problems they tend to develop.
The more you can ease the family's stress, in financial terms, in demands
on their time, the better off they will be, particularly in the first period
of adjustment. Added on top of a death in the family, everything, from
making dinner to paying for the funeral bills, can seem overwhelming. All
the cards and words of sympathy are nice, but I will never forget the fellow
faculty member who sent her husband over to fix a crack in the foundation
of our house where water was pouring in. It was the sort of thing my husband
would have done, of course, but he wasn't there to do it.
AS A PARENT, MINIMIZE ANY
OTHER CHANGES IN THE CHILD'S LIFE. This is one area where
I think my education in psychology truly helped my children. Stress, I
know, is not additive. Having three stressful events happen, such as a
death, changing schools and moving to a new neighborhood, put children
(and adults) at much more than three times the risk of problems such as
depression, substance abuse, etc. Even though my first impulse was to sell
the house, move back to California, find a new job and put all the children
in new schools, I did not do that. I waited a year to sell the house, and
then another eight months before we moved. Let me say this again, because
it is important...
If you can at all manage it, do NOT move, do NOT change
jobs, do NOT put your child in a new school, do NOT get married again.
Wait at least a year to do any of these things.Obviously, there are exceptions
to this. If the bank is going to foreclose on your house because you can't
make the payments, or your child is getting beat up at school every day,
then an immediate change may be in order. Overall, however, it is much
better to get adjusted to this major change in your life before doing anything
else.
Some references
Click here for Sudden Infant Death syndrome, an introduction, including effects on parents and siblings.
The Sudden Infant Death Syndrome (SIDS) web site is
absolutely one of the best places on the web. Be sure you read several
of their pages. They provide answers to questions a lot of people have,
such as "What should I say (and not say)?" "Is it possible to prevent SIDS?"
Click
here to go to their home page, but do not stop there.
Click here to go to the next assignment.
Click here to go to the last
page in this chapter, on children's friendships.
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