I write blogs infrequently since it often takes me time to think through what might be relevant. It does help when I hear from my readers. I recently got a note from a reader, who was a psychologist and a mother mourning the death of her adult son. She was reacting to my questioning an article in which the author reported that grief is time limited. The author had said that if in six months, mourners have not accommodated they need professional help. The response I got from this reader was very insightful. She wrote, based on her own experience, that it took about 6 months before the disbelief about the death became real. At about this time she felt she really began to grieve as she began to deal with the fullness of what she had lost. She noted that grief can come in spurts, and that it has a trajectory that may be unique for each of us. However, it doesn’t come and go in six months. We no longer think of grief as following a formula such as suggested by Kubler—Ross (On Death and Dying). I agree that grief doesn’t express itself in a step by step manner but it does unfold. It may look different for each of us depending on who died, our own experience with grief, and where we are in our own life cycle. For children it changes, perhaps more dramatically, as they mature and can look at what they have lost in different ways. What this means to me is that we cannot understand grief if we are looking for symptoms of psychiatric illness as part of the process. Instead, we need to recognize that grieving is a complicated part of living that changes us and from which we do not “recover” as from an illness.
Another aspect of this process that has given me pause relate to illnesses that lead to deaths in young families with children. I think this topic was stimulated by the recent discussion about the Affordable Health Care act that will bring health insurance to many families who had no coverage. I have always worried about families in which the parent who died provided health care insurance for his or her family. It isn’t always easy for the surviving parent to get coverage. In some states there is coverage for dependent children. Do some children have special needs after the death of a parent that reqire special attention?
In today’s world we are studying genetic factors that can lead to certain illnesses that can lead to death. Heart disease that runs in families is a good example. We can often follow heart problems from generation to generation in a family. In the same way there is growing awareness of the gene for breast cancer that goes from generation to generation as well. This gene can be recognized and family members can know who is at risk. My question is how do surviving family members deal with this news. What do children think as they see their parent die and wonder what the future holds for them? The burden of trying to help their children falls on the surviving parent. Whether you like it or not, at a time when you would like to look the other way, this cannot be an option. You need to be alert to your child’s needs and what options might exist or are being developed to deal with this problem.
One choice is to do nothing. I am thinking of a young girl who was very aware that her mother died of breast cancer at the same age as her grandmother did. She lived in fear for her own future. Her father felt helpless as he too was aware of the family history, and so did not talk about this problem with his children. Another mother I met talked about her school age son who carried the same genes for an illness that killed his father. There is a treatment that, if offered before he entered puberty could change the outcome. His mother is aware of this but is not doing anything about it. She feels too overwhelmed by her grief for her husband.
On the other hand, parents can take the lead in helping their child. Another mother, whose child just starting kindergarten, is concerned about how to talk to his teachers about his risk of having an episode that if unattended could kill him. She has tried to use language her son can understand to explain to him what to do if he doesn’t feel good at school. With her doctor she is finding ways to talk to the teacher about what to watch for and how to help. She will always worry a bit about her son’s well being and is preparing what to say to him as he gets older. However, her concern is real but with the appropriate response her child will be fine.
There are several ways that can help you feel informed about these situations, some of which don’t cost money. For example, The American Cancer Society (www.cancer.org ) provides families with information about breast cancer and can aid you in finding help as you decide how and what to tell your children. You need to have a relationship with a pediatric health care professional who can help you and can help your child(ren). If people who are reading this blog have any experience in this area please write and share it with other people who are reading this blog. Thank you.