Dear Dr. Gramma Karen,
I am a young dad looking for some advice regarding my five-year-old daughter, Rachel. My mother has stage four cancer and we know she will die soon. Rachel is extremely close to her; they have always spent lots of time together, at least a twice a week.
Two specific areas you can help us. First, how do we handle that my mom does not want Rachel to come to the hospital to see her? Rachel is highly intelligent and extremely sensitive and tends to internalize things. She has not asked about her grandmother in a week.
Second, what are your thoughts about Rachel attending her grandmother’s funeral? We are thinking not to have her attend, but rather have her go to her aunt’s house instead.
(We have already read your suggestions for talking with Rachel: “Guidelines For Telling Your Child That a Family Member Has a Serious Disease or Illness”; they were helpful.)
Dr. Gramma Karen’s Response
Please know that I am so very sorry that your mom is dealing with serious cancer. I cannot imagine how hard this must be for all of you.
You asked for some advice . . .
While Grandma Is In the Hospital
It sounds like your mom is clear that she does not want Rachel visiting her in the hospital, and, of course, her request must be honored. However, although you didn’t ask specifically for my advice on this matter, I will take the liberty of offering some suggestions for how Rachel and your mom might be “in touch” during your mom’s hospitalization.
You describe Rachel as highly intelligent and extremely sensitive, and prone to internalizing things. You said that Rachel has not mentioned your mom in a week, so I urge you to take the lead in initiating conversations and keeping them going. Rachel may not verbalize right now what she is feeling and thinking, but she most likely will listen to what you have to say. I suggest you say to her something like this, “Rachel, as you know, Grandma is very sick and she is in the hospital. Her being so sick makes us all sad, but I imagine you are particularly sad because you and Grandma are so very special to each other. As hard as it may be for us to talk about Grandma’s illness, I want to make sure you know everything that is going on.
Do you have any questions you want to ask?”
Then, of course, you answer her specific questions. However, because she tends to internalize things, she may just shake her head No, or she may say she doesn’t have any questions.
You can pick up the conversation, perhaps along these lines: “This is what we know about Grandma’s kind of cancer . . .” followed by “This is what we don’t know/aren’t sure about Grandma’s kind of cancer . . .” (I make specific suggestions for things to say in my guidelines, referenced above.)
The point is to keep Rachel up to date with truthful information. If she doesn’t have information she can trust, she will provide her own explanations to herself, many of which that can be totally erroneous. For example, she may be thinking that Grandma is sick because of something she, Rachel, said or did. And, three of the most important questions on her mind might be: “Is Grandma going to die?” “Are you going to die?” “Am I going to die?”(As you know from my guidelines, I have some suggested responses.)
Ways Rachel Can Let Her Grandmother Know She Is Thinking of Her
Then, if these ideas are first discussed with your mom, you may suggest things that Rachel might do to let Grandma know she is thinking of her: make some drawings for Grandma; make an album of photographs of the two of them together; buy some artificial flowers / make some out of construction paper; do artwork that can be displayed in Grandma’s room. Grandma may or may not want direct communication with Rachel, e.g., Skype or talk on the phone with your daughter.
Whether to Allow Rachel to Attend Her Grandmother’s Funeral
Regarding your specific question about Rachel attending her grandmother’s funeral, you and your wife know Rachel better than anyone else, but here are some things you might consider before making your decision.
1. Some parents of young children do not want their young children to attend a funeral because the service is highly ritualized and has little meaning for a child. Related to this, some parents do not want their children exposed to religious doctrine because they fear it can result in young children having fears about life and death, or the doctrine is contrary to what they want their young children exposed to.
2. Some funerals focus on people sharing their memories of and stories about the deceased and include lots of laughter as well as tears. Many parents want their young children to experience this type of funeral, or this part of a funeral if it is a combination of a religious service that allows for eulogies from the participants.
Many parents have a relative or friend bring their young children to just those aspects of the funeral that personalize the deceased, and have them not present for the parts that are religious and/or ritualized. For example, some parents do not want their young children to attend any part of a service or funeral that takes place at a cemetery, as the lowering of a casket into the ground can be a terrifying experience for a young child.
Pick and Choose Parts of Her Grandmother’s Funeral
You and your wife can pick and choose which parts of the funeral you would like Rachel to be a part of, if any. Parents often feel such relief to know that they don’t have to commit their young children to an entire funeral.
You might ask Rachel if she would like to be present when Grandma’s family and friends tell stories about her (if that is part of the ceremony). You can let her know that some people will cry when they think about how much they loved Grandma and how much they will miss her, but stories that make us cry and laugh are an important part of honoring and remembering someone and saying goodbye to them.
You might decide that being involved in any part of Grandma’s funeral will be overwhelming for Rachel and will include aspects that will have little or no meaning for her, or will be confusing and/or scary. If you decide not to have Rachel involved in any aspect of Grandma’s funeral and Rachel wants to know why, you can explain that you think the service and its rituals are long, hard to understand, not designed for kids, and end up being boring. This is not how you want her to remember Grandma.
Rather, you can explain that as a family you are going to honor Grandma by, for example: telling stories of things you’ve done together; preparing and eating some of Grandma’s favorite foods; sharing photos; lighting remembrance candles. Rachel may have some ideas, too.
In closing, please know that I am thinking of you and your family during this difficult time.
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