Host: Sometimes in pediatrics unfortunately a child can be lost. The process of healing is very difficult. How should a parent or unfortunately this is a young child or an old child approach that problem?
Steve Shelov: It's very difficult and there are different issues around grieving. The parents go through, if they have other children when they have lost their child or just if they lost their only child, but let's take a situation where they've lost their child and there are other siblings. First, realize that the siblings will go through a process of mourning themselves. Even babies will become fussier and understand that there is something missing. But older children above age three may first become hostile and angry and acting out as part of their process of mourning.
After that, after several weeks perhaps or a month they can go through a process where they'll become withdrawn or sad and continue to talk about the lost sibling. That's very, very typical, and that may go on for weeks and even months and may fantasize that the child maybe coming back or also maybe fantasize that they have something to do with the loss of that sibling even though they had nothing to do with it. So those are expected kinds of reactions, in grief reactions that are normal. So as a parent how do you deal with those kinds of things.
First try and return to a normal routine as soon as possible, kids like adults need routine and the more you can do that the more the child who realize that life is continuing.
Second, have conversations, open conversations with the child especially the over three-year-old. Acknowledge how we all are said and we all miss your brother or your sister. Those kinds of feelings that you can express and hear them express are all part of making that process go more smoothly, but it is not short, it is not quick. It will take weeks and maybe even more.
Third is engage other people from the family to assist in those support efforts with your child that's left behind. Reassure them that life is going to go on, that they love them very much and that they are the center of the activity that remains to be going forward and expect that they will have periods of -- they are calm again and then they will regress especially around birthdays or other celebrations. Those are all perfectly normal times when they will really miss the siblings that they have lost.
And fourth, be aware that there is sometimes where there is a need for professional help. Where psychologists or psychiatrists may need to be brought in. When are those times, those are the times where the mourning process is going for a long period of time where there is marked withdrawal over months and ability to get back to the normal activity, if they are in school withdraw from friends or disappointing school performance or crying or outbursts.
After a month or two of that and it's not returning to normal it's time to get some professional help.
Host: How does a parent when a child dies move on.
Steve Shelov: The other major subject when a child dies is the parents are on mourning process and it's very, very difficult and hard to chart like a perfect categorical way that it goes because it's different for every parent.
First, there will be an immediate process of first anger hostility as to why it happen to sense of going through those stages of mourning that we know so well from the Elisabeth Kubler-Ross processes of mourning. They will be withdrawal after the anger. They will be having had some denial that will go on. They will gradually toward a process where they will get beyond that death. It may take weeks and months. It certainly will take weeks and probably a better part of the year to get over that.
The key there is some of the same steps we've talked about with children. Getting back to a normal routine as much as possible. Engaging friends and other family members through that process. Realizing that others are going through it as well. Developing ways of paying tribute to the lost child whether it's their own internal memorial or within schools or something that says, I remember this child, I always will remember this child. Recognizing special events that take place on those anniversaries are all part. A parent who loses a child never forgets that child and it's never to be expected that he will ever be out of that persons memory. It just recedes to a background state so that life can continue.
Same thing goes for professional help for parents. If in fact you are not able to let go off that and then you find yourself constantly moving over that or feeling guilty about it or responsible when there was nothing to do with your own negligence which most of time is the case. But that continues to sort of the persistent mental thought in the family then you may need to get somebody to help you work through those feelings. Generally by a year or so and it may take that long. Things are able to move onto a more even keel, but it may just take that long.
Host: It's probably going to find a group if the kid had a certain disease and it might be on the same situation because the real expert is someone who went through the process before you, is that true?
Steve Shelov: Yeah, often very helpful. Support groups of this either if it's -- they've died of a particular disease that has its own sets of support groups that you can join either online or in an actual face-to-face meeting. All of that is very much helpful to hear other people who went through it or going through it so you can share feelings and the same emotions.
Host: A lot of these social website like MySpace have actually groups and they have ways that you say, well, let's make people a weir of such a rare condition or whatever it is and the process helps you to heal a little bit too, doesn't it?
Steve Shelov: Absolutely, there are specific groups often that have been developed around specific diagnosis of -- rare diagnosis or ones that have children who die as a result of them, but there is American Heart Association through pediatric cardiology. Those groups of kids who died from general heart disease or the rare metabolic diseases. I take advantage of both the information as well as the kind of support that those families will give you because their experiences will help you go through your experiences.
Host: I thank you very much!
Steve Shelov: Thank you!
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