4- Children facing Death

Question 1

Can’t differentiate death & separation

Believe death is reversible

Answer 1

Children from birth to 4

Question 2

Come to understand irreversible & final
May believe they can cause death
*Younger-Death is going to sleep or on a trip

Answer 2

Children between 4 & 6

Question 3

Understand death irreversible & universal

Develop logical thought, realistic understanding of cause of death

Answer 3

Children between 7 & 11

Question 4

Abstract understanding of death
May perceive as heroic or tragic
May choose escapism, denial, acting out

Answer 4

Children 12 - Adolescent

Question 5

Myths about grief in children & adolescents include:

Answer 5

Do not grieve
Should not go to funerals
Should always attend funerals
Recover from loss quickly
Shield from los

Question 6

Children’s grief is commonly..

Answer 6

Misunderstood

Question 7

A child’s grief is manifested by the childs (2)

Answer 7

Developmental stage

Access to surround supports

Question 8

T/F Children should not and cannot be protected from death and loss.

Answer 8

TRUE

Question 9

To assist grieving children it is important that families receive larger…

Answer 9

Community Support

Question 10

Interventions for preschoolers include:

Answer 10

Simple terms, open to questions

Age appropriate literature

Question 11

Interventions for 6-8 include:

Answer 11

Encourage participation in rituals

Support in sharing controlled emotions

Question 12

Interventions for 9-11 include:

Answer 12

Encourage participation in care-giving

Give information about dx & px stat

Question 13

Interventions for Adol 12-14 include:

Answer 13

Allow to assist in caregiving, but not 2 burdensome

Allow choice in rituals after death

Question 14

Interventions for Adol 15-17 include:

Answer 14

Discuss ways they can help

Anticipate intense mourning & help them understand grieving process

Question 15

_____ is a natural medium for children to express their feelings & allows them to feel some control

Answer 15

PLAY

Question 16

T/F Children will express grief through play whether facilitated by adults or other children.

Answer 16

TRUE

Question 17

Some helpful activities and toys?

Answer 17

Dolls/Action Figures & houses
Puppets
Aggression release (drums, punching bags)

Question 18

Children & teens also benefit from this therapy, providing avenues for expression.

Answer 18

ART

Question 19

Hospice & palliative often use ____ with children and adolescents. Funeral homes too!

Answer 19

ARTS - collages, scrapbooks, music

Question 20

Children age 1-9 die from..

Answer 20

Unintentional/Intentional Injuries
Congenital defects
Cancer

Question 21

Youth 10-19 die from…

Answer 21

Unintentional/Intentional injuries
Cancer
Heart disease

Question 22

There are 4 pathways to children death: (SPCP)

Answer 22

Sudden
Potentially curable disease
Congenital abnormality
Progressive condition

Question 23

Children with progressive disorders often have multiple episodes until they die. Care-givers who have fought for survival may be..

Answer 23

Ill-prepared to provide end-of-life care

Question 24

T/F Children often suffer needlessly at the end of life.

Answer 24

TRUE

Question 25

Pediatric palliative care focuses on the....

Answer 25

Family & Child is central focus of care

Question 26

1.Important in child palliative is continuity of care by a...

Answer 26

Consistent physician

Question 27

2.Families may need ________ care to take breaks from bedside care. Children need available support __/_

Answer 27

Respite | 24/7

Question 28

Barriers to palliative care for children include: | BLUCS

Answer 28

``` Belief that children shouldn't die Compulsion to save life at all costs Lack of financial resources Unwillingness to let child go Switch to palliative not until very end ```

Question 29

T/F children often suffer pain that is not recognized or treated,

Answer 29

TRUE

Question 30

2 Assessments used in childrens pain?

Answer 30

Faces | QUESTT

Question 31

QUESTT =

Answer 31

``` Questioning Using (scales) Evaluating clues Securing parental involvement Taking cause into account Taking action ```

Question 32

If possible a nurse should be with family @ home until...

Answer 32

Very End

Question 33

After prognosis, the nurses role becomes:

Answer 33

Support parents in understanding implications

Question 34

The first step in working with families is always:

Answer 34

Attentive listening to feelings

Question 35

Guidelines in talking to parents include: UUI

Answer 35

Use everyday language Use drawings to explain dx & px Involve family in developing palliative goals *Listen carefully & pay attention to questions*

Question 36

In talking to children facing death: LOB

Answer 36

Listen to child's questions Beware giving too much/too little info Offer to talk, but accept silence/subject change