1. Working with Life-limited Children and Young People – Questions and Concerns Erica Brown Vice President Acorns Children’s Hospices ealbrown@googlemail.com

2. The Impact of Life-limiting Illness The Child A child’s response is likely to be dependent on: their age the phase of their illness physical changes in their body how much the illness inhibits everyday activity.

6. Listening to Children’s Questions Listening carefully to life-limited children’s questions is one of the most important ways adults can offer support.

7. Exploring Children’s Questions Talking about the question as well as giving an answer is the best way for adults to understand exactly what a child wants to know. The best people to talk to life-limited children are parents or adults who know the child well.

8. Children May Wonder: Can I trust this adult? Can I talk to this adult? Will the adult listen to me? Will the adult dismiss my questions as unimportant?

9. Children’s Questions will reflect: Their cognitive development Their life experience Their emotional development Their cultural/religious background © Erica Brown

12. 4 Main Categories of Questions Questions which ask for information. Questions which check out emotional responses. Questions about the reason for the illness. Questions related to spiritual and religious concerns.

13. Young Children’s Questions Generally young children’s questions are based on a need for reassurance. It is important that the answers they receive are honest and consistent.

14. Child: ‘Where will my mummy be?’ Adult: ‘Where would you like mummy to be?’

16. Child: ‘What happens when someone dies?’ ‘Adult: Do you have an idea of your own?’

21. Older Children and Young People’s Questions As children mature they require deeper explanations, more specific content in the replies that adults give to their questions and opportunities to communicate their own ideas and thoughts. They are more likely to talk to people outside their family and to their peers for support. © Erica Brown

22. Child: ‘When will it happen?’ Adult: ’That sounds like dying is a scary idea. Can you draw me a picture to tell me how that feels?

25. How Can Adults Help? Talk to the child about their illness. Do not give the child false hope in an attempt to alleviate the child’s anxiety. Keep daily routines as normal as possible. Answer questions as openly as possible.

26. It is important to: Consider the age and developmental level of the child. Listen carefully to exactly what is being asked. Think about any unspoken contexts within a question. Clarify any confusion or misunderstanding. Reply to questions in straightforward, easily understood language, avoiding clichés, euphemisms or rehearsed answers. Give answers that help dispel fantasy and encourage reality. Make distinction between physical remains and spiritual aspects of death. Acknowledge adults do not have all the answers.

27. In every task the most important thing is the beginning and especially when you deal with things young and tender. Plato