This was written by Kelly Michelson, associate professor of Pediatrics at Northwestern University, attending physician in the pediatric intensive care unit at Ann & Robert H. Lurie Children’s Hospital of Chicago, and editor of the Greater Illinois Pediatric Palliative Care Coalition newsletter. She is a member of the OpEd Project Public Voices Fellowship.”
By Kelly Michelson
How do you explain to hundreds of grade school children that a beloved kindergarten teacher with breast cancer is dying? A friend recently asked me for advice as this was happening at her child’s school. Both she and the school leadership felt lost. While the situation was tragic, I was glad they wanted to have the conversation. I was glad they were reaching out for help.
My friend’s request reminded me of when one of my son’s kindergarten classmates died of brain cancer. At the time, I asked my son if the teachers talked about his classmate’s death. He told me that the kids started to talk about it, but the teacher discouraged their conversation. I felt disappointment and concern. I thought teachers would appreciate the importance of allowing children to ask questions and express their feelings. While I talked with my son about his classmate, not all children have someone at home to whom they can turn.
As a physician who cares for families of dying children regularly, I am used to having these conversations, but I know most people are not. They may not know how to go about it or know what is appropriate to say, especially with children. Bereavement expert, Kristin James, confirmed this. She provides guidance to hundreds of families in Illinois when their children die, and she said schools often ask her for help when either a classmate or adult in their community has died.
These conversations are important. But like life, death is ubiquitous. It’s on the local news and in any action movie a child is likely to see. Even Chris and Martin Kratt, lovable brothers from a popular PBS show who teach children about animals and nature, can’t escape the fact that one animal must die so that another can survive.
Further, most kids will endure the death of a family member or friend before their eighteenth birthday. Research in 2012 by the New York Life Foundation and the American Federation of Teachers found that 7 out of 10 teachers have a student in their classroom who is grieving. With more than 25 shootings in K-12 schools so far this year, too many students have an up-close look at death in the classroom.
Aside from school shootings, some may wonder why schools should have any responsibility for helping children cope with death and dying. Surely the place for such conversations is at home, with the content and focus left to the discretion of parents or guardians. Parents should be the ones to impart their own values and cultural views about death on their children, such as if there is an afterlife or not.
I agree that parents and guardians should take the lead and talk to their children about death. But the reality is, children may still turn to trusted teachers, and the consequences of avoiding these conversations are significant. Children affected by death can experience anxiety, depression, regression, nightmares, bed-wetting, and poor school performance.
As any bereavement specialist will say, it’s in the best interest of the students for schools to help the staff learn to honestly and openly answer questions about death and to provide a safe place for students’ conversations.
Teachers need a straightforward approach when students ask questions like, “Since we played together, will I get cancer and die too?” or “Will a bad guy come to our school and hurt us?” or when a teacher notices a student’s grades slip.
The American Psychological Association advises us that it is okay to acknowledge with children that bad things like school shootings or the death of a classmate or teacher happen. At the same time, teachers can reassure their students that many people are working to keep them safe, including their parents, teachers and local police.
Also, it’s good to clarify what the student is asking. A child might ask, “Why is Jane’s locker gone?” because she wants to talk about her death, or because she wants to know if she can move her locker to where Jane’s was. And teachers should remember that these are rarely one-time conversations. Children process tragic events over time. I still talk with my son about what happened to his former classmate.
Here are four other resources and suggestions for teachers:
- The U.S. Department of Education provides resources for schools and teachers to guide tough conversations. They even encourage schools to have plans in place for such tragedies.
- There are online resources such as those developed by the Coalition to Support Grieving Students.
- Bereavement experts like James recommends the pneumonic CHILD. Consider the child’s age and developmental stage. Be H Involve children when possible. Listen. And Do it again and again.
- Healthcare professionals, like bereavement specialists and child-life specialists, can be an invaluable resource to guide schools and teachers. Most towns have someone with expertise in bereavement issues with whom schools could partner.
Teachers should not feel alone as they help children cope with illness, death, and grief. Even with my experience helping families of dying children, I, sought advice from an expert, a child-life specialist, before telling my children that I have breast cancer.
Learning to cope with life’s tragedies is as important as reading, writing or arithmetic. Having teachers who know how to talk about death in age-appropriate ways will help our students heal, learn, and grow.