THE MYTH OF THE REPLACEMENT CHILD: PARENTS' STORIES AND PRACTICES AFTER PERINATAL DEATH

Parents bereaved by perinatal death adapt to their losses in different ways. When bereaved parents give birth to a child or children subsequent to a perinatal death, their constructions of the family necessarily change. The subsequent child is thought to be at risk of psychopathology (the replacement child syndrome) if parents have not sufficiently grieved their losses. This qualitative interview study examines the family stories told by bereaved parents, with particular attention to how parents represent the dead child and subsequent children in the current family structure. We categorized parents' stories as those which suggested that parents replaced the loss by an emphasis on parenting subsequent children, or maintained a connection to the dead child through storytelling and ritual behavior. The two ways in which parents maintained the connection were to preserve the space in the family that the dead child would have inhabited, or to create an on-going relationship with the dead child for themselves and their subsequent children. There seem to be multiple paths to parenting through bereavement. The place of rituals and memorial behavior is also examined.     

Parental Grief and Memento Mori Photography: Narrative,Meaning, Culture,and Context

Postmortem photography is a widespread practice in perinatal bereavement care, yet few studies have explored how it affects bereaved parents, or how it might be received by parents of older children. This study is an examination of the meaning, utility, and social context of postmortem photography in a sample of 181 bereaved parents. Data were subjected to both quantitative and qualitative analysis. Photographs were positively regarded by most parents after perinatal death and several parents of older children. Other parents rejected postmortem photography for aesthetic, personal, or cultural reasons. Brief recommendations are offered for healthcare providers.     

Evidence for healing interventions with perinatal bereavement

The purpose of this article is to explore the concept of perinatal grief and evidence-based healing interventions for it. The loss of a pregnancy or death of an infant causes profound grief, yet society has long minimized or ignored this grief, which is among the most painful of bereavement experiences. Throughout the last century, research on grief and the special needs of bereaved parents has changed the context of professional intervention from protective to supportive. The central focus of bereavement interventions is to assist families in healing by helping them make meaning of their losses. The use of symbols, spirituality, and rituals has been shown to help bring meaning. Research has shown that memories are key to healing, and that gender, age, and relationships bring different grief expressions and experiences. While children's understanding of loss and grief differs with developmental age, they should also be given the opportunity to participate in grief rituals and practices.Professionals who care for bereaved parents have a unique opportunity to offer support by validating their grief, facilitating rituals, providing mementos, and letting the bereaved tell their stories. While no intervention can bring back their beloved children, appropriate intervention can promote healing.     

Bereaved parents' perception of the grandparents' reactions to perinatal loss and the pregnancy that follows

This article presents bereaved parents' perceptions of their parents' (the grandparents) reactions at the time of loss and in the pregnancy that follows. Data originated from two phenomenological studies conducted to understand bereaved parents' experiences during their loss and subsequent pregnancy. However, this article reports a secondary thematic analysis focused on bereaved parents perceptions of the grandparents' support (or lack of) at the time of loss and during the pregnancy following loss. Our findings illustrate some families found the means to share their grief at the time of loss in a constructive manner, while in others the intergenerational relationship was strained. Most important to parents was intergenerational acknowledgment of the ongoing relationship to the deceased child as an important, though absent family member, especially during the pregnancy that followed. Those supporting bereaved families can play an important role in helping intergenerational communication around perinatal loss and the subsequent pregnancy.     

MANAGING BEREAVEMENT IN THE CLASSROOM: A CONSPIRACY OF SILENCE?

The ways in which teachers in British schools manage bereaved children are underreported. This article reports the impact of students' bereavement and their subsequent management in primary and secondary school classrooms in Southeast London. Thirteen school staff working in inner-city schools took part in in-depth interviews that focused on the impact of bereaved children on the school and how teachers responded to these children. All respondents had previously had contact with a local child bereavement service that aims to provide support, advice, and consultancy to children, their parents, and teachers. Interviews were audiotaped, transcribed verbatim, and analyzed using ATLAS-ti. Three main themes were identified from analysis of interview data. Firstly, British society, culture, local communities, and the family were significant influences in these teachers' involvement with bereaved students. Secondly, school staff managed bereaved students through contact with other adults and using practical classroom measures such as "time out" cards and contact books. Lastly, teachers felt they had to be strong, even when they were distressed.Surprise was expressed at the mature reaction of secondary school students to deaths of others. The article recommends that future research needs to concentrate on finding the most effective way of supporting routinely bereaved children, their families, and teachers.     

儿童死亡后居丧父母悲伤护理研究现状

儿童死亡是父母生活中遇到的严重负性生活事件。相对于成人死亡而言,父母悲伤反应强烈,不仅影响到其身心健康和彼此之间的关系,还会进一步影响到整个家庭乃至社会。该文从儿童死亡对家庭产生的应激和影响,父母悲伤反应的影响因素及相应的干预措施三方面进行了综述。     

Decreasing the Risk of Complicated Bereavement and Future Psychiatric Disorders in Children

TOPIC: Decreasing the risk of complicated bereavement and future psychiatric disorders in children. PURPOSE: This literature will determine what major factors influence a child's response to death and to understand how children react to the death of a parent at different developmental stages. It will evaluate the following:

• a) What are children's emotional responses to the death of a parent?
• b) How can a surviving parent help the grieving child complete the tasks of grieving?
• c) What skills are important for a parent to learn in order to help the grieving child through the tasks of grieving and
• d) How can mental health providers help the grieving family and the grieving child?

SOURCES: Relevant literature from child psychiatry, child psychology, and nursing. CONCLUSIONS: The death of a parent is a major stressful event for children and their families. This traumatic event can bring serious psychological and social distress to bereaved children and their families. Children who are not supported in the early phases of grieving can develop serious emotional and behavioral problems that can lead to the development of some major psychiatric disorders. Providing early prevention support programs for surviving parents and bereaved children can help both the parents and the children adapt to their losses. These structured programs can decrease the risk of complicated grief in bereaved families. More research studies are needed to validate the effectiveness of these early prevention program interventions.     

Managing bereavement in the classroom: a conspiracy of silence?

The ways in which teachers in British schools manage bereaved children are underreported. This article reports the impact of students' bereavement and their subsequent management in primary and secondary school classrooms in Southeast London. Thirteen school staff working in inner-city schools took part in in-depth interviews that focused on the impact of bereaved children on the school and how teachers responded to these children. All respondents had previously had contact with a local child bereavement service that aims to provide support, advice, and consultancy to children, their parents, and teachers. Interviews were audiotaped, transcribed verbatim, and analyzed using ATLAS-ti. Three main themes were identified from analysis of interview data. Firstly, British society, culture, local communities, and the family were significant influences in these teachers' involvement with bereaved students. Secondly, school staff managed bereaved students through contact with other adults and using practical classroom measures such as "time out" cards and contact books. Lastly, teachers felt they had to be strong, even when they were distressed.Surprise was expressed at the mature reaction of secondary school students to deaths of others. The article recommends that future research needs to concentrate on finding the most effective way of supporting routinely bereaved children, their families, and teachers.     

Parenting school-aged children after the death of a child: A qualitative study on victims’ families of the Sewol ferry disaster in South Korea

Abstract

This study aims to identify parenting experiences after the death of a child. Using interpretive phenomenological analysis, we mapped the experiences of 16 parents with school-aged surviving children after the death of their sibling to the 2014 Sewol ferry disaster in South Korea. Interviews illuminate five master themes of parenting surviving children following a child’s death: (a) parental anxiety, (b) conflicts and obstacles in the parent-child relationship, (c) changes in parenting style, (d) striving to support children’s grief, and (e) seeking outside help for parenting. Implications for supporting grieving parents and their children are discussed in light of the findings.     

Living in a world without closure: reality for parents who have experienced the death of a child

The death of a child has been described as being for parents one of the most traumatic of losses. Nevertheless, information about how parents experience transition through the death trajectory is lacking. This phenomenological study explored parents' lived experienced of transitioning through the death of a child. Twenty-eight bereaved parents (17 mothers, 11 fathers) took part in retrospective, open-ended interviews. Findings showed that, regardless of the time, parents continued to live in a world without closure and, more importantly, did not want to experience closure in their transitioning. To parents, "closure" meant an end to their child in every sense of the word. Their experience of living in a world without closure was supported by four themes: "keeping the memories alive", "being a good parent", "being there at my child's death", and "being there for me after my child dies". Findings yield new insights into how parents live with the death of a child.     

The aging of grief in Israel: a perspective of bereaved parents

This article focuses on long - term grief of older bereaved parents within the context of the Israeli society. The themes that emerged in a group discussion with 29 elderly bereaved parents whose sons were killed during military service support previous findings that the passage of time has no diminishing effect on parents' grief or on relinquishing attachment to the deceased. Aging appears to increase internalized involvement with the long - lost child, fears of fading memories, and the need to eternalize the deceased. In reviewing the past, parents reevaluate their coping with the loss and their relationship with the surviving children. The strong attachment seems to continue in external and inner representations of the lost child. In Israel, this preoccupation is enhanced due to society's attitude to dead soldiers, creating thereby an interface between society and bereaved families. The authors conclude that grief is a central theme in aging parents, and the term "aging of grief" is suggested to describe the course that grief and its many aspects may take with the passage of time.     

Death and Dying Anxiety Among Bereaved and Nonbereaved Elderly Parents

This study examines differences in death and dying anxiety between bereaved and nonbereaved elderly Israeli parents, as well as correlates of these factors among bereaved parents. A total of 97 parents (49 bereaved, 48 nonbereaved) completed measures of death and dying anxiety and religiosity. Bereaved parents reported significantly higher dying anxiety scores than nonbereaved parents, but there were no significant differences between the 2 groups in death anxiety. Religiosity was unrelated to death and dying anxiety. Dying anxiety was higher among bereaved mothers than bereaved fathers. Death and dying anxiety were not associated with the length of time since the loss of the child or the nature of the child's death. Results are discussed in light of the difficulties that bereaved parents experience after the loss of their child. Implications for theory, for health and welfare professionals, and for policy are suggested.     

An expanded perinatal bereavement support committee: a community-wide resource

While perinatal health care professionals have discussed individual methods to support bereaved parents after a perinatal death (miscarriages, stillbirths, or neonatal deaths), there needs to be a comprehensive approach to perinatal bereavement support that extends not only to bereaved family members, but to the perinatal staff and the medical and nonmedical community. To facilitate such support, a perinatal hospital bereavement support committee was established. Its functions are described, including the development of hospital bereavement protocols, educational programs for all medical and nonmedical staff, and the establishment of local support groups.     

Two Weeks Post-Death Report by Parents of Siblings' Grieving Experience

Nurses who work with children and families need to be aware of the impact that the death of sibling has on children. Although many children have experienced losses, the loss of a sibling of course has a tremendous affect. Nurses must educate parents and children about death and the affect on the entire family. Siblings should be involved in the communication about the impending death and in the funeral arrangements. Open communication between the dying child, the siblings and the parents is very important. Young children will have different needs than older children because of their difficulty in understanding the finality of death. It is natural for parents to try to protect their children from unpleasant experiences such as death and dying. Research supports the dying process including the funeral. Children and their families need support through out the dying experience including follow up after the actual death. They need to be assured that their feelings and actions are common to others that have suffered a significant loss.     

Parenting foster children with chronic illness and complex medical needs

The experience of parenting foster children with chronic illness and complex medical needs was explored in a phenomenological inquiry with 10 foster families. Thirteen participants currently fostering chronically ill children with complex medical needs were interviewed. Recorded interviews were transcribed and analyzed using van Manen's method. Data analysis yielded five essential themes: Foster parents described being committed to the child in their care, coming to know the needs of a medically complex foster child, and identifying effective and ineffective interventions encountered through day-to-day living with a medically complex child. Furthermore, they shared what it was like to experience loss of a child through relinquishment and death. Last, for these parents, fostering children with complex health care needs was a life-changing experience. The findings show that parenting a chronically ill foster child with complex medical needs is a multifaceted experience having implications for multiple disciplines.     

Adult children of parents with mental illness: Dehumanization of a parent – ‘She wasn't the wreck in those years that she was to become later’

Children who have lived with parental mental illness experience long‐standing reduced health and social outcomes, alongside ongoing personal distress. While there has been some dialogue regarding interventions to support children who are living with parental mental illness, there remains a paucity of knowledge regarding adult children's experiences and potential needs. Given this, the aim of the present study was to establish parenting narratives of adult children who had experienced childhood parental mental illness. This included their experiences of being parented alongside their own subsequent parenting roles. Three men and 10 women, ranging from 30 to 78 years old, met individually with a researcher to tell their stories. Narratives were thematically analysed to establish themes. The findings of the study demonstrated that individuals who have lived with childhood parental mental illness dehumanized their parent with mental illness. The authors argue that all mental health services should be underpinned with a whole of family assessment and care philosophy. There is also a need for all mental health services to consider how policies and procedures might inadvertently dehumanize clients who are parents, which could contribute to familial dehumanization. This could prevent the dehumanization of parents who experience mental illness to preserve parental and child relationships.     

ADULTS VIEW THEIR CHILDHOOD BEREAVEMENT EXPERIENCES

This study sought to determine if depression is an inevitable outcome of childhood bereavement experiences , as the Freudians believed , or if children can experience healthy mourning , as Bowlby predicted . In an application of Q methodology , 43 adults parentally bereaved as children sorted statements about childhood bereavement experiences and outcomes in adulthood . Debriefing interviews followed . Four distinct types of experience emerged through factor analysis: appreciation , frustration , enmeshment , and ambivalence . Depression was not found to be an inevitable outcome , and Bowlby's prediction that certain positive family factors can influence a child toward healthy mourning during childhood were corroborated . Salient factors contributing to healthy childhood mourning included positive relationships between the child and both parents , ample emotional and psychological support from the surviving parent , and open and honest communication with the child about the death and its impact on the family .     

Always With Me: Understanding Experiences of Bereaved Children Whose Baby Sibling Died

An arts-based qualitative method was used to explore the experiences of children's bereavement after a baby sibling's death, in the context of their family and school life. Data were collected during in-depth interviews with 9 bereaved children and 5 parents from 4 Canadian families and analyzed. A central process, evolving sibling relationship over the years, and a pattern of vulnerability/resilience, ran through all four themes, which reflected ideas of connection, impact of parental grief, disenfranchisement and growth. Findings indicated that home and school are critical to children in creating safe spaces for expressing the evolving nature of infant sibling bereavement.