Britain’s first Children’s Commissioner, Professor Sir Al Aynsley Green claims children are often “hidden mourners” who grieve under the radar of many services, even though bereavement can have enduring and life-changing consequences for many of them.
Sir Al will explain how his own experience of losing his father at the age of 10 has informed his campaigning on the issue when he speaks at the Irish College Physician’s of Ireland’s annual St Luke’s Symposium next month.
He will challenge Irish doctors to reflect on their own response to children who have lost a loved one. “I want Irish doctors to ask themselves how competent they are when relating to grieving children,” he said.
In a recent British Medical Association (BMA) blog he recalled how as a little 10-year-old boy he waited alone on a bench “in a deserted white-tiled, ether-smelling hospital waiting area”, playing with a toy lorry as his mother visited his father.
After several hours, he was stunned when an aunt appeared and told him, “Your daddy has just died, and you have to be the man of the family now and look after your mum and sister.”
His grief was compounded when he realised that his father had pleaded to see him as he lay dying, but “the harsh hospital policy of the day” meant children were not allowed to visit wards.
His response was to vow that he would be a doctor “to stop other girls’ and boys’ mummies and daddies from dying”.
Research has shown that longterm consequences for bereaved children whose grief is not properly supported, can be very serious, ranging from poor educational attainment, joblessness, or psychological and psychiatric ill health.
His mantra for hospitals and medical professionals who are dealing with the terminally ill is to “think adult, think child” and to always ask themselves how the children in a family will be affected by the death.
“We must ask of Irish hospitals, are you child friendly? Do you understand the needs of children when adults are critically ill or dying?,” he said.
Different circumstances of death require different responses, he stresses.
Sir Al believes the “excellent” hospice movement in both Ireland and Britain supports adults and children dealing with expected deaths but he believes the real challenge is unexpected death, especially when it is traumatic or violent.
“It’s an issue for Emergency Departments who receive critically injured adults, and also for police forces going out to give bad news to families. What does this mean for the child in the family, the child whose father has just been killed on a motorbike? This is a very different scenario to expected deaths,” he said.
The most harrowing of all circumstances, he pointed out, are those encountered by young people and children whose parents or brother or sister have killed themselves.
His recent blog which generated a “phenomenal” response, followed a BBC 4 radio broadcast with journalist Paddy O’Connell, when both spoke frankly about the long term consequences of losing a parent as children.
The BBC had to repeat the broadcast “due to popular demand” with countless adults getting in touch to share their own stories of unsupported grief as young people.
Sir Al was frustrated when a recent major BMA report on end of life care in the UK, failed to address the needs of dying children or children coping with the death of a loved one.
He recalls how 40 years after his own childhood ended in that ether-smelling hospital, the impact was laid bare when during a television programme about childhood bereavement he began to weep uncontrollably.
“I suddenly realised a huge, unrecognised, repressed anger over how I had not been allowed to see my dad to say farewell to him before or after he died, when he was brought home to lie in our sitting room before his funeral,” he said.
He said this issue raises extremely important questions for faith.
“Does it matter if a child is bereaved in a family with faith or not? Are they more resilient or are they more angry that they are bereaved?,” he asked.
He also is curious about whether wakes are still commonplace in Ireland or whether other rituals exist to help mourners celebrate a life. “The key point is that death is part of life and it is very important that we don’t medicalise grief as a medical disease. It should be an experience that children and adults can talk about and come to terms with.”
Having discovered through research that many clerics in the Anglican Church feel uncomfortable and ill-prepared when dealing with bereaved children of different ages, he asks whether this is an issue for the Roman Catholic Church in Ireland. “What are you guys doing about preparing your clergy to relate to and to support children? There must be debate within the other denominations too, and within ethnic groups,” he said.
Sir Al will point out in his RCPI lecture that childhood bereavement is not just an issue for the health service, “It is for schools, it’s for social care, it’s for faith. In fact it should be everybody’s business.” While questioning the competence of many of these sectors, he says the Irish Childhood Bereavement Network is doing a “fantastic” job.
“They are a benchmark for how a national organisation can work for, and with, children and families who are bereaved. They are excellent,”
Professor Sir Al Aynsley Green will speak at RCPI as part of the RCPI annual St Luke’s Symposium, Medicine in Changing Times is an opportunity to hear from leaders in healthcare on topics that relate to transforming healthcare delivery and transforming postgraduate medical training.
The event takes place from 09:00 to 13:30 in No.6 Kildare Street, Dublin on Saturday 22 October 2016. Book your place at www.rcpi.ie/stlukes16/
Sir Al’s lecture is entitled Think adult, think child! Why doctors caring for dying adults should ask what the death means for children in the family.