35.1: Declan

Declan is now at home and is being supported by the local community services co-ordinated by the Paediatric Oncology Outreach Nurse Specialist. You are one of the community nurses caring for Declan and his family at home. During one of your home visits mum breaks down and cries. She is finding things very difficult. She is feeling anger towards her friends that their children are healthy. ‘I am never going to see Declan go to school.’ She shares that she doesn't like the horrible person she is becoming

  • How would you respond to this situation?
  • How do you support mum?

› Suggested answers

  • How would you respond to this situation?

Very important to assure Kate that these are very normal feelings and that she is not a horrible person. Explain to her that many parents experience these thoughts. She is grieving the loss of all her hopes and dreams that she had for Declan. This is commonly referred to as anticipatory grief.

  • How do you support mum?

Encourage mum to talk about this. She may like to consider talking with someone like a social worker or psychologist who specialises in this work. Important to let her know that many parents find this beneficial as you can talk freely about your thoughts and feelings and this person can help develop strategies to help manage.

It’s four months since Declan died peacefully at home surrounded by his family.

The Specialist Palliative Care Nurse who is Declan’s key worker is working with the family, primarily mum, as dad is at work when she visits and has previously made clear it is his wife who needs the support not him. Kate (mum) is quite concerned about her husband. David appears withdrawn, he is working long hours and refuses to talk about Declan.

Kate is unsure how to support her husband. At the same time Kate is struggling, she feels isolated.

  • How do you address these issues raised?
  • What resources/supports could be useful for the family?

Explain to Kate that males and females grieve differently with the loss of child. Remind her that services and support is available for fathers too. Regarding her isolation, explain that bereavement support groups may help her with other bereaved parents.

Important that both Kate and David have the right supports available to them. Remember we cannot force people to talk and seek help but we can ensure the supports are available. Bereavement follow up is imperative for both parents.

Two key areas to be addressed:

  • That Kate has understanding on why David is grieving this way and strategies on how to support him. Kate also needs the opportunity to talk all these issues through with a skilled clinician on an ongoing basis.
  • David needs the opportunity to address his grief but in his own way. Providing the opportunity to talk to someone he feels safe with. This may be a challenge and may take time to introduce.