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Dealing with end of life and grief

Despite improvements in survival rates for children and teenagers with cancer, in some patients the disease cannot be controlled and is ultimately fatal.

This raises the question of how to manage the terminally ill student in the classroom during the later stages of the illness and how to respond to parents and classmates after the death. Even in the final phase of illness, school can remain a rewarding experience for the young person and those around him/her.

What to do in case of terminal illness?

Often simple measures can help the student get the most from his/her remaining life. For example, those who become too fatigued to attend school for a full day will often benefit from half days or even an hour’s attendance daily. As energy ebbs, assigned work should be adjusted accordingly. The young person who has lost a lot of weight may be uncomfortable sitting in a school desk chair, but may do quite well if allowed to bring a pillow or cushions to sit on.

Help the classmates to cope with death and grief

When a student dies, classmates may express their grief in a bewildering variety of ways. Some are quite open, while others may appear almost indifferent to the loss of their classmate. Such responses are a normal variation in the gamut of young people’s grief reactions. They may assimilate the information about a death gradually, as they become able to deal with the event and its implications.

Feelings of loss for the young person with cancer should be acknowledged, but no attempt should be made to force classmates to talk about the death or to deal with the grief before they are ready. Most young people do so in their own way and at their own pace, if they are allowed the space and not forced or hurried.

Attending the memorial service or funeral of the student is a way of helping classmates understand the meaning of death. Even for very young children, especially if they have not seen their sick friend for some time, the service may help them realise that death is irreversible. In addition, it provides an opportunity for saying a last goodbye and for expressing sorrow for the loss of a friend. This is not to say every friend or classmate should attend the service. The decision to do so rests with each individual and with each student’s.

As in the period of the student’s illness, classmates are likely to have many questions after his/her death. Again, most are best able to cope with this distressing event if they are given honest, simple, straightforward answers to their questions.

Classmates may also want to create a memorial to their friend, such as a tree to be planted in the school grounds or some piece of equipment to be donated to the school.
Organising such a project and raising funds for it can be a valuable and therapeutic experience. In addition, the parents, brothers and sisters of the young person will usually be greatly comforted by the way in which others share their feelings of loss.

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