When a family member is ill or dies

When a close family member is ill, it can upset a teen's fragile sense of control over his life. Illness, especially terminal illness, is neither foreseeable nor avoidable, and it changes the balance at home when parents channel their energies into taking care of the sick person. This may be the first time your teen has had to think about the difficulties imposed by a family member's long illness or about the imminent death of someone he loves. He may express his concerns by becoming depressed or angry; he may become angry with the sick person or with you, or frustrated that a situation over which he has no control is interfering with his life. Try to accept your teen's negative emotions without criticism. If you respect his feelings, he'll learn to respect your hurt and grief. Your teen may also find ways to be helpful and want to be part of the family coming together during a crisis.

Early teens are very needy and require much reassurance from you. Middle teens are more likely to confide in their friends or just seek their support by hanging around with the gang. Older teens may know intellectually that the family needs their help and support, but they may be unable to take on a more adult role. Be careful not to load them with responsibilities that prevent them from being with friends or having time alone just to be adolescents. But perhaps they can prepare dinner some nights or take care of younger children in an arrangement that you work out together. You may have to let the housework go or hire some help during this period. When friends and family offer casseroles or to mow the lawn, take up those offers.

Teens really need to know what's going on when a family member is ill. It's important that you be honest with them, even if the truth is painful. If you don't tell them the illness is terminal, they may feel betrayed when Grandpa dies, as if you didn't trust them with important information that could have helped them prepare themselves. Keep communicating throughout a long illness. As you watch your brother go through the rigours of chemotherapy, you can tell your teen of his progress each day: "Uncle Hal has lost his hair, but he's able to eat now." Some teens are fascinated by illness and begin surfing the Internet for whatever details they can find. This is not a morbid interest; they are genuinely trying to help. Talk about the loved one with them, explaining how difficult it is for you and for everyone touched by the illness: "I find it hard to watch him get sicker every day. He's lost all colour in his face."

Visiting an ill person

When your teen plans to visit the sick person, prepare him. Warn him that Grandma may not know him, and suggest to him what he might talk about and how to behave: "You might tell her about the hockey game you were in last week and hold her hand if you like. You only have to stay half an hour, then you can wait for me in the hospital cafeteria." If a parent or sibling is dying, you may find that your teen avoids visiting. Gently encourage her without pushing. If she cannot face it, suggest she make a card or write a letter to keep connected with the sick relative. When the end is near, let her know clearly: "You should see Joanna now, because the doctors think she might not live through the night."

Making decisions

An older teen can participate in a family conference to decide whether Mom will come home to die. Work out a role for him that he can sustain throughout her illness, perhaps reading to her every day. Create some important rituals and memories. Perhaps you want to celebrate Hanukkah early because your father won't live until the holiday. If your teen is particularly close to the person who's dying and is having a difficult time, you may want to seek outside support for him. His peers may not know a lot about the stresses of caring for a loved one with a terminal illness. A school or religious counsellor may be able to say the right thing to him. If you know he'll hate missing class for a counselling session, suggest that they meet at lunch or before school so that he doesn't have to miss class.

Breaking bad news to teens

Your teen may look as if he's an adult, but he can be quite vulnerable emotionally. When you deliver bad news about a death or serious illness affecting someone close to him, you should choose words carefully. He deserves to know everything, because he will feel you do not trust him if he's kept in the dark. But he needs your support to deal with the shock. Sit beside him, and turn off the music or TV so that you can concentrate on one another.

1. First, give a little warning of what you are about to say: "I have some bad news to tell you."

2. Then, say what has happened: "Grandpa had a heart attack. He's in a coma in the hospital."

3. Third, tell him what it means: "The doctors think he could die today." It's better to use direct words, such as death and die, whose meanings are clear.

4. Guide him by telling him what he could do to help: "I'm going to the hospital. I would like it if you'd come with me."

5. Let him absorb all the information any way he wants, whether by crying, by going to his room, or by turning back to the computer.

6. Don't censure him if he won't go to the hospital, but prepare him for what he'll see if he does decide to go: "Grandpa's breathing is very uneven, and it's hard to watch." Let him know he can ask questions, either of you or of another relative if you feel overwhelmed by the situation.

Facing the death of a loved one

It's often during the teen years that your child first experiences the loss of someone he loves. Sometimes it's a grandparent or a friend who has been close to your family. By the age of thirteen, most teens have an intellectual understanding of death, but young teens have quite volatile emotions. As they first experience mortality, even if it's someone they don't know well, teens may feel their grief deeply. They may exhibit their sadness, fear, or anger as physical symptoms, especially if they're going through puberty. An older teen who has put a great deal of effort into rebelling and separating from parents may feel guilty when someone dies. He may recall that he hadn't seen or even spoken on the phone with Grandma for months; he'll need reassurance that his struggle for some independence from the family is normal and that Grandma still spoke of him affectionately before she died. A teenage boy may struggle against other people's expectations of how he should behave. Don't let anyone tell him to "be a man about it." He has the right to cry.

Your teenager may not turn to you for support, but it's important that you talk to your teen about the death, sharing your own feelings about and memories of the person. She will appreciate this, but she may be unable to handle the emotions it raises and flee to her room. She may talk about her loss to a close friend or group of friends and they may want to come to the funeral to support her. If she seems reluctant to talk with family members, accept that reluctance, but raise the subject again as the months pass so that she can explore her feelings with the rest of the family when she's ready.

Give your teens a role in the funeral service, if they can handle it. Ask them whether they're willing, but don't push if they seem reluctant. A sensitive thirteen-year-old may feel too self-conscious to read her poetry, but she may be able to read a passage of Scripture. At fifteen, your son may fear the job of pallbearer, because he's afraid he'll be too shaky to carry the casket. But he may be able to walk along as an attendant or an escort. A self-confident eighteen-year-old may be able to relate her memories of Grandpa during the service. Whatever age your teens are, prepare them for what will happen at the funeral and guide them in appropriate behaviour.

Page 2 of 3

The death of a close family member

If your spouse or child has died, you may be emotionally absent to your teen as you struggle with your own grief, and you may be unable to support your teen as he copes with the death of his parent or sibling. Although the support of his friends will help him at the time, they are unlikely to understand if he's still upset one year later. It may help your teen to talk with other teens who've had a similar loss at a grief support group for adolescents. Bereaved Families of Ontario, Compassionate Friends, hospices, and schools throughout the country run such programs.

If your teen was just beginning to establish a separate identity and had frequent conflicts with the parent who died, she may have difficulty separating from someone who's no longer there. If she was the second oldest and is now the oldest living child, her sense of her own place in the family will begin to shift. Parents who have lost one child may develop an extreme fear of losing another and may restrict the freedom of their other teens, even if they had previously led an active social life. Try to negotiate guidelines that are manageable while still putting your mind at rest.

Unfortunately, teens too often experience the death of a classmate or friend through traffic accidents or suicide. Many school boards have plans in place, such as a counselling team for tragic events, to help students deal with tragedies. In the microcosm of a high school, the sudden death of a student or teacher can reverberate, triggering strong emotions and possibly copycat suicide among other teens, even those who didn't know the victim well. Young teens may personalize a death, thinking "It could have been me," or, if a classmate loses a parent, "It could have been my mother." They need to work through their own fear of death, and they may be unable to shake a feeling of foreboding after the event. Some are unable to sleep; others react with anger at the unfairness of a death.

Counselling by slightly older peers and by teachers may help them cope, but parents also play a role. If your teen wants to attend a classmate's funeral, agree to accompany her and a group of her friends. Unaccompanied teens who don't know how to behave at a funeral may make things difficult for the bereaved family, although they may help one another. Tell your daughter what's appropriate in attire and behaviour and what she might say to the bereaved parents. Help your teen gain some perspective on the tragedy by talking it over with her. Resist the impulse to lecture about drinking and driving, but acknowledge that bad things do happen to good people and that the death has been a shocking experience for everyone.