Psychologically speaking: Can I go visit grandma in the hospital?

If you can deal with what is going on, your child will most likely do fine.

By DR. BATYA L. LUDMAN
Hospital generic 224.88 (photo credit: Ariel Jerozolimski [file])
Hospital generic 224.88
(photo credit: Ariel Jerozolimski [file])
Dear Dr. Batya, My mother was diagnosed with cancer and has been in and out of the hospital over the past year. While for now she is okay, her future looks less good. We are not sure whether to take our six-year-old son to visit his grandma in the hospital or how to prepare him for future visits in the event that things deteriorate. A.C., Jerusalem I am sorry that you are going through what must be a very difficult and stressful time. The way children think, which is affected by their stage of development and their experience, directly impacts their response to health, illness and loss, with respect to both themselves and others. As parents, the more you are able to understand what is going on in your child's head, the better prepared you will find yourself for such tough decisions as to whether he should visit grandma. Unfortunately, at some point you may also need to prepare him to deal with issues around death, such as attending a funeral and shiva. While age is an important factor, a child's stage of emotional development and level of maturity, coupled with how previous experiences were handled, will have the greatest impact on how he does in terms of your mom's cancer. Young children tend to be concrete, may incorrectly attribute occurrences to their actions and are often strongly bound by rules. They often think that their thoughts and deeds directly influence the health and well-being of themselves and others. Children have often wished that someone would disappear, or die, only to discover later that coincidentally, something has happened to this individual. They may wonder or believe that they, in some way, caused the illness to happen through their bad deeds. Older children may wonder if other people, such as their parents, or even they themselves, will eventually become ill like their loved one. Depending on the role your mom has had in your son's life and the nature of their relationship, your son may wonder if his grandma will continue to be there for him and if not, who will take her place. You have lots to consider before deciding whether to take your son to see your mom. Here are just a few questions you may want to think about before that important visit: Is your son prepared for what he may see, and what can you do in advance to help? Is grandma, for example on oxygen, unable to talk, sharing a room with someone missing a limb or unable to have her grandson climb up on the bed for a story? Have you role-played and rehearsed with your son as much as you can for the new sights and smells and how people may look without frightening him? You can use words such as: Grandma may look tired, her skin may have more wrinkles, and she may need some help to breathe better. Can you be there to provide lots of hugs and support as well? How does your son feel about going to the hospital? If a child does not want to go and states this, never force him to make a visit he (and you) may ultimately regret. It is better to live with this decision even if he may later wish that he had gone. If your son wants to go and you feel that it would be good or helpful for him, and that he can handle it, by all means, regardless of age, consider it. Many kids are far less bothered by the trappings of illness and simply see it as seeing their beloved grandparent in a different setting. They may have questions and be curious while having little understanding of a progressive disease process. Are you and the person hospitalized, in this case your mother, able to handle your child's visit? Will you be upset if he's upset? Will someone be able to leave with him when he has had enough? Will you be able to answer and are you okay with him asking "innocent" questions before and after the visit and in front of grandma? Will your son and grandma be happy seeing each other or will it create more stress? Can visits be short so as not to tire out grandma? Remember, her tolerance for noise, jumping on the bed, eating and even laughter may not be what it once was. On the other hand, it might be just the tonic she needs and brighten her day unimaginably. What can your child do before and during the visit to make grandma more comfortable? Can your son make a card or room decoration, can you talk about how to hold grandma's hand or gently message her feet? Can he speak with her on the phone? Recognize that no matter how much preparation you do ahead of time, the actual visit may not go as planned. Your son may be frightened by a noise, other patients or something you least expect. Tell your child as much as he needs to know, but no more than he needs to know. If someone is terminally ill and therefore not going to get better, let your child know that this illness is not like an ordinary sickness and that everyone is doing the best they can to make grandma comfortable and happy. At some point you will need to let your son know that the doctors and you don't expect grandma to get better. Always explain things in language a child can understand and with correct medical terms while not overwhelming him. Often his imagination will be worse than the truth you present. Like a beloved pet or a leaf on a tree, everything some day will die and that is part of the life cycle. It need not be scary. Be as simple, honest and accurate as you can be and recognize that he will come back to ask more questions, and this in itself is an important part of his understanding the process of what is going on. If you are having difficulty in facing what is going on, make sure you yourself get professional help to enable you to cope or to talk with your son. If you can deal with what is going on, your child will most likely do fine. At the end of the day, you are the best person to decide what is best for him. Have faith in yourself. The writer is a licensed clinical psychologist in private practice in Ra'anana. ludman@netvision.net.il