I worry a lot. Will I die too? Will you die too?

Children are often worried after a sudden traumatic death. Immediately they may ask themselves the question, How could this happen to me? Their safe world is suddenly shattered, and the assumption that the adults around them can keep them protected is destroyed. Some children may begin to have nightmares, sleeplessness, and feel anxious or fearful, and they arent really sure why. Others regress or panic when Mom or Dad are out of sight. So often they worry about their own health or that of a loved one.

Giving children reality checks about their own health can be reassuring. The pediatrician and school nurse are good resources and allies to ease their minds. The doctor can take their temperature, give medicine, and answer medical questions to help comfort girls and boys. Educators can also provide extra support for children. Interventions such as calling home, having a safe space to go to, picking a class buddy, and allowing extra teacher time create a tangible plan with student involvement.

When a death occurs children may worry about other family members dying too. Many girls and boys question, whether outwardly or unspoken, what would happen if their parents died. Asking the question out loud is an opportunity for parents to reassure their children that they will be taken care of, and invite them to be part of the decision-making process. In this way they may feel they have regained a sense of control after a traumatic death.

Peter (7): a case study

Peter was 7 years old. He died of a brain tumor soon after he fainted on the school playground. Peter had first complained to his teacher of a bad headache, then fell off the swings and became unconscious. His parents rushed him to the hospital, where the doctors discovered a brain tumor.

He died after an unsuccessful emergency operation. Peters classmates and siblings had lots of questions about his death. They worried a lot about what could happen if someone gets ill. They worried their parents could die. They worried they could die too.

Scottie (7; Peter's friend in second grade)

Since Peter died I get lots of headaches. Will I die too?

You seem very healthy and that means you will probably live for a long time. Usually when we get ill we get better all by ourselves or with the help of medicine and a doctor. If you get a headache it doesnt mean anything bad will happen to you. Lets ask your mom if you can visit your pediatrician, Dr. Jones. He can give you a physical exam and reassure you that you are OK. If you have any questions about your health or Peters death, bring them along to the visit. Dr. Jones is a good person to help answer those questions.

I have one question. Can I catch what Peter had?

Peter had a rare illness that usually doesnt happen to children. It is called a brain tumor. You cant catch a brain tumor the way you can catch a cold. You cant get it from your parents the way you get blue or brown eyes from Mom and Dad. You cant get it just because you have a headache or fall off a swing.

Sometimes I think about Peter at school. I dont feel like eating and my tummy hurts. What should I do?

Scottie, the next time your tummy hurts you could visit the school nurse. She is a good helper right at your school that you can talk to. She might understand it is common for children to get stomachaches after someone dies. Sometimes their hurt or worry goes right to their tummy.

My worry does go right to my tummy. It hurts.

It is normal for worries to go to your stomach or another part of your body. Show me just where the worry is in your tummy. Point to it for me. Take a deep breath right there, and then let it go. Put your hand on the sore spot and rub it a little. That might help to rub the worry away.

It is hard for me to pay attention in school. I daydream a lot and think I am going to cry when I think about Peter. Then I want to call home. What should I do?

I understand you have so many feelings in school, and you dont know when you might feel sad or worried. That makes it hard to concentrate on schoolwork. It might make you miss your mom a lot too.

Your mom and dad and I had a conference with Mrs. Novak. We made a plan to help you with all of these hard feelings in school. Heres what you can do. Call home once a day to touch base with Mom if you start to worry. You can pick the time. If you feel worried or upset in class you could pick a person to talk to, like the school nurse. Mrs. Novak will know where you are going if you suddenly feel sad and leave the room. You can choose a class buddy to make sure you get your homework assignments and help you with schoolwork. Mrs. Novak said she would give you special time to help with assignments.

Sarah (11; Peter's older sister)

I worry a lot that if Peter can die, my mom and dad can too. What would happen to me? Who would take care of me?

Thats a good question. I think they will live a long time, but no one can promise when or where someone will die. We could ask them to have medical check-ups to reassure you they are OK.

Lots of children worry after a death about the health of other people in the family and what would happen if their parents died. Ask your parents when you are ready. I think they can reassure you someone will take care of you. They can tell you their plan or you can help them think about it. Maybe you even have an idea about who you would like to be with and let them know.

Julie (6; Peter's younger sister)

Since Peter died, I worry about going to sleep. If I sleep I have bad dreams. Will I die if I go to sleep?

No. Sleep is not the same thing as death.

But at Peters funeral I heard my aunt say Peter is at rest. That makes me worry about even taking a nap.

You are safe to take a nap and go to sleep. Sometimes people use the words rest and sleep when they talk about death. It is not the same. Death is when the body stops working. Your body is working when you are resting and sleeping. Maybe your mom can leave a little light on in your room and you can sleep with your pal, Mr. Teddy.

But I still have so many nightmares. I wake up screaming and crying. What can I do to stop the worry?

There are some things you can do to stop the worries. Here are a few ideas. Make a worry box. Decorate it with pictures, stickers, and words that tell about your worries. Then put the worry inside. You can share it if you like, but you dont have to. List your top five worries. Share them with someone if you want to. Write a letter or draw a picture about your worries. Maybe tell Mom or Dad or a favorite teacher what you are worried about. Get a doctors note after your parents have their medical exam. Keep a diary. It can even have a lock. Draw or write how you feel. It is a safe place for you to store worried feelings or share them with others. It is your choice.

Concluding thought

All of these children were impacted by Peters death. Regardless of their age, it was natural for them to worry after a sudden trauma. Interventions that allow young people to release their worry can be very helpful in placing these worries outside of themselves. Actively involving children in exploring thoughts and feelings, expressing pent-up emotions, asking questions, and using reality checks can help to release these worries in safe and meaningful ways.

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