Friday 15th April 2016
Mac Voice, the magazine for Macmillan professionals: Spring 2016
Claire Hall and her colleagues have developed a childhood bereavement checklist.
Each year more than 24,000 children in the UK experience the death of a parent.  By the age of 15 around one in five children will have lost a parent, sibling, grandparent or friend. 
As Macmillan nurses working within a specialist palliative care unit, we frequently support patients, families and carers who may need help preparing children for bereavement. It is crucial for us to take a caring approach that embraces practical, psychological, psychosocial and spiritual support. We know that early and proactive interventions to prepare children for loss can help them adopt healthy coping strategies.  By investing time in exploring family dynamics, we can identify all of the children who may be affected, including those who we may not meet directly.
Our children’s checklist
Communication and documentation are pivotal to our assessments. To support this, we have developed a ‘children’s checklist’ as a form of documentation.
The checklist gives us a structure to explore:
- the understanding individual children within a family unit have about the current ill health of a person
- how they are reacting to the situation
- how we can link in with schools and other broader social networks or agencies involved, to direct timely conversations and signpost to support where needed.
The form includes space for us to write down:
- the names and dates of birth of different children who are affected
- roles and contact details of key carers for children, and who we can contact at their schools
- information resources or memory boxes children have received
- the children’s understanding of what is happening and their coping mechanisms
- any wishes that parents or carers have around guardianship or future care arrangements
- details of other agencies involved in supporting children.
How we use the checklist
We use this document to support our holistic needs assessment. It can be completed from a multi-disciplinary team perspective.
The checklist allows us to explore opportunities to create and capture future memories for children and young people, and to promote resilience in the face of loss. In addition, any legal arrangements can be highlighted and addressed, along with the acknowledgement of any wishes and future care arrangements.
This tool has been extremely valuable and well used within our team, enhancing patient care. It is felt this tool could be easily applied by other services, to give a structure to supporting families at challenging points in their journey.
You can download the children's checklist [Word document] or email me for further details.
For more information about the checklist, email Claire.
Macmillan and Winston’s Wish have developed a new patient information booklet for adults: Preparing a child for loss.
A new e-learning course called Working with children pre‑bereavement can help you support children when an adult has a life-limiting illness. Visit Learnzone for more details.
1. Winston’s Wish website. Facts and figures. www.winstonswish.org.uk/about-us/facts-and-figures (accessed 2 February 2015).
2. Stokes J. Then, now and always: supporting children as they journey through grief. Winston’s Wish. 2004.
3. Marshall S et al. Encouraging/supporting dying patients to talk to their children. End of life journal. 2013. 3:2(1–4).