Life on the other side of the fishbowl

Alex James is telling me about a six year old whose dad had just died of cancer. The mother and daughter had returned to the Hospice of St Francis, where Alex runs a bereavement support programme for children aged 2-19. They had viewed the body and were filling out the death certificate, everyone very hushed and still. The little girl pulled Alex to one side and whispered, ‘Can I ask you something?’

‘Of course’ said Alex.

‘How do they know my dad’s definitely dead?’

‘Well, his heart stopped beating’

‘Yes, but how do they know that? What if it hasn’t really?’

Rather than reassuring the child with platitudes, Alex did something that had never before been tried at the hospice. Along with a nurse, she took the little girl back to her father’s body and placed the stethoscope in the child’s ears. They stayed like that for an hour, the child listening intently and asking very pragmatic questions about what, exactly, she could hear, until the little girl was satisfied that her daddy really was dead. ‘She’d been worrying about it for ages’, Alex said, ‘and hadn’t wanted to upset her mum by asking her, so we helped her to understand it’.

I went to visit the hospice as part of this year’s Children In Need campaign, to find out about the work done by the children’s grief support team at St Francis. Children In Need kickstarted the programme by funding a social worker, its inaugural member, three years ago. As the anecdote above demonstrates, the work carried out by the team is amazingly unsentimental. ‘These families are drowning’, Alex explains, ‘and you have to let them drown; you can’t be there for them forever. But what we try to do is to lift them up from time to time and show them dry land’.

The idea of leaving a kid to be upset is heartbreaking for most adults. But a dead mum or dad is upsetting. There probably shouldn't be anything more upsetting to a child than losing a parent; it would almost be disingenuous to try and 'solve' their grief. Instead, each member of her team works one-on-one with a family until the day that the family realises they don’t need help any more.

Alex's team offers support to up to fifty children at a time. Unusually for such programmes, they offer pre-bereavement support (they’re very careful not to call it counselling) as well as post-bereavement support. ‘Children will really open up to us after the parent has died if they feel like we actually knew mum or dad,’ Alex explains. ‘They can trust us when they talk about them. A lot of the work they do is about helping the remaining parent and child to find ways to communicate their grief to each other; to understand that every feeling is valid’.

Kids who connect with their support worker before the parent has died, Alex tells me, do much better, typically, in terms of dealing with their grief and are often ready to go it alone by about twelve weeks after the death of a relative. In striking contrast, children who gain access to the service only post-bereavement find it much harder to come to terms with and are often still seeing their key worker a year later. ‘The other thing’, she reminds me ‘is that grief isn’t linear and kids change as they grow up. So just because Dad died at five and you understood everything then doesn’t mean you won’t have questions when you’re eight and you understand a lot more.’ Children are encouraged to call back to the service whenever they feel the need.

Although we probably imagine children to be utterly bereft when a parent dies, Alex reminds me that this might not always be the case. ‘Some of these adults have been ill for a big chunk of the child’s life, and they’re relieved when it’s over and they can get on with their lives. ‘ She tells me of a teenager who confessed to relief that her motor-neurone-sufferer mother had died before the university term began, so that she could start her course along with her peers and not have to take an (expensive) gap year; of a nine-year-old boy who admitted he was ‘glad’ his father had entered the hospice ‘because now the bathroom has stopped smelling funny’. This is the side of death we don’t like to look at; the terrible truths that actually, life stopping for three years when you’re fifteen can have a huge impact. The team at St Francis help the children to understand that it’s OK to feel like this, that they’re not required to have a Disneyfied reaction to grief.

Sometimes, true emotion comes out elliptically. Not long ago, Alex visited a family whose mother had recently died. The family – three children aged fifteen and down – were sitting formally in the lounge, chatting apparently freely. ‘Everything’s fine’ was the message coming through.

Then Alex looked across at the fish tank. The fish had belonged to their mother, the tank a distraction from the endless days of dying.

‘How are the fish doing, do you think?’ she asked the family.

‘What do you mean?’ the little one asked.

‘Well’, Alex said, ‘we’ve been looking at the room from this side, looking into the fish tank. How d’you think the room looks from their side? What do they see since Mum’s died?’

The kids thought about it.

‘The room’s darker’ said the eldest girl.

‘Yes, and it’s quieter’, said the middle one, ‘Mum used to love to always have music on. There’s no music now’.

Then the little one piped up again. ‘And Daddy often forgets to feed the fish now because he’s drinking more. Mummy never forgot’.

Just like that, Alex said, the floodgates opened. The children were done talking about their grief to well-meaning adults; had honed the platitudes over their mum’s long illness. But turn the subject onto the fish, and what the fish might be thinking of the experience, and suddenly they were brimful of stories and emotions that they needed to share with Alex.

I left wishing the impossible; that none of these kids had had to suffer a parent dying. But the other big thing I thought was: thank goodness for someone like Alex, who really gets it. She's not trying to be their best friend; she's not trying to fix things. She's utterly caring without being cloyingly sentimental; she's calling death by its name when these kids have often had months of side-stepping from adults around them; and she's providing a neutral ear. It's the sort of thing children could probably often do with regardless of bereavement. To be able to provide it so compassionately and yet simultaneously dispassionately is all kinds of amazing.