What to tell the kids?

LydiaNN · Jun 28, 2007

Unless you want to find yourself in a boatload of trouble, I'd refer her to her guardian. You don't have any right to break confidentiality just because your patient has died. Also, in a situation such as this, where the death was related to a lifestyle choice, the last thing you want is to be perceived as passing judgment... I'm not saying that you would be doing that, but if this girl or her guardian took something you said the wrong way... boy, it really doesn't even bear thinking about.

HeatherB,CST · Jun 28, 2007

Wow, I am interested to see what responses you get here...My only thought is to pose this same question to the chaplain at your hospital and see what his/her recommendations are.

What a hard question to be asked. If it were my daughter, I would like for her to be told the truth, and all her questions answered honestly and compassionately. Keep in mind it is a conversation she will likely remember the rest of her life.

HeatherB,CST · Jun 28, 2007

Unless you want to find yourself in a boatload of trouble, I'd refer her to her guardian. You don't have any right to break confidentiality just because your patient has died.

Wow, this reply snuck in as I was typing my above post...I hadn't even thought about HIPPA.

Crux1024 · Jun 28, 2007

What a hard question to be asked. If it were my daughter, I would like for her to be told the truth, and all her questions answered honestly and compassionately. Keep in mind it is a conversation she will likely remember the rest of her life.

I agree with you, BUT its not the nurse that should be having this conversation with the child. As the other poster said,theres lots o' trouble to be found if they dont handle this the right way.

al7139, ASN, RN · Jun 28, 2007

Hi there!

It is really hard when a young child is asking questions like this to know what to say, especially if you don't know about their religion and culture. My best advice, especially for a 12yo is to answer their questions honestly, but sensitively and without any implied judgement on the mothers alcoholism. Your hospitals chaplain and patient advocates can be a great resource for these situations as well. They are there for the families as well as to help you with how you should relate to all the family members when a loved one passes away. Some hospitals even have books that can be given to children that are age specific for questions on death and dying. Also, if you have developed a good relationship with the deceased persons family, I think it is perfectly acceptible to ask them how to reply to the daughter's questions.

Hope this helps.

Amy

ktwlpn, LPN · Jun 28, 2007

I had a patient who was in the hospital for a few weeks and ended up not making it. She was a young woman with four kids. She died of liver failure due to alcoholism. When the 12yo daughter asks me why this all was happening, do I tell her it was because she drank too much? How do you say that in the right way? Do I refer her to her new guardian or should I explain? Any ideas?

Do you mean while this was happening the dtr asked you these questions while visiting her mother or are you still seeing this child? I think it's up to the family/gaurdian to explain alcoholism to this girl-especially since we know addiction can be an inherited trait..You could limit your conversations to the liver failure and explain what happened to her body as she went through the process.But if the daughter asks/asked pointed questions regarding alcoholism then I think it is appropriate for you to answer them.At her age she saw plenty and knows much already.She must have gone through H#ll ...I was 13 when my father died after a 6 yr battle with cancer and I had no one to ask that kind of question.The girl is lucky to know you....

leslie :-D · Jun 28, 2007

why would her alcoholism ever have to be mentioned?

a compassionate and gentle, "her liver failed her" should suffice, followed by a warm hug and your sympathies.

leslie

Super Nurf · Jun 29, 2007

why would her alcoholism ever have to be mentioned?
a compassionate and gentle, "her liver failed her" should suffice, followed by a warm hug and your sympathies.
leslie

This is the best answer. By far.

casi, ASN, RN · Jun 29, 2007

Is there anyway you can refer the family to some sort of counseling service? There is no doubt in my mind that if the child lived with her mother for any amount of time she knew her mother had a drinking problem. She may or maynot be able to correctly define it, but she knows it was there.

Someone needs to address the issue with her, sooner than later she'll put two and two together. It also needs to be addressed that alcoholism is a disease and not a personality flaw.

I know there are books out there that help kids understand alcoholism as a disease and the disease as the direct cause of their parent's actions. I couldn't name any off the top of my head since the only one I've ever seen was one my mother bought me when I was 5 that was a great workbook that through activities and stories helped reinforce the idea that a disease was causing Daddy's actions and not me. It didn't solve everything, but it helped some.

Should you be the one to tell the girl this? Probably not. Unless you are very close to the family you don't know what she knows and you don't know where she is emotionally. It would be best to just tell her that her Mother's liver failed and leave it at that.

rnmomtobe2010 · Jun 29, 2007

I agree 100% with you earle58.

gr8rnpjt, RN · Jun 29, 2007

why would her alcoholism ever have to be mentioned?
a compassionate and gentle, "her liver failed her" should suffice, followed by a warm hug and your sympathies.
leslie

Perfect answer. 'nuff said.