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Spokane, Washington  Est. May 19, 1883

Honesty key to breaking bad news

Catherine Johnston And Rebecca Nappi The Spokesman-Review

Q: A much beloved preschool teacher for my now 8-year-old died suddenly recently. This will be the first person in her young life who has died. Is there a good way to break the news to her? And any suggestions on an activity or two we could do together to commemorate the teacher’s life?

A: When talking to a child about death, use clear, age-appropriate and honest language, advised Mary Anne Ruddis, executive director of the American Childhood Cancer Organization Inland Northwest.

“Acknowledge that her teacher died and that she will not be coming back. Acknowledge also that you don’t know why it happened. No one does. As parents, we want to have all the answers, but life is a mystery and letting children know that sometimes there is no answer can help them learn to live within that mystery,” she said.

Remember, too, that children “do” grief differently than adults.

“It is not a linear process but rather an emotional journey that she may revisit at other times,” Ruddis said. “Also, she may begin to have fears that her parents or others close may die. Be as supportive as possible in recognizing the fear without completely dismissing it or over-indulging in it.”

Can she attend the memorial service with you? That will help.

“If not, have her say goodbye in another way,” Ruddis said.

Some suggestions: Write a card, or draw a picture, and send it to the teacher’s family.

“Light a candle and (talk about) what she loved about her teacher and what she will miss most about her,” Ruddis said.

Many excellent books have been written about children and grief. Two of Ruddis’ favorites include “The Fall of Freddie the Leaf” by Leo Buscaglia and “Waterbugs and Dragonflies: Explaining Death to Young Children” by Doris Stickney.

Q: Our dog is getting on in years. My wife thinks that when Spot starts getting sick, we must have him euthanized. I want to offer him at least some medical care, if he needs it and I know that care can be expensive. How can we come to consensus?

A: We love our pets and hope they will live as long as we do. Unfortunately, we end up without them after only 10 to 15 years or so. And we face difficult decisions when they age and experience diminished good health, get injured or fall ill.

Talk about Spot’s health now before you face a crisis and jump to uninformed decisions. Maybe you and your wife agree that chronic conditions, such as arthritis, will be treated, but terminal illness, such as cancer, will not be treated aggressively, and Spot will be kept comfortable.

“Veterinary care remains a step-by-step process that should be under the complete control of the owner,” said Steve Harris, veterinarian at Flying Cloud Animal Hospital in Eden Prairie, Minn. “Incurring catastrophic costs need not be the case.

“The alternative (to euthanasia) is pre-geriatric care such as weight control, quality diet and exercise, incremental health maintenance through the family veterinarian and exploration of financial options when needed. Euthanasia should be the last option when determining health care decisions,” Harris said.

If health insurance for your dog offers comfort, investigate options. Many pet insurance plans have a deductible and cover a percentage of fees for emergency health events. Also, veterinary groups often have funds to subsidize costs when owners cannot pay all their expenses.

“Many owners describe those (pet’s geriatric) years as some of the best they ever enjoyed with their pet,” Harris said. “Planning for the costs and understanding, in advance, what level of treatment will be done can remove a lot of the fear and uncertainty about that impending time.”

Catherine Johnston, a health care professional from Olympia, and Rebecca Nappi, a Spokesman-Review feature writer, welcome your questions about what to do in times of illness, dying, death and grief. Contact them through their EndNotes blog at www.spokesman.com/ blogs/endnotes.