Past cases: September 2006
Here are the cases dealt with on Ruth’s page for September 2006.
My mother is dying in the UK – how do I prepare the children?
How horrible for you, much more than it may be for the children. This is your mother with all the memories of all you were to each other. I hope that you are dealing with it OK.
There are so many things to consider here; your letter says it is not necessary for you to go home, there are other people who can help to look after her, but you must feel a long way away. At least nowadays it is so much easier to communicate.
The children are a different matter. You say that they were born away from the UK and only knew your Mum when she came to stay. In that sense she was rather like an exotic visitor; all very exciting when she was there, and probably someone who wrote brilliant letters and sent good presents, but not really a part of their lives.
Their ages are important too. Children develop a concept of death as they grow older, so that your four-year-old already has some small understanding. Death is understood when we know it is irreversible and inevitable, and four year olds generally can understand that someone won’t come back. But her Grandmother is someone who only ever came and went, so I imagine that her death won’t affect the little one too much. She will be sad that you are sad but not really sad for herself.
The seven-year-old will probably remember things they did together, and miss her in a vague sort of way and wonder what will happen to her now, and the ten-year-old will miss her but will also start to think about the death of people she is much closer too, ie you and her father.
So when you ask about how to prepare them all tell them that Grandma is seriously ill and not likely to get better. And then allow them to ask questions and then answer them. Explain what is happening, explain that Grandma’s body has just come to the end of things – but also take time to reassure them that while everyone does die, you have no intention of dying for ages and ages. Do not promise to live to be 100 – you can’t. A dying eagle might fall on your head and squash you flat, you can only promise to do your best to live for ages. And explain too about funerals and what happens then. In my experience, children worry about the practical, and if you can explain that the soul leaves the body and what is left is a shell which can be buried or cremated without hurting anyone, you will help a lot.
After a death some people explain that the dead person has become a star and they go out to look for Granny in the sky. And you can make collages to remember all the good times you had together, and look at photos of good times you had together. In some ways it is much easier in your position, since there will be lots of family stories and you just have to go on telling them.
Remember, too, that you are allowed to be unhappy and to feel sad. The children must understand that you have lost someone very important; even if they do not miss her as much.
Neall still wets the bed most nights. Help!
Neall is nine and this is a big problem for his mum. She says that he wets the bed most nights and will sleep through, she doesn’t know how to stop him and worries about him having friends to stay or staying elsewhere.
This is a not uncommon problem with boys and it may be that his father had similar difficulties. In fact about one in a hundred men still has an incontinence problem sometimes. This is mostly a man problem but a very few girls are affected too and it’s a big problem.
There are different causes for the problem, and different solutions. I am assuming that Mum has tried to wake him at useful times so that he empties his bladder – cutting down on his drinking will not work.
Some children just have a very small bladder and can’t hold a lot of urine. Some have bodies which do not make enough desmopressin – this stops the body from making as much urine at night – and a spray can help these children to improve. But the most common cause is a slightly immature nervous system which means the body does not get strong enough messages from the bladder to tell them to wake up in time. If Neall is one of those children who might not wake if a bomb fell beside them, then that will just make things worse.
For the latter child, there are two fairly successful methods. Both are helped by adding a star chart which notes the dry nights and offers a reward for a certain level of success. Doctors may provide the child with a bell or buzzer – a pad is placed under the sheet and as soon as it detects moisture, the bell or buzzer sounds. The theory is that the child will stagger from his bed to the loo, and will learn to tighten his muscles as soon as he hears the noise – so that quite quickly he will learn to wake up just as he needs to wee.
Unfortunately, I have heard of many families where the whole family is woken by the noise except for the child concerned who sleeps blissfully through. For this child, hypnosis can be very helpful. During deep relaxation, the child is given the message that as soon as he feels the need to wee, he will wake up and go to the loo. Often he will be given a tape to listen to as he falls asleep – this can be useful.
Most children don’t enjoy waking up wet (although I remember one boy who used to lie in bed at 15 and wee rather than get out of bed!!) and will be pleased to learn how to do things differently. Obviously it is helpful if Neall puts his own sheets in the wash, just so that he learns some responsibility, but he shouldn’t be made to feel it is a Terrible Thing. By the way, many children are dry when they visit friends. I think this is because they sleep less soundly, just in case, and so are able to get up when they need to.
Christian won’t try new foods…
It’s actually a bit worse than that. He eats hardly anything and seems frightened of new things, even if everyone else in his family is eating. He’s starting to get underweight for his height and doesn’t seem as strong as his friends. At eight, that is difficult.
Lots of children are faddy when they are young and as they get older they grow through it. And quite a few children only eat a restricted diet – but as long as they continue to grow taller and bigger, that’s fine. Ross, a friend’s son, has grown to adulthood on a basic diet of peanut butter sandwiches and chips and not much else at all. The worry is that Christian is not growing properly.
Children with Asperger Syndrome are often difficult about all sorts of new things – but there are a lot of other symptoms and Christian’s Mum would have probably heard it suggested by now. And some children, who are very stubborn, find they back themselves into a corner about what they will and will not eat, and then can’t find a way through. Others find they cannot eat food with bits in, or are so uninterested in eating that they don’t care to stay long enough at the table to eat.
It’s hard to be clear exactly where Christian’s problems lie. If he eats or drinks suitable foods, you can try to sneak additives in to them – it’s not difficult to put vitamin drops into most foodstuffs or drinks. If he eats sandwiches, you could try to offer peanut butter or cheese or other high calorie fillers just to give him some energy. Milk shakes can have egg and sugar added to make it more valuable; sometimes a child who cooks is more likely to try the food they have made.
You might also like to try the premise that he is generally a frightened person, and talk to him about being worried about lots of things. You could then encourage him to be brave in different arenas, starting with something where he felt more comfortable. Perhaps he could help his little sister be braver with dogs or spiders, perhaps he could swim a bit further or go upstairs on his own. Then you could ask him to be brave in trying new foods – initially just one bean, or strawberry, or mouthful of something.
He could choose what he wanted to try, but I would encourage him to stay there till he has tried whatever and then be pleased. Some boys have enjoyed trying food from various football teams – pizza for Italy, pancakes for America etc. – others want to eat like Dad, other children need to be distracted.
At this age, it is difficult and important. If you don’t have joy really soon, go to the doctor and ask for referral to a psychologist or dietician.