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Cancer in the school community


The bereaved school community

Friday 1 June, 2018

This section introduces a very difficult issue - one that hopefully never affects your school community. Although many people diagnosed with cancer will be successfully treated and live for many years, not everyone will recover and some people with cancer do die. There are ways to prepare if you know the prognosis is poor. The school can also support people who are bereaved.

How to prepare for a cancer death

When a person with cancer has a poor prognosis and may not survive, your school community can plan ahead to prepare people for what might happen. This might include:

  • staff and students visiting the person, if desired by their family - it may be advisable for students to go with parents or other supportive adults, and to avoid going in class time or as a class group. This can help minimise disruption to familiar routine and avoid pairing the death and the class too closely in students' minds
  • students, staff and parents continuing to communicate with the person in other ways (via emails and letters, for example)
  • the principal arranging for key community members to be told of the situation and kept up to date
  • staff having discussions with students about death, loss and grief.

Keep in mind that after the person dies, the school may also want to host a service, arrange a memorial prize, offer counselling and/or fundraise.

Saying goodbye

"We were told to say our goodbyes, but I wasn't ready to say it. Friends and family always said that at least I had the opportunity to say goodbye because his death didn't happen suddenly in an accident. The truth is, it is just as bad either way, and you are not prepared for it even if you are expecting it. From the day my father was diagnosed to the last day was the hardest eight months I will ever face." - Daniel, student whose parent had cancer

Action to take when someone dies

When someone in your school community dies - particularly a student or colleague - your school's guidelines for managing critical (serious) incidents may apply.

The school must decide, with the family's permission, how to inform people. It is usually better to tell students in their normal class groups or in small groups, rather than holding an all-school assembly. It is important that students are told in an honest and sensitive way, without overloading them with too much emotion from the person giving them the information. Often the principal will work with other executive staff and/or the school counsellor to draft a short script or guideline for teachers to tell their classes what happened. Teachers are often very grateful for this as it relieves them of the pressure of deciding what to say while they are still processing their own initial grief. The school counsellor may be able to offer further guidance and support.

Staff can be briefed with the following information:

  • an outline of key points that clearly explains the circumstances of the death
  • some positive words of reminiscence
  • details of how the school will honour the person who has died, if appropriate
  • details of the funeral service and arrangements for attendance, if known and if the family wishes the school community to participate
  • the best way to send condolences from the school and individuals
  • details of support and counselling services.

Staff should be asked to speak to classes only if they feel able to manage students' reactions and questions. Some staff may like a member of the school executive team or the school counsellor to be with them when the class is told. In some schools, or for some individuals, faith or religious tradition plays a central role in dealing with loss. If your school has a chaplain or spiritual adviser, they may be able to help tell people about the death and provide support.

The purpose of telling students is to draw the school community together and facilitate the grieving process. Students who are experiencing or have previously experienced other forms of loss (e.g. sick parent, family separation or divorce) may need extra support. The cultural diversity of your school community may also influence what you say and how you say it. Some cultures have particular customs around death and bereavement.

Be aware that older students may have already found out about the death through social media such as Facebook. Social media can help members of the school community share their sorrow, record memories and send condolences. However, remind students about the family's right to privacy and the importance of not spreading rumours or adding to the family's grief.

Not everyone in the school community will hear the news through class meetings, so you may need to use other means. For example, you can send a letter or email to parents, put a note in the school's newsletter or meet separately with colleagues. Remember to tell all the people who need to know, such as canteen staff, Outside School Hours Care staff, and relief teachers.

Indigenous families

If an Indigenous member of your school community dies, any information should be handled in a culturally sensitive manner. In some cases, it may be offensive for the school to mention the person's name or to use the image, voice or video recording of the person. School staff should be aware of this possibility and check with the person's family or community.

Funerals in Indigenous communities often take up to five days, so affected students and staff may need to be away from school for a week or more.

When death is sudden

While members of your school community will usually be aware if someone is near death, in some cases, a person's death will be sudden or unexpected. As with other deaths, you should follow your school's critical incident procedures.

It can be hard for some people to grieve - and react to a crisis - if they feel unprepared. Students might be angry that they weren't told the person's prognosis in advance. Others might feel hurt that they could not say goodbye.

For suggestions about how to help people who are bereaved, see below. You and your colleagues will have to be particularly sensitive if the death was sudden. You should be prepared for strong emotional reactions, and be ready to offer support (such as counselling) to those who need it.

Additionally, the school needs to inform others who may be affected or who might need to support the students (for example, by sending a letter or email to parents).

Helping people who are bereaved

If someone in your school community dies, each person's reaction and grieving process will be unique. Responses to grief depend on the individual's personality, how close they were to the person who has died, their own experiences with death and their access to support services. Bear in mind that it is normal for someone to feel out of control, overwhelmed or even disbelieving.

Be mindful that the staff who are trying to support grieving students may also be dealing with their own grief and loss. Staff should not feel that they need to hide their grief. It is important for students to see the adults around them modelling a range of healthy grieving processes. For people who are bereaved, you can:

Listen

Encourage the bereaved person to talk about the person who has died. If you have a conversation, be attentive and non-judgemental. Allow the person to silently reflect on their loss. Don't try to talk about other things if they aren't interested. Let the person cry, act angrily or talk about something else.

Find outlets

Explore different ways that the students can express their emotions. Primary students may want to make cards to send to the family, while adolescents may want to be with close friends in a supported setting. With the family's permission, an online tribute or remembrance page may be a good way for the school community to share memories and send condolences. If it seems appropriate and the family agrees, a school memorial service can also help grieving students, staff and parents. Other options include creating an area of remembrance or raising money for a cancer charity.

Show support

If you can, offer support to the family or closest friends. Sending a note of sympathy is a simple but caring gesture.

Be patient

Accept that it may take some time for the intense feelings of grief to abate. As time goes on, it can become easier to recognise birthdays and anniversaries, although life has changed forever.

Stick to school routines

Some consistency can be helpful for students as long as teachers are flexible about how much schoolwork they can cope with.

Teach about cancer

Include discussion of cancer research and treatment in the curriculum where appropriate, particularly if students raise the topic.

Seek further support

Bereavement support services may help you or someone you know who is going through a difficult time.

Understanding grief

Grief is a natural response to losing someone. Depending on their relationship with the person who died, members of the school community may experience a range of emotions, including sadness, numbness, disbelief, loneliness, guilt, anger, relief and acceptance.

People express grief differently. Some people openly display their emotions, while others may show no visible signs of grief. There's no right or wrong way to grieve or set amount of time it lasts. It is important that people respect each other's way of grieving. For more information, call Cancer Council 13 11 20 or see Understanding Grief.

How young people understand death

Children and adolescents understand loss in different ways, depending on their age and maturity level. To find out more, consult your school counsellor or the hospital social worker.

4-7 years

Early primary students:

  • may think death is temporary might realise that death means someone isn't around anymore, but may not understand the cause of death
  • sometimes believe their behaviour caused the death
  • might wonder who will look after them or teach them
  • might worry that cancer is contagious or that they will die too
  • may be very open and ask confronting questions

7-12 years

Late primary students:

  • understand death is permanent know some reasons why death happens (e.g. illness, old age)
  • are less likely to blame themselves for the loss, but might blame someone else
  • want to know the facts about death, including what happens after death
  • are better able to articulate their feelings and act sympathetically

12-18 years

Secondary students:

  • usually understand the facts of death
  • might respond in a self-centred way to the loss
  • may struggle with their own mortality
  • may express feelings in positive ways (e.g. listening to music, playing sports, writing in a journal)
  • usually want to spend more time with friends after a loss
  • may express their distress through risk-taking behaviours (e.g. skipping classes, experimenting with drugs or alcohol, acting recklessly)
  • need to know that support and counselling are available
  • might find it especially helpful to participate in a private or public memorial service

Memory book

"When my husband died, it was after his cancer metastasised and he had a sudden stroke on our son's seventh birthday. That was so hard. When my son returned to school, the teacher and all the kids had made a book about Joey's dad. It was so thoughtful, and it means a lot to have a tangible keepsake like that." - Patricia, parent whose husband had cancer

When a student dies

The survival rates for children and young adults with cancer have improved substantially over the past 20 years. Today, the five-year survival rate for young people with cancer is over 80%, and this rate is expected to increase because of improvements in treatments.2 However, some children and young adults do die from cancer.

The death of a young person is an enormous tragedy, and it can be difficult to accept. It is important that your school community responds in a compassionate manner. The principal or the student wellbeing coordinator should ask the family of the deceased student what the school can do to help, how the parents would like to inform staff and students (if they don't already know), and if a memorial can be organised.

If you and your colleagues worked closely with the student, you are likely to feel saddened and will need to take time to deal with your own feelings before talking to students. It may be helpful to attend the funeral service.

The student's classmates will react in different ways, depending on how old they are (see above). Their reactions will depend on their relationship with the student and their own coping mechanisms. Classmates should be able to turn to school staff for guidance and support.

Remember that a child who dies may have siblings at the school, so parents will still be part of the school community, and this may be difficult at first for other parents who are not sure what to say.

"I was devastated when Lisa died. I didn't think it would happen. She was my best friend and school just wasn't the same without her." - Melissa, classmate of secondary student who had cancer

When a parent dies

When a parent in the school community dies, the reactions of community members can vary. If the parent was a well-known community member, people may outwardly grieve the loss. If the parent was not particularly well known in the school community, many people may be unaware of their death.

Students who know a classmate's parent has died will probably worry about their own family. They might want to express sympathetic sentiments, and wonder how to support their friend and what to say. With the family's permission, some students may attend the funeral service to support their classmate, as may staff and other parents.

Other parents may also reach out to help the family in the weeks and months afterwards. Parents can help make meals, keep track of the child's homework, or provide transport to school and after-school activities.

You and other school staff members will probably be aware of the death, and you should explain the situation to students, if necessary. You will need to grieve the death in your own way and provide in-class support (such as more flexible homework deadlines) to a student who has lost a parent.

When a student's sibling dies

The loss of a student's sibling is extremely traumatic. No matter how close the young person was to their sibling, they will need time to mourn the loss. The student may have to take time away from school, and their parents will likely be occupied with making funeral and other arrangements.

Schools can be supportive when the student is away from school, and try to help them manage their schoolwork on their return. It is understandable that a student may be more focused on their family than on schoolwork for a time. Sometimes it is helpful to refer a grieving child or young adult to school or other counselling services, in consultation with their family.

The sibling's treatment team can also support the bereaved student, especially by answering any questions about the illness and explaining the medical aspects leading up to the death. A hospital or school chaplain may be another source of support. You can check that the family is aware of the bereavement services offered by CanTeen and Redkite.

When a staff member dies

When a teacher or other prominent member of the school community dies, there is a far-reaching impact. You and your colleagues will need to deal with your own grief, as well as comfort students who may also be grieving.

If you are grieving, find out about all available employee support services and take time to deal with your own feelings. If you worked closely with the person, you may wish to attend the funeral. The school may organise a memorial service to honour your colleague and to allow staff, parents and students to pay their respects.

Students can take the death of a teacher particularly hard. They will mourn in individual ways. It is okay for students to know that you are sad, too - they rely on adults to model healthy grief. Reassure students that grief is a natural reaction, and that counselling is available. The principal or a counsellor can talk to students about grief and ways to remember their teacher (see below).

How to support grieving children

  • Understand that each child will react to loss in their own way.
  • Do not underestimate the impact of a bereavement, even if a child is very young or does not seem sad. Their grief may be expressed through play or other behaviour.
  • Realise that children often work through their feelings slowly, facing them in bearable doses.
  • Explain the death in concrete terms. Avoid euphemisms such as "passed away", "lost" or "gone to sleep".
  • Answer questions in an open, honest and ageappropriate way. Accept that children may need to ask the same questions many times.
  • Allow children space to grieve - you do not need to "fix" their sorrow. It is natural for people to express sadness in various ways, just as they express other emotions.
  • Maintain routines and boundaries. School can offer a reassuring sense of predictability.

Lasting tributes

If the person who has died was well known in the school community, your school might want to establish an ongoing way to honour them. Options include:

  • planting a tree or garden
  • placing a memorial plaque somewhere in the school grounds
  • establishing an annual award named after the person
  • acknowledging anniversaries.

Planning a memorial

In addition to any funeral or other formal service organised by the family, your school might hold a memorial service to honour the life of a student, parent or colleague. Participation in a memorial service allows the community to share their grief and honour the loss of the school member. Community members can collaborate with the family to organise the event.

When planning a service, you might consider:

The setting

Will the service be held at the school? How formal will it be? Is there any special music that could be played or performed?

Who will attend

Will you make a public or school-wide announcement to let people know about the service? Would the family like you to ask everyone to wear a particular colour as a gesture of support? Who will lead the service - Are there school staff, friends, students or family who would like to be involved?

Sharing memories

How can people share favourite memories or thoughts? Will there be a program or a slide show?

Flowers, donations and cards

Should people bring flowers, or would the family prefer donations to a charity? Where can people leave sympathy cards?

Appoint a staff member (school counsellor, chaplain or teacher) for children to talk to if they become upset before, during or after the memorial service.

Seeking professional support

It is important to understand that bereavement is a process, not a single event, and can take many months or even years. A student or staff member should be referred to professional help if they simply need someone to talk to, but especially if they demonstrate significant changes in behaviour, such as:

  • saying they want to die too or becoming extremely preoccupied with dying
  • suffering academically or at work for an extended period after the death
  • acting sad and withdrawn for an extended period
  • increased risk-taking or self-harm
  • having trouble socialising.

Talk with your school principal and colleagues about ways to support bereaved members of your school community. If you think that a student needs professional support, consult your school counsellor. Staff who need counselling for themselves may be able to access it through an Employee Assistance Program (EAP) if this is available at your school. Some people may need ongoing support for many months.

You could also contact one of the organisations listed in the table below. These can be good starting points for general advice or for referrals to bereavement counselling.

Bereavement support services

Australian Centre for Grief and Bereavement

Offers online information for people experiencing grief and bereavement.

1800 642 066 | grief.org.au

Cancer Council

Can refer callers to local services or recommend a telephone support group CanTeen offers online information and bereavement support tailored for young people aged 12-25 years.

13 11 20

CanTeen

Offers online information and bereavement support tailored for young people aged 12–25 years.

1800 226 833 | canteen.org.au

GriefLine

Provides community and family services to support all Australians who have encountered a loss.

1300 845 745 | griefline.org.au

Redkite

Offers bereavement support for families and friends of children and young people aged 0-24 years.

1800 733 548 | redkite.org.au

The Compassionate Friends

Has member organisations across Australia that offer support to any family that has lost a child.

1300 064 068 | tcfaustralia.org.au/contact

The National Centre for Childhood Grief

Offers counselling for bereaved children aged 3-18.

1300 654 556 | childhoodgrief.org.au

Section summary

  • If a prognosis is poor, take time to plan how best to communicate with students, families and staff.
  • In the event of a person's death, ask the family for consent to tell the school community.
  • Tell students in small groups.
  • Send an email or letter home to all families, if appropriate.
  • Create opportunities for students to talk about the death and ask questions.
  • Encourage students to express grief and sympathy in ways that feel comfortable to them.
  • Model healthy grief.
  • Be sensitive to cultural differences.
  • Consider holding a memorial service.
  • Explore ways to honour the memory of the person in an ongoing way.

Expert content reviewers:

Claire Tobin, Principal Medical Advisor, Department of Education and Training, VIC; Dr Antoinette Anazodo, Paediatric and Adolescent Oncologist, Sydney Children's Hospital and Prince of Wales Hospital, Director of The Sydney Youth Cancer Service, and Conjoint Senior Researcher, University of New South Wales, NSW; Lisa Barrow, Clinical Nurse Educator, Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC; Margo Bulic, Psychosocial Support Worker, CanTeen, ACT; Amber Copeland, 13 11 20 Consultant, Cancer Council Queensland; Donna Drew, Clinical Nurse Consultant, Paediatric Oncology/ Palliative Care, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW; Allesha Fecondo, Education Consultant, Victorian Paediatric Rehabilitation Service, and Education Liaison, Ronald McDonald Learning Program, Ronald McDonald House Charities Australia, VIC; John Friedsam, General Manager of Divisions, CanTeen Australia, NSW; Pina Hutcheson, President, Catholic Primary Principals' Association of WA; Cara Irvine, Year 8 Coordinator, Alfred Deakin High School, ACT; Andrew Long, Assistant Director, Policy and Research, Independent Schools Council of Australia, ACT; Dr Alistair Lum, Post-doctoral Research Fellow – Behavioural Sciences Unit, Sydney Children's Hospital, University of New South Wales, NSW; Kristine Luszczynski, Learning Program Manager, Quality and Standards, Ronald McDonald House Charities Australia, NSW; Anita Neville, National Manager, Ronald McDonald Learning Program, Ronald McDonald House Charities Australia, VIC; NSW Department of Education, NSW; Mandy Roney, Consumer; Shannon Rush, Primary School Program Manager, Camp Quality, SA; Luke Wade, Education and Career Support Consultant, Redkite, QLD. 

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