When Grandma no longer likes it

When grandparents slowly become old and frail, their grandchildren also notice this. Especially if the grandparents were very present in the grandchildren's everyday lives. Whether on the weekly Grandparents' Day or on Sunday outings together - at some point their strength and energy dwindle and the roles are reversed: it is increasingly the younger generation that supports the older generation.

What does it do to a family when grandma and grandpa are no longer able to keep up and have to drop out as playmates and conversation partners more and more often? Irina Kammerer is Head of Counselling and Therapy for Children, Adolescents and Families at the Psychological Institute of the University of Zurich. She recommends starting earlier and generally incorporating the transient more into everyday life.

Children have fine antennae and can sense exactly when parents are withholding information.

Riccarda Frei, psychologist

According to Irina Kammerer, even the youngest children can be given a comprehensible dimension of the cycle of life, the beginning and the end. The annual cycle with its four seasons offers many vivid examples, which creates an awareness of the ageing process and promotes understanding for ageing grandparents. «Becoming frail is a process and doesn't happen overnight. That's why even young children experience the ageing of their grandparents,» says Irina Kammerer.

A serious illness changes everything

It's different when grandma or grandpa has a terminal illness and mum and dad seem more tense than usual or are often sad. Many parents keep their feelings to themselves in such situations because they want to protect their offspring from certain topics and feelings.

«Which is completely understandable,» says Riccarda Frei. She is a specialist psychologist at the Competence Centre for Paediatric Palliative Care at Zurich Children's Hospital and a bereavement counsellor for children and young people. Nevertheless, she believes it is important to communicate openly and transparently within the family and not to make a secret of illnesses and age-related complaints. «Children have very fine antennae and can sense exactly when you are holding something back. Uncertain situations therefore often make them even more anxious,» Frei points out.

How much should you tell your offspring about an illness or the grandmother's weakening overall health? Irina Kammerer's recommendation is: «Explain as much as necessary, as little as possible.» Parents should therefore not trick their children by trivialising the situation, but at the same time should not overburden them with information.

«I don't know»

Mums and dads would do well to answer their children's questions as honestly as possible and also admit when they don't have an answer to one or two questions. When giving explanations, it is important to stay in the present - and describe, for example, what the child can expect from the next visit to Grandma.

Far-off predictions, on the other hand, are not in demand. Riccarda Frei points out that younger children in particular, who don't yet have a concept of the future, can't do anything with it anyway.

Half-knowledge often causes even more anxiety. It is better to state things clearly from the outset.

Riccarda Frei, psychologist

The psychologist would mention diagnoses such as cancer or dementia by name. «Children have good ears - sooner or later they'll find out anyway.» That's why it's better for children to be told by their parents than by their neighbour or overheard in a phone call.

«I once saw a teenager being told that her mum had a lump in her breast to avoid the word «cancer»,» she says. The girl then searched the internet for answers, found what she was looking for, but didn't dare ask her parents about it. «Half-knowledge often causes even more fear,» warns Frei. «It's better to state things clearly from the outset.» This is particularly important so that the family develops a common language for what is happening and can discuss it.

Preparing for difficult visits

Adults often transfer their own fears onto their children and try to keep them away from situations that they themselves don't know how to deal with. They also have to make difficult decisions: should you take the ten-year-old to hospital with you when his grandfather is in a vegetative state? «It depends on the child,» says Riccarda Frei. «Some are naturally sensitive to the hospital environment, others are simply curious. I would decide on a case-by-case basis.»

Every encounter with sick people helps children to understand death as the last step in a process.

Irina Kammerer, psychologist

The psychologist advises preparing for such a visit in any case: Describe the hospital room, perhaps show photos of it, look at picture books about it. Tell them what Grandad looks like, that he is wired up with tubes through which he receives food and medication to help him. Think with the child about how they can occupy themselves in the hospital. Discussing the visit in advance provides security and orientation. («You can do arts and crafts or draw there, we'll hang up the drawing in Grandad's room and then leave.»)

«I would also clarify in advance who will leave the hospital room with the child if he or she has had enough after two minutes,» says Frei. This gives the child the opportunity to regulate the distance for themselves at any time. «In general, every encounter that is possible until death helps to categorise everything and to better understand death as the last step in a process,» explains Irina Kammerer. This applies to adults as well as children.

When children start to understand death

We know from developmental psychology that small children do not yet realise the significance of illness. But even babies can sense when something changes in the family, when the mood is different, when mum and dad are worried. Children also only grasp the concept of the finality of death from the age of seven or eight. While younger children think «Grandpa will be back soon» and only learn through experience that Grandpa is really no longer there, older children realise: «Death can happen to anyone - mum, dad and myself.» Dying therefore seems more threatening to children as they get older.

There also needs to be sickness-free times when the family can do carefree things together.

Because younger children do not yet grasp all the dimensions, Riccarda Frei believes it is important to talk to them too. At preschool age, girls and boys tend to make a lot of things about themselves. Sometimes they develop feelings of guilt and feel responsible for the tense atmosphere at home and the weakening grandfather. It is important to explicitly relieve children of feelings of guilt and to say so («It's nobody's fault. You didn't do anything wrong!») - even if such words may sound superfluous to adult ears.

Mothers and fathers would do well to signal to their daughter or son: «Every feeling is allowed! You can be sad or angry or scared. There is no right and wrong. And you can be happy despite everything.» Because children shouldn't feel guilty if they've had a fun afternoon with their friends and haven't thought about Grandad.

Bridge programmes instead of pressure

Older children sometimes react with anger, rage and withdrawal to serious illnesses in their environment and may no longer want to visit their weakening grandmother - even if their mother, father or grandmother would like them to.

«In this case, you should take the pressure off and give the young person the freedom to make their own decision,» says Irina Kammerer. It often helps to mirror («I can see that you don't want to go to Grandma's right now, but it would still be nice if you could see her again») and to keep making offers, approaching young people and building bridges («We'll visit Grandma later. Why don't you come with us if you like?») - in the knowledge that you might be rejected again.

Parents should integrate change, transience and farewells into everyday life as a matter of course.

Irina Kammerer, psychologist

«It's important to find the right moment for such a conversation,» says Riccarda Frei. A joint activity or in the car - sitting next to each other without the possibility of escaping the situation - often provides better opportunities than if the teenager is sitting in their room and doesn't want to be disturbed while gaming. It can also help to involve other caregivers who have a better connection to the child during the pubertal detachment phase between parents and child - the godmother, for example, the football coach or the school social worker.

Give the children time

What do you generally need in uncertain times when you're thinking about saying goodbye to your family? «The most important thing is to keep in touch and, as parents, keep an open ear for your children,» advises Riccarda Frei. «These topics are rarely over with one conversation.» This makes it all the more important to divide the information up into different conversations.

Give the children time to let what has been discussed sink in and approach them again («How do you feel about that?», «Do you have any questions?»). Younger children in particular can easily give the impression that they are not really absorbing the new information - until a few days later when questions suddenly arise. This is where you need to start again.

If the offspring don't want to talk about it at all, that's fine too. «However, it's important that children have peace of mind: If I want to, I can ask mummy and daddy at any time,» says Riccarda Frei.

Providing orientation and security

Maintaining and continuing familiar daily routines and rituals is now more important than ever - after all, they provide security and orientation in uncertain phases. At the same time, there is also a need for illness-free times when the family can do carefree things together.

Openness is essential: Mums and dads are allowed to let their child comfort them when they are in tears. This can, for example, strengthen their offspring's self-efficacy - as long as they don't hand over responsibility for their feelings to the child. Such gestures help children to deal with feelings of helplessness and to realise: «I can do something too!»

«Death is not present in our culture. That's why we find it so difficult to deal with,» says Irina Kammerer. «This makes it all the more important for parents to integrate transience, farewell and change more naturally into everyday life - so that it doesn't hit children so abruptly when they have to deal with it.»