A nurse is caring for a child who has terminal cancer. Which of the following responses by the child’s school age brother should the nurse expect?
A.
Believes that his brother’s death will be reversible
B.
Regresses to an earlier developmental level
C.
Alienates himself from his peers
D.
Believes his bad behavior is causing his brother’s death
The Correct Answer and Explanation is:
The correct answer is D. Believes his bad behavior is causing his brother’s death.
In this scenario, the child’s school-age brother is likely to experience a variety of emotions and misunderstandings related to his sibling’s terminal illness. School-age children, typically between 6 to 12 years old, are in the cognitive developmental stage that Jean Piaget described as “concrete operational.” During this stage, they begin to think logically but still have difficulty grasping abstract concepts, including death and its finality.
A common reaction for children in this age group is a phenomenon called “magical thinking,” where they may believe that their thoughts, actions, or behaviors have power over events in their environment. This can lead to the misconception that their misbehavior, anger, or even negative thoughts are responsible for their sibling’s illness or impending death. Guilt and self-blame are common emotional responses because they may not fully understand the true medical reasons behind their sibling’s condition.
Option A (Believing that death is reversible) is more typical of younger children, such as preschoolers, who may see death as temporary and reversible due to their more limited understanding of its permanence. School-age children, however, begin to recognize death as irreversible, though they might not fully comprehend all its aspects.
Option B (Regression to an earlier developmental level) is more commonly seen in younger children under stress or experiencing grief. While some school-age children might exhibit some regressive behaviors, it’s less common in this age group compared to younger children.
Option C (Alienation from peers) might occur in adolescents, who are more likely to withdraw from social situations as a response to grief. School-age children, on the other hand, tend to seek social interaction for support and reassurance during stressful times.
Understanding these developmental responses can help the nurse support the child by providing age-appropriate explanations and addressing the child’s feelings of guilt and confusion. The nurse can work with the family to ensure that the child’s emotional needs are met through counseling and clear communication about the situation.