Hospice, it seems, is eager to simply drop our services. We're supposed to get four weeks of services after Micah's death. yet we've barely reached two weeks and it appears they are pulling back rapidly. That leaves me cataloguing each child and their needs to determine if losing the services through Hospice is going to leave each child vunerable or they are stable at the moment.
A's therapist is coming this evening for the last time. So, I have to assess if this will be enough therapy for A, or do I need to set up a long-term therapist. My insinct is that A is okay right now. He's had the most losses in his life, and he's lost siblings before. So, he has experience walking this path and understands that it does get better. He also has lots of distractions that the others don't have. He's deep in soccer training already, and has opportunities to be with friends, coaches and school personnel. There is a support group Hopsice runs for teens who have lost someone close to them. He is resistive to going, but I really think if I can encourage him to go, and talk with his Guidance counselor and coaches to just keep an eye on him this fall, that will probably be sufficient for his needs for now.
S has ongoing therapy. Honestly, due to his own losses and history, he probably needs weekly therapy for now. However, the system up here is not like it was in our last state. When E came out of inpatient, she was placed in four times per week at-home therapy initially. S would greately benefit from that. It's just not available up here. This state provides better services across the board to all teens struggling, but less intensive for individuals who meet the threshold of really struggling. So, I would guess he'll end up in every other week therapy, since I think that's about as frequent as his outpatient therapist can fit him in. There is a psychologist who goes to the high school every Friday to provide services to teens there as well. So, I'm intending to talk to his guidance counselor about the possibility of having him see her on the off weeks of his regular therapist this fall. He needs to grieve the loss of a brother he just barely knew. However, he needs to grieve a lot more than that. He will also need help learning healthy coping skills and how to handle the health issues he is still facing.
E also has ongoing therapy. However, yesterday the floodgates opened up and she is extremely lost in her grief right now. She had refused to talk about it and was trying very hard to not think about it. She said it was just too painful. Instead, she was viciously attacking her siblings and leaving them in tears. I finally had to ban her from having interactions with any of them before she would talk and let her pain out. Of course, E struggles with obssessing over things and strong grief is definitely something she obssesses over. So, while she is now talking and letting it out, she is as overwhelmed as she feared she would be if she did so. I have an email into our case manager with the wrap-around services in hope they can help me increase her therapy for now specifically to help her with grief counseling. It's the only thing I can think to help her right now.
C has been having therapy with an art therapist for several months now. I never quite understood how art therapy worked for older children until I saw it in action with C. I am floored at how well he responds to the medium and his therapist specifically. He is very sad. There are nights he spends in our room half the night, or on the couches because he cannot bring himself to sleep in his room. However, he is managing it. He mostly hides on his computer games or his Kindle, reading Harry Potter books. However, last night he asked if he can begin his homeschooling year now. So, we will start his schooling for the year today and work as much or as little as he wants each day now.
Ch is hiding. He doesn't talk much and he doesn't really join the family much right now. He has a history of attachment disorder and I worry a great deal that if he blocks his family out, he will fall back into that old insecurity. I made an effort to reaach out to him twice every day, to hug him, to talk with him, to tell him that I love him. I am setting him up with grief counseling to help him process what has happened. I have also made the decision to enroll him into public school for this year. I felt like he needed one last year to finish his ESL struggles. However, Ch is extremely extroverted. He found out R would be going to the middle school alone and specifically requested he be allowed to go with his little sister to keep an eye on her and let her feel safer with her big brother there. So, I have decided it would be best for him to have an opportunity to step out of this house and be a normal kid now. He's apprehensive but excited about this change. I just hope getting him a private therapist will help him with the deep pain I can see he is feeling and afraid to touch right now.
R is an enigma to me. On the one hand, she is responding quite well to the grief counseling through hospice. However, we lose that in two weeks, and they are already trying to withdrawal services now. On the other hand, I'm not certain she will tell me when she starts to struggle. She is more likely hold it in until she cannot anymore and explode with pent up emotions. She is also incredibly shy, so it takes time for her to warm up to anyway. I'm uncertain what avenue we need to pursue for working with her in the upcoming months. However, there was only five months between her and Micah, so the one thing I am certain of is that this is deeply painful for this child and she likely feels quite lost right now. She has a tendency to fear that she gets lost in the chaos of this large family, and it is very important to be proactive with her needs. I have an email into our case worker with our wrap-around services regarding her needs specifically. Perhaps she would do best to be added to the art therapy of her younger siblings, or best to get her an individual therapist of some sort. Something needs to be put in place for her before Hospice is completely done with the kids. If not, she may be the one who feels guilty and lost for years now with grief she was not able to process in a healthy avenue.
L is a firecracker. She is extremely verbal and has been processing all over II and I. This is the child who wants to know if there is matter in heaven. If things must have weight and take up space to be matter, then does matter exist in heaven? She wants to know how you get from your body to heaven. Last week, she declared that if she killed herself then she could go to heaven to be with Micah. She was Micah's buddy. She was ten months when we went out to see him the first time. She went with us at 15 months to bring him home. She was his playmate, his soulmate and his best friend. The last time he was in the hospital, she came to stay with us. She considered it her job to be the BIG sister to Micah his entire life. He always thought she was the big sister just as much as she did. Where there was Micah, there was L watching over him, guiding him and loving him. She is also refusing to participate with her art therapy now. She won't say why she refuses but she doesn't want to talk to her therapist. We finally talked her into just doing the art with R there to comfort her (R adores arts and crafts so she was thrilled to be included and we might decide it is best for both girls for her to be a part of the art therapy at this point). However, L is openly declaring she will do the art but she WILL NOT TALK while she does it. We'll see if that holds true for long. This is the child who will refuse her therapy but turn around and act possessed in anger later. She needs her therapy, and she needs to cooperate with it. However, we will not and cannot force her. We can only continue to provide her with the opportunity to utilize the therapy.
J is my baby. He loved Micah deeply. Micah had this habit with his autism that he would latch onto a child and mirror their developmental progress until they hit 4 years old. Once they were four, he couldn't develop beyond that point, so he would seek another child to latch onto. He latched onto L when he came home and she was 15 months. However, he couldn't progress beyond 4, and she was extremely advanced in her development. By the time she was 2.5, he was lagging behind her. By the time J was one, Micah was latched onto him instead of L. We used to wonder what Micah was going to do when J hit four and Micah either had to continue to develop finally, or was lost without someone to mirror. We never got there. He spent 2.5 years of J's life modeling and mirroring J's development. That made them best friends. When Micah was sick, it was J who would lay next to him and comfort him. He's only 3.5 now. I have some memories of that age, but II had none. I fear J will not remember his brother. I also fear he lacks the development and words to fully process what has happened. When he does talk about Micah, he uses fake tears. It's in there, but he doesn't know how to work with it. Thankfully, he also responds marvelously well to his art therapy. Unlike L, he is not resistive to this process. Instead, he happily grapped his therapist by her hand and led her to the dining room, where he is in there now nattering her head off. I believe with continued art therapy, he will process. I just don't know if he will hold genuine memories of his brother, or only those we tell him as he grows up. It was my deepest wish that Micah would have lived long enough for little J to remember him in his own right, but we had no control over that.
I'm very good at balancing the children and their needs. People remark that I know so many children so intimately and so well. It's just who I am. Figuring out how II and I navigate through this murky pain......I'm not as good at that part. The only thing I can say is that we continue to cling to each other through this. That seems to be the one thing we both grasp, that we should not do this alone. When one of us has a horrible day and struggles, the other seems to be more stable and can hold them up. I figure if we both fall down, we'll cling and hold each other throughour tears. We have the option of a support group through hospice, but niether of us are sure we are ready to try it yet. For now, we just focus on the memorial we are holding to say good-bye to Micah this weekend, and our other eight children who desperately need us. That is all either of us seems to be able to do for now.