QUESTION: I have recently been approved as a foster parent and my first placement will be coming today. They are two boys, ages nine months and five years. Their mother is critically ill in the hospital. Do you have some advice on dealing with this situation and the possible loss of their mother?

ANSWER: It is fortunate that these children will have the stability of one another through this difficult period. Like kittens in a litter, some comfort will be gleaned by sharing this separation with one another. Use this sense of family as a springboard for helping them deal with the separation from, and potential loss of their mother.

The nine month old will need physical holding and reassurance. Since words cannot be exchanged, your job will be to provide him with as much physical holding and comfort as possible through this trying time. Soothing his cries by walking, holding and talking to him in reassuring tones about the situation, will be experienced on some level as nurturing. Keeping him in frequent visual field of his older brother will also be stabilizing.

Establish routines with both children that offer stability in the face of change. Consistent meal times, nap times, play times with other children they are familiar with, walks to the park and nighttime stories will provide a structure for security. Find out as much information as possible about the children's schedules, food favorites, story time favorites and keep as much as possible the same in their lives. Comfort toys like stuffed animals and other concrete objects should be kept constantly on hand. If possible, care for them in their own home environment and encourage visits from family and friends they may have.

Make toys such as puppets, drawing supplies and miniature toy houses with little people available for the five year old. Children's work is play. By being able to play out the very scenarios they fear or desire, they are able to maintain a sense of continuity of themselves, despite the tumultuous nature of events their lives may bring them. Play externalizes their pain, while simultaneously helping them experiment with ways to adapt to change.

Finally, do not shy away from answering any and all questions in as comforting and truthful manner as possible, when asked. Find out as much information as you can about their mother's illness and communicate as clearly and forthrightly (in five year old language) as you are able. If you do not know something, say that. If the outcome from an operation is unknown, express that the doctors are hoping to make their mother better, but they do not know for sure how her body will respond.. Emphasize that they are experts and they are working to help her.

Encourage the older child to draw his feelings. Ask him to draw his fears, followed by his best hopes for the best outcome possible. Assure him that he will be cared for, no matter what happens. Drawing his feelings, ending with a positive scenario gives him opportunity to have his feelings acknowledged. This in itself is a very soothing interaction.

When she was nine years old, my niece went through a trying time with her best friend who was scheduled for surgery to remove a life-threatening brain tumor. Late one night, she called to talk to her "psychiatrist" Aunt (myself) because she could not sleep. She was frightened that her friend would die, which was a distinct possibility. Over the phone, I asked her to draw her fears, which turned out to be a casket and funeral scene. I then asked her to draw her best hopes, which turned out to be she and her friend skating together down their favorite hill. After drawing these scenes, she was able to fall asleep more peacefully.

My niece's friend lived and experienced a complete recovery to everyone's amazement and relief. Recently, I received a picture in the mail of another scene my niece had drawn. Her teacher had given her an assignment to draw a scene about an important person who has been significant in your life, besides parents. She drew a picture of talking on the phone with her Aunt, tears rolling down her cheeks, and a calendar in the background with her friend's surgery date clearly circled.

You have an opportunity to make a difference in these children's lives and you are answering the call. Your willingness to create a safe harbor for these children during this stormy period will be etched deeply in their hearts and souls.

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