Helping Children Deal with Grief

Question 1

What are the factors that make the death of a child often more difficult than other losses?

Answer 1

1. Social expectations for parents
2. Unexpectedness of a child dying before a parent
3. Negative social responses
4. Loss of support from partner or spouse
5. Need to care for surviving children

Question 2

What are the sources of parental grief?

Answer 2

Death causation guilt
Illness related guilt
Parental role guilt
Grief guilt

Question 3

Grief reactions in children are__

Answer 3

Varied, wide-ranging, and unique to each individual.

Question 4

Is it better to shelter children from loss and death? Why or why not?

Answer 4

No, research evidence suggests that not assisting them in bereaving will predispose them to significant pathology and life-long challenges.

Question 5

What are the types of losses for children?

Answer 5

Death of a parent or caregiver
Imprisonment
Substance Abuse
Divorce
Separation from siblings
Physical, sexual, emotional abuse
Relocations and moves
Changes in their daily routine
Serious illness and /or hospitalization

Question 6

How a child or young person grieves depends on?

Answer 6

Age
Developmental stage
Personality
Ways they usually react to stress and emotion
Relationship with person who has died
Earlier experiences of loss or death
Family circumstances
How others around them are grieving
Amount of support around them

Question 7

How many youths in the U.S. lose a parent to death by the age of 15?

Answer 7

Nearly 1.5 million youth in the U.S.

Question 8

What percentage of children lose a parent to death before they reach the age of 18?

Answer 8

5%

Question 9

Talking to children about death…

Answer 9

• Address the child’s security fears and needs
• Avoid statements that can lead to language misinterpretation
• Understand that a child’s grief may be expressed by play and/or acting out
• Include children in grief experience and give them permission to grieve.
• Information should be accurate and developmentally appropriate
• Children should be told as soon as possible by a person close to them and in familiar surroundings.
• Convey to the child that they are cared about and loved even if the adults around them are upset and distracted.
• All them to attend funerals if they want

Question 10

Children are often__

Answer 10

the forgotten grievers

Question 11

How do children respond to bereavement?

Answer 11

• Similar to adults with disturbances in sleep, eating, and habit patterns
• They are more vulnerable to psychosomatic disorders, depression, adjustment disorders, and behavioral changes.
• Children are vulnerable to not only their own responses to loss but also to the responses of their parents or caregiver.

Question 12

How do Infants demonstrate bereavement (age 0-6 months)?

Answer 12

• Infants sense when something is wrong and that there is a change in the emotional atmosphere.
• They will mirror the grief of a caregiver
• They may react by crying more and being hard to calm down.
• Infants may be fussy and show sadness in spurts.

Question 13

Responses to Bereavement: Infants

Answer 13

• Substitute attachments and introduce a new caregiver that will be consistent
• Provide for physical needs and maintain the child’s daily schedule
• Give nonverbal reassurance such as hugs and rocking

Question 14

How do toddlers demonstrate bereavement? (Age 6 months to 2 years)

Answer 14

• It is impossible for young toddlers to grasp the permanence of death. They think death is reversible and don’t understand that the beloved will not return.
• Toddlers feel sadness in short spurts but then go back and play.
• They may regress in eating and toileting in response to stress in the family.
• Young children have a hard time expressing their feelings verbally, but don’t assume that they are not sensing the loss and suffering.
• Disinterest in toys, food, and activities may reflect sadness.
• Acting out in play is another way young children process loss.
• They may ask questions about when the deceased will return or how they can contact them.
  Abstract concepts such as heaven, soul, or spirit may be hard for toddlers to understand.

Question 15

Responses to Bereavement: Toddlers

Answer 15

• Answer honestly and avoid using cliches such as “gone on a trip” or “went to sleep” or “are lost.”
• Offer plenty of both nonverbal and verbal support and reassurance.
• Maintain a daily schedule
• If there is a death, use the word “dead” and that they are not going to return. Clarify that the person isn’t away or just sleeping.
• Provide art, music, or a flexible environment.
• Play is the child’s “work” and how they work through their feelings

Question 16

How do pre-schoolers demonstrate bereavement (ages 2-5)?

Answer 16

• They understand death in physical and biological terms, but death’s permanence is still hard for them to accept.
• They think life goes on, but in a different way.
• They may wonder if the dead person is “asleep” and then awaken.
• They may repeatedly ask when the deceased will return.
• Children of this age do not understand cause and effect and may think they caused the death.
• They may personify death as a person who comes to get you if you are not fast enough to escape.
• “Magical thinking” can lead them to blame themselves.

Question 17

Responses to bereavement: pre-schoolers

Answer 17

• Explain death and causes of death in factual terms.
• Help the child distinguish between life and death.
• Indicate that the loved one will not return.
• Give clear answers to questions.
• Dispel magical thinking by explaining the true causes of death and reassuring them that their behavior or feelings had nothing to do with it.
• Include children in the funeral or memorial services if they wish, but do not force it.
• Keep the environment as stable as possible.
• Reassure the child that he or she will be cared for.
• Utilize are to enable children to express their feelings.

Question 18

How is bereavement demonstrated by School Aged Children (Ages 5-8)?

Answer 18

• Children in this age group begin to understand the permanence of death but don’t believe that everyone will die someday
• They still personify death as a ghost or bogeyman whom they can escape through ingenuity
• They identify strongly with the deceased and fear death
• They worry about others dying, with often leads to possessiveness toward the remaining family members and regressive behaviors.
• They are naturally curious and ask many concrete questions in trying to make sense of what it means to be dead.
• Some typical behaviors are aggression, avoidance of risk-taking, escape into fantasy, clinging to the remaining parent or loved one, nastiness, irritability, school phobia, tantrums, whining, anger, and fear of the future.
• Magical thinking may lead to self-blame
• Problems in academic performance and general behavior are common
• Children may also exhibit physical reactions such as headaches and stomach aches when they feel overwhelmed.

Question 19

Bereavement Responses: School-aged children

Answer 19

• Help reduce the child’s confusion about what is happening by answering questions clearly and honestly.
• Notify the child’s school of the loss and keep in contact with teachers to note any behavior changes.
• Try to maintain a stable home environment
• Reassure the child that they are not responsible for the death or loss and that it is not a punishment.
• Address fears the child may have over secondary losses such as leaving school, or friends, etc.

Question 20

How do pre-adolescents demonstrate bereavement?

Answer 20

• They generally accept death as inevitable, final, and personal.
• They may fantasize about alternatives to death and may develop philosophies of an afterlife
• They are curious about the “gory” details and understand the secondary losses associated with death
• They may appear not to have much feeling or compassion.
• They may feel undue self-imposed pressure to assume some of the roles of the deceased.
• They may display withdrawal, anger, anxiety, fears, concern with their bodies, and acting out.
• They may fear that they’re “going crazy,” show a decline in school work, be easily distracted, and become possessive of the remaining parent or loved ones.
• Because of physical changes and normal separation ambivalence, they may have regressive behaviors.

Question 21

Bereavement responses: pre-adolescent

Answer 21

• Loss complicated this already stressful time of development
• Peer relationships are extremely important at this age, so try to help them get involved in activities
• Notify the school of the loss or death and encourage relationships with a favorite adult
  Give them clear info abut the funeral and what his or her normal grief reactions might be; try to dispel fears about the future and reassure the child that things will get better over time.

Question 22

How do adolescents demonstrate bereavement? (ages 12-18)

Answer 22

• Adolescence is a time of challenges and transitions and losses or death further complicated this period of physical and emotional upheaval
• Adolescents are busy trying to develop autonomy and their own identity apart from family and often resist communication with adults.
• They may cry and brag with peers and friends or escape into sex, drugs, and risk-taking to reduce their anxiety rather than ask for help.
• The perennial teen question of “who am I?” is complicated by a loss or death
• Some typical emotional responses include anger, fear, a sense of deprivation and abandonment, lowered self-esteem, depression, guilt, insecurity
• Adolescents may be embarrassed by the loss and avoid discussing it due to fears of being different from friends at a time when peer acceptance is crucial.
• School problems and defiance are not uncommon.

Question 23

Bereavement Response: Adolescents

Answer 23

• Recognize that the major tasks of adolescents are to establish a sense of personal autonomy and identity
• Avoid overwhelming adolescents with new roles in the family
• Realize that teens long for freedom but need adult supervision, so set realistic limits to show you care
• Get professional help if the teen exhibits signs of prolonged depression, serious acting-out behaviors, or continual suppression of emotions.
• work with the school if they are experiencing significant problems; often a school counselor can intervene if they refuse to talk.

Question 24

How can you help children express feelings through interventions?

Answer 24

Worry lists
Letter writing
Worry and safe boxes
drawing & other art projects
poetry
writing/selecting music to play
storytelling
music
dance & movement