Category: children

Grieving parents often face the additional challenge of trying to help their surviving children process the death of a sibling.

While there are many factors that influence how a particular child understands and works through his or her grief, age at time of bereavement plays a significant role.

Children’s grief can look very different than that of the adults around them. And that grief may resurface later on as the child grows and matures, even long after the death of a loved one.

I came across this helpful article that lists common bereavement reactions by age group and have reprinted it in its entirety. It was originally published at KidsHealth New Zealand. http://www.kidshealth.org.nz

Key Points to Remember About Bereavement Reactions:

• how any child or young person grieves when someone they love has died will depend on many things
• babies, children and teenagers tend to grieve in bursts, and at other times will look for reassurance and comfort in their normal routines and activities
• bereaved children and teenagers will need ongoing attention, reassurance and support – it is not unusual for grief to resurface later on, even well after the death

How any child or young person grieves when someone they love has died will depend on many things, such as their:

• age
• gender
• their developmental stage
• personality
• ways they usually react to stress and emotion
• relationship with the person who has died
• earlier experiences of loss or death
• family circumstances
• how others around them are grieving
• amount of support around them

Babies, children and teenagers may often seem unconcerned, playing or doing their usual activities, so adults can assume they are not properly aware of the death, or affected by it. They are, but in their own ways. Babies, children and teenagers tend to grieve in bursts, and at other times will look for reassurance and comfort in their normal routines and activities.

Bereaved children and teenagers will need ongoing attention, reassurance and support. It is not unusual for grief to resurface later on, even well after the death. This can happen as they move through different life milestones, and develop as individuals.

Babies and Toddlers:

At this young age babies and toddlers don’t have an understanding of death nor the language to say how they are feeling. However, they can definitely experience feelings of loss and separation and are likely to pick up on the anxiety or distress of close adults or others around them.

Common reactions can include:

• looking for the person who has died
• being irritable
• crying more
• wanting to be held more; being clingy
• being less active – quiet, less responsive
• possible weight loss
• being jumpy, anxious
• being fretful, distressed

How to help them:

• keep routines and normal activities going as much as possible
• hold and cuddle them more
• speak calmly and gently to them – and be calm around them
• provide comfort items, such as a cuddly toy, special blanket etc

Preschoolers

At this age children find it hard to understand that death is permanent. They are also at a stage of magical thinking, for example, thinking someone will come alive again or thinking somehow they made someone die. They understand separation though, and feel insecure and frightened when the familiar things around them change. This age group needs a lot of reassurance that they will be safe and looked after.

Common reactions can include:

• looking for the person who has died
• dreams, or sensing the presence of the person who has died
• fearfulness, anxiety
• clinginess
• being fretful, distressed
• being irritable; having more tantrums
• withdrawing, being quiet, showing a lack of response
• changes in eating
• difficulty in sleeping
• toileting problems, bed wetting, soiling
• regressing in progress; for example, returning to crawling, wanting a bottle

How to help them:

• keep routines and normal activities going as much as possible
• tell them you know they are sad – start to teach and use words that describe feelings
• tell them they are safe, and who is looking after them
• keep separated from them as little as possible
• comfort them with hugs, cuddles, holding their hand, and by encouraging them
• speak calmly and gently to them – and be calm around them
• explain death as part of life, so they come to understand it bit by bit. Using some examples in nature may be helpful, such as watching plants grow, bloom and die or seasons change
• provide comfort items, such as a cuddly toy, special blanket etc
• encourage play – children can often use play to help them process what’s happened; for example, sand play, puppets, dolls, writing, drawing, painting and various physical activities

Primary School Children

Primary school children are still learning to understand death and can have some confused thoughts about it. They may think death is temporary, or that the person who has died may still feel things, such as coldness, hunger or loneliness etc. They may ask where the person is now, and have blunt questions to ask about what happened to them and to their body. Explaining death to them is very important.

Common reactions can include:

• looking for the person who has died
• having dreams about, or sensing the presence of, the person who has died
• blaming themselves for the death
• being easily distracted, forgetful
• being anxious; having increased fears, such as of the dark, of others’ safety
• clinginess – wanting to be near you or others more
• withdrawing, being quiet, showing a lack of response
• being fretful, distressed, not wanting to go to school
• feeling embarrassment; feeling different from others; may conceal their loss
• physical complaints, such as tummy aches, headaches, aching
• being irritable, having more tantrums, being defiant, or developing antisocial or aggressive behaviour
• changes in eating or sleeping habits
• toileting problems, bed wetting, soiling

How to help them:

• frequently reassure them they are safe, and who is looking after them
• keep routines and normal activities going as much as possible
• tell them you know they are sad – start to use words that describe feelings
• keep separated from them as little as possible
• allow questions and provide honest answers
• comfort them with hugs, cuddles, holding their hand, and by encouraging them
• speak calmly and gently to them – and be calm around them
• explain death as part of life, so they come to understand it bit by bit. Using some examples in nature may be helpful, such as watching plants grow, bloom and die or seasons change
• let them help in planning the funeral or something to remember the loss
• provide comfort items, such as a cuddly toy, special blanket etc
• encourage play – children often can use play to help them process what’s happened; for example, sand play, puppets, dolls, writing, drawing, painting and various physical activities

Older Children (10-12 years)

Common reactions include:

All of the above relate to this age group, but it’s important to be aware that by this age children know death is final. They are also more aware of how adults and others around them are reacting to death. This group may also:

• be especially anxious about the safety of family and friends, and themselves
• try very hard to please adults and not worry them, and so not let themselves grieve
• feel stronger emotional reactions, such as anger, guilt, sense of rejection
• want to take on more adult responsibilities, trying very hard to please
• feel embarrassment; feel different from peers; may conceal their loss
• become more focused on what’s happened and ask questions, think about it a lot, have dreams about it, and perhaps want to talk about it often to others

How to help them:

They need all of the help in the previous section plus:

• time to talk with you and other trusted adults, when they need to
• regular reassurance – spoken, and with encouraging physical touch (such as hugs, pat on the back etc).
• honesty about events, and feelings
• to know you understand their grief
• regular encouragement
• avoid expectations of adult behaviour – allow them to be the age and stage they are

Teenagers

By adolescence, death is accepted as part of life, but it may not have affected a teenager personally yet. Their reactions may fluctuate between earlier age group reactions and reactions that are more adult.

Teenagers will often want to be more with friends than family as they seek support. They may find the intensity of emotion overwhelming or scary and not be able to find the words or ways to talk about them with others. They may want to feel they’re coping, and be seen to be, but inside be hurting a great deal, or be putting their emotions on a shelf for a later time.

Death can so shake teens that some react with risk taking behaviour – to escape the feelings and reality and as a source of comfort; for example, drinking, drugs, more sexual contact or reckless driving.

Common reactions can include:

• being easily distracted, forgetful
• having difficulty concentrating at school
• being unsettled in class, a change in class performance, not wanting to go to school
• being overwhelmed by intense reactions, such as anger, guilt, fear
• having difficulty expressing intensity of emotions, or conflict of emotions
• blaming themselves for the death
• anxiety – increased fears about others’ safety, and their own
• having questions or concerns about death, dying, mortality
• dreams about, or sensing the presence of, the person who has died
• wanting to be near family or friends more
• withdrawing to be alone
• physical complaints, such as tummy aches, headaches, aching
• being irritable, defiant, more antisocial or displaying aggressive behaviour
• risk-taking behaviour to escape, to comfort, or to prove they’re alive and strong; for example, drinking, drugs, more sexual contact or reckless driving
• changes in eating, sleeping habits
• bedwetting
• jokes or humour, masking feelings
• saying, or acting like, they don’t care
• wanting to take on more adult responsibilities, trying very hard to please
• strained relationships with others – fear or awkwardness about being close to others
• feeling embarrassment; feeling different from peers; may conceal their loss
• a sense of loneliness – isolation
• a change in self-image, lower self-esteem
• possibly suicidal thoughts
• possibly moving from sadness into depression

How to help them:

• be honest and let them know what’s happening
• be willing to listen, and available to talk about whatever they need to talk about
• acknowledge the emotions they may be feeling—fear, sadness, anger
• it can be helpful for parents, or other adults, to share their own feelings regarding the loss
• frequently reassure them they are safe, who is caring for them, and which adults they can trust to ask for further support
• keep routines and normal activities going as much as possible
• talk to them about grief – what it is, that it’s normal, that everyone is different
• avoid expectations of adult behaviour – allow them to be the age and stage they are, encourage them to express their thoughts and feelings – give them ideas of things they could try, such as doing physical activities, writing, singing, listening to music, talking with friends, reading etc
• allow questions and provide honest answers
• comfort them with hugs, cuddles, holding their hand, and by encouraging them
• speak calmly and gently to them – and be calm around them
• talk about death together; answer any questions they may have
• let them help in planning the funeral or something to remember the loss

Bereaved children and teenagers will need ongoing attention, reassurance and support. It is not unusual for grief to resurface later on, even well after the death. This can happen as they move through different life milestones, and develop as individuals.

If you are concerned about any extreme reactions, or if you think the young person may have become depressed, contact your doctor or other trained adviser, such as a counsellor, senior staff member from their school, social worker, community or youth worker or a local family support agency.

Originally published on: http://www.kidshealth.org.nz