Clinical Reference Systems: Pediatric Advisor 10.0

When we lose someone important to us, many things change in our lives. The same is true for children. To help children cope with a death, we must understand how they think about death and what has changed for them.

No two children respond exactly the same way to the death of a love one. Children are likely to respond to death differently and need different kinds of help, depending on their prior experience, their age, and what happens after the death.

Young Children

Children, ages 2 to 7, mainly miss the loved one who has died. They feel sad that they are not with the person anymore, as if the went on a long vacation. Even with careful explanation, do not be surprised if your 3-year-old asks when the dead person will visit. This does not mean your child believes in ghosts, simply that he or she does not understand that death is really the end. Understanding comes with continued patient explanation in simple terms. "Remember Sara, Grandma died. That means that we won't see her again."

Explain your family's spiritual beliefs about death in very simple terms. But be prepared for the likelihood, that your young child may repeat what you say and then behave like he does not understand what death means.

• Make sure your child doesn't feel at fault.

  Young children believe that their thoughts, feelings and words have magical power. All children are angry from time-to-time with people they love, particularly siblings. A young child who loses a loved one, will need help understanding that angry feelings or hateful wishes do not cause people to die. (Even older children and adults must be reminded of this truth from time-to-time).

• Keep a normal routine for your child.

  You may be concerned about how a death will affect your young child in the long run. You may wonder if they will be depressed later in life or if they will have emotional problems. Rest assured, that a child who has ongoing attention to his needs, a safe and stable routine, and reliable people who care about him, will not have long- term emotional problems.

  To assure that a child feels secure, even with the loss of a parent, the child's well being must come first. After a death it is important that your child is allowed to share in the family grief process, but just as with adults he will cope best if returned to a normal routine as soon as possible.

• Let your child grieve with adults, but not like adults.

  Because young children do not understand that death is final, your preschooler may go on happily playing and going about regular activities, even after the death of someone very important to her. Young children should not be punished or scolded for not grieving like adults. The child will feel sad, as he becomes more aware of what death means in his life.

  Children should not be shielded from the sad feelings of grieving adults. Yet, if you find that you are routinely turning to your child for comfort in grief, she may feel overburdened and frightened. If you have no energy to care for your child adequately in your grief, than it is important to ask for and find appropriate help. Unless you are seriously depressed, your child should not be sent away from you. Yet, it will be important to find considerable help from family and friends to spend time with your child, take your child to normal activities and attend to your child's needs.

  Adults need to grieve and that grieving can take away important energy from the needs of a child. It is important for your child to know you are sad, but if you are unable to attend to your child's needs because of that sadness, please ask for help. There are many excellent bereavement counselors and therapists that can help you cope with your grief and help you get your family back on track.

School-Age Children

With the death of an important loved one or parent, expect that your school age child (ages 7-10) will have thoughts that you will die too. Help her talk about her fears. Signs of such thoughts may be difficulty separating from you to go to school, many headaches and stomachaches, or even behavior problems. It is important to ask your child what they are feeling and thinking and to reassure them, in a realistic way, that you are healthy or in other ways unlike the person who died.

School-age children often worry about their own health, especially after the death of a loved one to an illness or one who is also young. If your child says his head or stomach hurts, have your doctor check him. At the same time, though, consider having your child see a child psychologist, social worker or counselor experienced in working with grieving children. Sometimes a few sessions of play therapy may help a child express their feelings and the physical pains go away, before more medical testing is needed.

Teenage Years

Teenagers think much like adults do about death. They know death is the end and that the dead person will not come back. At this age, religious beliefs can comfort the child. Yet the death of a parent or other important person while the teenager still needs them can be devastating. The teenager knows that the person will not come back and is not comforted by the magical thinking of younger years. It is important that your teenager is welcome in the family's grieving process and is given opportunities to talk about the loss with adults who are also grieving. Expect that your child will have things to say that are difficult. Be open to the possibility that your child is angry with you or even the person who died. Allow opportunities for your child to talk about and have all of her feelings accepted.

Although, your teenager may wish to be alone more than usual after the death, seek counseling from a licensed mental health professional if your child:

• withdraws for more than a week or two
• experiences a change in school performance
• begins having behavior problems.

Related Topics

Children's Literature: Death

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