Grief

Factors that Influence a Child’s Grief

• Age

• Personality

• Stage of development

• Previous experience of death

• Previous relationship with deceased

• Environment

• Cause of death

• Pattern of interaction and communication in the family

Patterns that Influence a Child’s Grief

• Stability of family life after the loss

• How the child’s needs for sustained care are met

• Ability to share and express feelings and memories

• Parental styles of coping with stress

• Availability of consistent relationships with other adults

Grief and Developmental Stages

• Infants - feelings of loss and separation, listlessness, quietness, weight loss, poor sleep.

• Children ages 2 to 3 years - often confuse death with sleep and can experience anxiety. In the early phases of grief, they can exhibit loss of speech and generalized distress.

Ages 3 – 6 years

• view death as a kind of sleep

• dead person is alive in a limited way

• questions about how person is doing

• view death as temporary or reversible

• may use magical thinking to try and understand

• may feel that they did something bad to cause death

• may exhibit eating, sleeping, bladder problems

Ages 6 to 9 years

• children more curious about death

• they ask concrete questions about what happens to a body

• they wonder about skeletons, ghosts, or angels

• death is perceived as final and frightening but not universal

• can develop school phobias, learning problems, somatic complaints, and aggressive or destructive behaviors

• can also withdraw from others

• feelings of abandonment are common in the death of a parent.

Ages 9 and older

• death is viewed as inevitable

• death is viewed as final and universal

• they may experience heightened emotions, guilt, anger, or shame

• they may have mood swings or increased anxiety over death

• may develop problems in appetite or sleep, regressive or impulsive behaviors, or survival guilt in the death of a peer or sibling

Interventions for Grieving Children

Explanation of death

• silence does not help children deal with the loss

• explanations should be kept simple and direct

• each child needs to be told the truth

• questions should be addressed honestly

• children need to be reassured about their own security

Correct language

Any discussion of death must include proper words such as cancer, died, or death. Euphemisms such as he passed away or we lost him, or he is sleeping should never be used because they confuse children and lead to misinterpretations.

Planning Rituals

Older children can and should be included in the planning and participation of mourning rituals.

These rituals help children memorialize loved ones.

It is important that a full explanation of what to expect at a funeral is given in advance.

Needs of Grieving Children in School

• The need to share about their loved one

• The need to use drawing, writing, role playing, and reenactment to safely project feelings about the loss

• The need to go to a safe place outside the classroom when unexpected or overwhelming feelings arise

• The need to create memory and feelings books about their loved one

• The need to be reassured by calling a surviving parent or visiting the school nurse to share health worries

Religious Beliefs

Theory has proposed that strong religious beliefs and participation in religious activities could provide a buffer to the distress of loss in two ways.

• A belief system that helps one cope with death.

• A network of social support that comes with religious participation.

Cross-Cultural Responses to Grief

Grief is a universal experience that crosses all ages and cultures. It is important to understand the family’s belief about what happens after death. All cultures have evolved practices that best meet their needs for dealing with death. It is important to ask questions in a sensitive and supportive manner.

Credits

Bereavement, Mourning, and Grief National Cancer Institute 2009

Discovery of Differences Among Grieving Children Helps Families Cope by Suzanne Trimel 2000

Helping the Grieving Child in School by Linda Goldman 1998