Waiho i te toipoto, kaua I te toitoa. Let us keep close together not wide apart.

- Maori Proverb

 

Parents understandably can feel overwhelmed with their own grief when a family member dies and it can be difficult to know how best to support children at this time. While each family has its own culture and traditions that may guide and comfort them following a death in the family, what follows is a brief guide to some of the main ways to support children.

Distress in children is often seen in their behaviour rather than what they are able to say. Be understanding that changes in behaviour may be an expression of grief.

Child development is very individual and falls along a continuum depending upon the child’s age, personality, culture, environment and life experience. Children may have experienced previous losses, including the death of pets, and how parents respond to these events helps guide children in how they address their own grief.

Sometimes children may not seem to be directly affected by a death, but their behaviour may indicate otherwise; they may become more emotional and clingy, they may develop worries and fear that someone else in the family may die. This is a time for lots of hugs and clear, age appropriate explanations of why their loved one died.

Ways to support children

  1. Being held and comforted. Keep them close to their usual caregivers
     
  2. Honesty about what has happened – age appropriate talks help a child make sense of things and helps reduce anxiety and confusion.
     
  3. Patience with regressive behaviour – sometimes children temporarily regress to an earlier stage of development, they may start wetting the bed again, or talking with a ‘baby’ voice. Patience and understanding will support the child to regain confidence in their own time.
     
  4. Discussion and communication to help them understand and integrate the bereavement – follow the lead of the child. Answer questions honestly and ask them what they are thinking and feeling.
     
  5. Talking about feelings and helping children and young people to identify what they are feeling – children may be experiencing strong feelings of sadness, anxiety and anger over their loss. Help them to make sense of these feeling by putting words to them.
     
  6. Keeping routines as much as possible – routines help a child feel secure and reassured that their world continues to make sense.
     
  7. It’s important to understand that the stronger the relationship is with the loved one, the more intense the grief feelings may be in times of loss.
     
  8. If possible, when a child “acts out”, remember that they may be overwhelmed by feelings – stay calm and respond to the child with warmth and empathy.
     
  9. For children who become overwhelmed with their feelings validation of the way they are feeling is helpful as well as distraction (let’s go for a walk, play a game).
     
  10. Grief is sometimes described as an emotional fingerprint, in that it is unique to each of us. There is no normal way to grieve. It is a turbulent time that can effect us physically, emotionally, mentally and spiritually. The main thing to remember when supporting children and teenagers with their grief is to reassure them you are there to look after them and to help keep them safe.
     
  11. Some ways to cultivate reassurance:
  • Listening
  • Inviting rituals into the family as you mourn
  • Offer choices around grieving.  “What way would you like to remember?”
  • Sharing your own grief can help children understand they are not alone, they may be reassured about their own big feelings and you will also be modelling healthy expression. However, if you are feeling particularly emotional it may be wise to ensure you have some time away from the children so they don’t become afraid by the intensity of your loss.
  • Promote outlets where feelings can be expressed, such as creative writing, art, sport, dance and play.
  1. Above all, a listening ear and your calm presence can be profoundly reassuring.
     
  2. Ask open questions, “What are you thinking about at the moment?”, “How are you feeling?”
     
  3. Validate feelings and thoughts, “I see that you are very sad right now”.
     
  4. Answer question’s truthfully and at the developmental stage that is appropriate.
     
  5. Affirmation of family/personal strengths – What can we do together that may help us through this time?

Age and stage matters – a closer look at child development and grief:

Children and adolescents grieve just as much as adults but may show it in different ways. The death of a family member can have a profound effect on children. Children have less of an ability to verbalise how they are feeling so their distress is often seen in their behaviour rather than what they are able to say.

Child development is very individual and falls along a continuum depending upon the child’s age, personality, culture, environment, and life experience. How a child experiences a bereavement will also be impacted by these individual factors and by their relationship with the person who has died.

Babies, children and teenagers may at times appear to be unconcerned, unaffected or unaware of a death as they continue to play or carry on with their day. A fundamental difference between the manner in which adults and children grieve is that children are not able to hold intense emotion for long periods of time. They tend to grieve in bursts.

Babies, Children and teenagers need ongoing support after bereavement, it is not unusual for grief to resurface later, when a child matures and goes through another developmental stage.
 

How children may react to bereavement:

The following reactions are common and are likely to settle over time when a child’s response to the death is acknowledged, they are supported to understand their feelings, are given age appropriate information and reassurance. It is important that normal boundaries are kept in place.

What helps grieving children?

Every child’s grief is unique. There is no magic formula but things that help include:

 

Babies and toddlers don’t understand the concept of death. They can respond to a change in their environment and will experience feelings of loss, abandonment and insecurity if a significant person is missing. They don’t have language to express how they are feeling and will pick up on the distress that is around them.

It is common for extended family or friends to offer to look after children following bereavement. Babies, toddlers and young children benefit from staying as close as possible to their usual caregivers.

Common reactions:

  • Increased crying & irritability
  • Being clingy, needing to be held more
  • Looking for the person who has died
  • Being anxious around strangers
  • Possible withdrawal, less interest in play or food (possible weight loss)
  • Regression in previously reached milestones

Ways to support:

  • Hold and cuddle more, keep them close
  • Keep to routines, if possible
  • Be calm around them and speak calmly to them
  • Provide comforters, favourite teddies/blankets

Pre-schoolers find it hard to understand that death is permanent. They often develop an interest in the death of birds and animals and are developing an understanding that being dead is different from being alive. This age group has rich ‘magical thinking’ where they may think the person can become alive again or that they did something to make the person die.

Pre-schoolers have a very literal understanding and think in a very concrete manner. It is important to use real words such as ‘dead’ as euphemisms such as ‘lost’ or ‘passed away’ may cause misunderstanding and confusion.

Pre-schoolers can feel insecure and frightened when things change and will require lots of reassurance that they will be kept safe and be looked after.
 

Common reactions:

  • Crying more, clinging and being fearful
  • Looking or calling out for the person who has died
  • Tantrums, being irritable or stubborn
  • Withdrawal or showing a lack of response
  • Changes in eating or sleeping habits
  • Temporary regression-bedwetting, returning to crawling, wanting a bottle
  • Having a sense of the presence of the person who has died

Mum and Daughter

Ways to support:

  • Provide information (this can be done over time) and honest answers to questions
  • Keep routines
  • Talk about who is looking after them and keeping them safe
  • Tactile support, hugs, encouragement, holding their hand
  • May have disrupted sleep, altered appetite, less ability to play
  • Keep close to familiar adults, anxiety may be seen even when being left with familiar adults
  • Honestly explain death as a part of life using what they can see, use plants or insects as examples of death in nature
  • Read children’s books together about death and grief
  • Use words that describe feelings
  • Encourage creative play and exercise as an outlet for thoughts and feelings
  • Include them in doing something for the funeral, drawing a picture to put in the casket or on the service sheet.
  • Create a memory box together

School aged children gradually begin to develop an understanding that death is permanent and irreversible. Some children may still think that death is temporary or that the person who has died will feel things and be cold, lonely or hungry. Children increasingly become aware that death is an inevitable part of life and can become anxious about their own health and safety. They may be concerned that someone else they love may die.

Children may be interested in what has happened to the person after they have died, where they are now and may ask blunt questions about what has happened to the person’s body.

It is important to answer questions honestly and provide enough information so that children are not left with gaps in their knowledge. The risk of insufficient information is that a child may fill this space with inaccurate information.

Children’s imagination and ‘magical thinking’ can mean a child may feel that their thoughts, words or actions caused a death, they may feel guilty.

Continuing to answer questions and explain death to this age group is important. Their understanding will be developed over time and they may need to revisit what has happened and ask the same questions many times to make sense of their experience.

Ongoing reassurance, love and affection is helpful.

Common reactions:

  • Blaming themselves for the persons death
  • Looking for or sensing the persons presence
  • Being distracted and forgetful
  • Increased anxiety for their safety and the safety of people they care about
  • Not wanting to be separated from caregivers, not wanting to go to school
  • Physical complaints, tummy pain, headaches
  • May try to suppress their emotions to protect the adults around them
  • Withdrawal from usual activities, being quiet or not showing response to the death
  • Feel strong emotional reactions such as anger, guilt or a sense of rejection
  • Behavioural issues, aggression, tantrums, defiance, getting into trouble at school
  • May try to please adults and take on adult responsibilities
  • Change in eating and sleeping habits
  • Temporary regression
  • Embarrassment around being different

Ways to support:

  • Reassure the child they are safe and who is looking after them (they may want to know who will look after them if you die)
  • Keep routine and normal boundaries around expected behaviour
  • Tell them that you know they are sad, use words to describe feelings
  • Keep separation from loved adults/caregivers to a minimum
  • Make time to listen to their thoughts and questions and answer honestly
  • Talk about death being a part of life, observe changes in nature and read books about death and dying together
  • Include them in planning for a tangi/funeral and talk about whether they would like to do something as part of the honouring of the person who has died
  • Make a memory box, scrap book, photo album together
  • Encourage play. This is a natural form of communication and an opportunity to process what has happened
  • Encourage exercise

Adolescents understand that death is part of life.

Developmentally they are in a time of big physical and emotional changes and may flip back and forth between younger age group type reaction and more adult reactions. Grief can impact that developmental task of moving from dependence to independence, where young people move from familial ties to increasing reliance on their peers.

It can be difficult to ask for support while asserting independence.

Teenagers may want to be with friends more than family for support. In some instances, teenagers will gravitate to their online gaming community for support and connectedness. This behaviour is a normal reaction! Having meal times at the family table may give you opportunities to “check in” with the grieving teen.

Keep in mind they may find the intensity of emotion overwhelming and may not be able to express what they are feeling.

Young people don’t like to feel different and a bereaved teenager may feel socially isolated. They may want to feel and look as though they are coping while trying to manage or deny difficult internal emotions and feelings. To escape this level of discomfort some teens may use risk taking behaviour.

Common reactions:

  • Difficulty concentrating, easily distracted
  • Withdrawal, needing more personal space
  • Take on adult responsibilities and become ‘the carer’ for those around them
  • ‘Act out’
  • Isolation
  • Try hard to please
  • Being overwhelmed by intense reactions such as guilt, anger or fear
  • Difficulty expressing their emotions
  • Fear for their own and others safety
  • Having questions about mortality, death, dying and spirituality
  • Using jokes and humour to mask their feelings
  • Feeling embarrassed, hiding or minimising their loss
  • Wanting to be close to friends and family
  • Physical symptoms, feeling sick, headaches, stomach aches
  • Dreaming about or sensing the presence of the person who has died
  • Getting into trouble, being defiant, irritable
  • Eating or sleeping more or less than usual
  • Risk taking behaviour to escape, find comfort or to prove they are alive and strong
  • Temporary regressing, self-confidence, bed wetting
  • Strained relationships
  • Change in self- image, lower self-esteem, confidence
  • Sadness may move to depression
  • May have suicidal thoughts

Ways to support:

  • Include them, be honest about what is happening
  • Talk about the death together
  • Be willing to listen and give regular opportunities to be available to answer questions
  • Acknowledge and share your feelings and let your teenager know that you understand it is hard for them
  • If they don’t want to talk to you, leave helpful information around the house
  • Talk about grief, what is normal and how everyone grieves differently
  • Ask for support from extended family, friends, teachers, GP. Ask other adults to be available and check in with the young person
  • Keep routines, where possible
  • Avoid expectations of adult behaviour
  • Praise and encourage them
  • Seek professional help if you are concerned

It’s important to remember that grief takes as long as it takes. Navigating though grief is not only a personal process but a family one as well. Create meaningful events and anniversaries with your family that will help children continue to process and make sense of their loss as they continue to grow.   

 

Useful Links:

www.skylight.org.nz

https://www.kidshealth.org.nz/bereavement-reactions-children-young-people-age-group

Thanks to Lorna Wood, Stephen Parkinson and Nigel Rowling for authoring this guide.
 
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