4 Important Concepts About Death When Supporting Children
Children as well as adults
need to understand these concepts when faced with death in order to fully grieve. Like young children, teenagers and
adults often struggle with accepting the reality of a death. Intellectually, they may have a rational understanding, but emotionally
they may find it difficult to accept what they know to be true. I have heard it said that the longest distance in the world
is the head to the heart. So it is not only children who struggle with death, but adults too. However, children who do not
yet understand these basic concepts about death may have even more difficulty in coping than those who do. Understanding helps
with acceptance.
It is best not to assume that children
know certain things about death based on their age. Instead, adults need to ask them to talk about their ideas, thoughts,
and feelings. As we allow children to shaire their understanding about death with us, we will know what concepts that they
may need help in understanding. Listening to children is vital especially around death.
Concept 1: Death Is Irreversible
When children
watch cartoons, television shows, video games and movies, children may see characters "die" and then come back to
life. In real life, we know that this is not going to happen. Children who do not fully understand this concept of death being
irreversible may view death as a kind of temporary separation. They often think of people who have died as being far away,
perhaps on a trip. Sometimes adults reinforce this misunderstanding by talking about the person who died as having "gone
on a long journey." Some adults today will share how they were told years ago as children that an aunt or grandparent
suddenly went on a trip or went to the hospital and never returned and so they never saw them again. These adults shared that
as time went on they often felt scared, confused and angry when they eventually learned their loved one had died and no one
told them the truth. They grew to not trust the adults to share truth with them. Children who have had a family member or
friend die may feel angry when the person does not call or return for important occasions.
If children do not think of a death as permanent, they have little reason to begin to mourn. Mourning is
a process that requires people to adjust their ties to the person who has died. An essential first step in this process is
understanding and, at some level, accepting that the loss is permanent.
Concept 2: The body and all of its functions stop working at death.
Very young children view all things as living- their brother, a toy car, a sticker bush that scratched
them. In daily conversations, adults may inadvertently play into this confusion by talking about the child's doll being
lonely or cold or saying they got home late because the car "died" and couldn't call as their iphone "died".
Yet, whereas adults understand that there is a difference between pretending a doll is lonely or cold and believing
that to be a fact, this difference may not be clear to a young child.
Young children are sometimes encouraged to talk to a family member who has died. They may be told that their loved
one is "watching over them" from heaven. Sometimes children are asked to draw a picture or write a note to the person
who died so that it can be placed in the coffin. These requests and comments can be confusing and even frightening to some
children who do not yet understand the finality of death. In a young child's mind, if the person who has died could read a
note, does it mean he or she will be aware of being in the coffin? Will the person realize he or she has been buried?
Children may know that people cannot move after they have died, but may
believe this is because the coffin is too small.Theymay know people cannot see after death, but may believe this is because
it is dark underground. These children may become preoccupied with what they perceive as the physical suffering of the deceased.
When children can correctly identify what living functions are, they
can also understand that these functions end completely at the time of death. For example, only the living can think, be afraid,
feel hunger, or feel pain. Only the living have a beating heart or need air to breathe.
Concept 3: Everything That Is Alive Eventually Dies
Children
may believe that they and others close to them will never die. Parents often reassure children that they will always be there
to take care of them. They tell them not to worry about dying themselves. This wish to shield children from death is understandable,
but when a death directly affects a child, this reality can no longer be hidden. When a parent or other significant person
dies, children usually fear that others close to them-perhaps everyone they care about-will also die.
Children, just like adults, struggle to make sense of a death. If they do not understand
that death is an inevitable part of life, they will have misunderstandings while trying to figure out why this particular
death occurred. They may assume it happened because of something bad they did or something they failed to do. They may think
it happened because of bad thoughts they had. This leads to guilt. Children may also assume the person who died did or thought
bad things or did not do something that should have been done. This leads to shame. These reactions make it difficult for
children to adjust to a loss. Many children do not want to talk about the death because it will expose these terrible feelings
of guilt and shame.
When teachers talk to children about how
everyone eventually dies, children may raise concerns about the health and safety of their own family members. If individual
children are particularly concerned about the well being of their parents, teachers can ask students if they can talk with
their parents. They can suggest that parents reassure their children that they are doing everything they can to stay healthy,
and that they hope and expect to live a long life. For example, if a child's father died of a heart attack, the child may
benefit from knowing that his or her mother has seen her doctor and had a physical exam. This shows the child that family
members are taking steps to stay healthy and safe. This is different from telling children that they or their parents will
never die.
Concept 4: Death Is Caused by Physical Reasons
When children experience the death of a family member or friend, they must
understand why the person died. If children do not understand the real reason their family member has died, they are more
likely to come up with explanations that cause guilt or shame.
The
goal is to help children understand what has happened. When explaining a death to children, teachers should aim for a brief
explanation that uses simple and direct language. They can watch for cues from the children and allow them to ask for further
explanations. Graphic details are not necessary and should be avoided, especially if the death was violent.
Although it would be unusual for a teacher to be the first to tell an individual
child of the death of a family member, teachers may need to make a class announcement about someone in the school or community
who has died, a classmate who has lost a parent or other family member, or another death that affects students in a classroom
or school. Parents may also ask teachers for guidance about how to tell their child about death.
Talking
to Children about Death
Children need and deserve to know the truth about illness and death. If we don't tell them the truth, what they
imagine will always be far worse. White lies and euphemisms create problems. These statements can leave them more frightened
and confused. If we tell them that their mom is in heaven and talk about what a great place heaven is and then we are
sobbing, they become confused. Instead tell a child," Mommy died and we believe that she is in heaven. It is a wonderful
place, but I will miss her very much. I am glad that she got to go to heaven, but I do wish she was here with us longer. She
also wishes that she could have stayed longer as well."
* if
we simply tell them that they were so good that God wanted them with Him, they may fear being good.
* if we tell them that their grandma has gone to sleep,
they may fear going to bed.
*
if we tell them that Daddy went on a long trip, they may believe that Daddy has abandoned them.
* if we tell them that death is darkness and nothingness, they may
become afraid of the dark.
Help children commemorate the loss. Light a candle together. Take time to tell stories
and share memories. Say a prayer or put up favorite photos. Make a memory box with special tokens and letters from the person.
Allow the child to make a donation with the child's allowance to an organization related to the death.On the first anniversary
of a death, look through scrap books, bake a cake, play the person's favorite music and eat their favorite meal. These actions
help to keep memories alive of the person as well as encourage expression of feelings.
Developmental Issues of Grieving Children and Teens:
Pre-school children: This is an egocentric age. They believe the world revolves around them
and often think that they cause things to happen. They often experience a death as abandonment. Their "magical thinking"
causes them to think it is their fault, or that they have the power to bring the deceased back. Some children who have lost
the disciplinarian parent, have been known to act out a lot, thinking that the parent will have to come back to discipline
the child. Their grief responses are short in duration but often intense and often at specific times. This may happen at dinner
time or bed time or getting to school time. Children this age tend to ask the same questions over and over again. They don't
understand the finality or universality of death yet. Often a child this age may say, " I know daddy died, but will he
come to my party?" Be patient and keep answering the questions. Many children of this age will "regress"
back to an earlier time of mastery. They may suddenly wet the bed, want to sleep in the parent's bed, want to be fed
or dressed, stop going on the potty, stop sleeping or napping, thumb sucking or other self soothing, baby talk, irritability
or become very clingy or worried about safety.
Use simple and honest
answers
Be patient
Include the child in rituals
Support the child in play
Allow for anger and physical expression
Maintain
consistent structure and routines
Allow the child to regress
Hold the child and give him/her extra attention and care
Encourage and allow for fun and happy times
Have books on
death and grief
Have toys and dress up, art supplies, play Doh which
help facilitate grief expression
Address grief issues in a group setting
without the focus on the grieving child.
Model by sharing own grief
stories
Helpful books: The Goldfish Went on Vacation:
A Memoir of Loss (and Learning to Tell the Truth about it)by Patty Dann(2007) A woman tells the true story
of her husbands diagnosis of a brain tumor, who was once fluent in multiple languages changes in front of her and her little
4 year old son into a mane whose brain can't remember the purpose of a paper-clip. Out of a family tragedy Dann has created
a book that will surely help many others with young children.
I Know
I Made it Happen: A gentle book about feelings by Lynn Bennett Blackburn (1991) Wonderful
book to read with children about magical thinking. Examples include divorce, illness, injury and death all raise issues for
children about security. Children have a need to find a cause for important events and often blame themselves.
When Dinosaurs Die: A Guide to Understanding Deathby Laurie Krasny Brown
and Marc Brown
Help Me Say Goodbye: Activities for Helping Kids Cope
When a Special Person Dies by Janis Silverman (1999)
Grieving Elementary Child:
Concrete thinkers who are
beginning to develop logical thinking patterns along with increased language and cognitive ability. After a death they question
how their lives will be different, what will be the same, and how one knows the person is really dead. They are involved in
how the body works and ask specific questions like, "Did the blood get all over the windshield?" or " Will
her hair fall out now that she is dead?" Their questions can be graphic and gory, displaying a fear of bodily harm and
mutilation. Try to give simple, honest answers to their questions. 6-12 year olds want to see death as reversible but are
beginning to understand the finality and permanence of death.
Common Behaviors
to Expect:
Regression
Fighting, Angry outbursts
Difficulty in paying attention
and concentrating
Daydreaming
Not completing homework or assignments
Sleepiness
Withdrawal
How to help:
Answer questions clearly and accurately. Provide art, journals, music and movement. Make time for physical outlets: sports,
games, walks etc. Help the child identify their support system. Work with the child on school assignments. Encourage
the child to take breaks from school work and to have some alone time when needed or time with the school nurse or school
counselor. Having a safe space to go when needed is crucial. Allow for expression of feelings. Maintain routines
and structure, but allow for flexibility. Classmates can be coached as well on how to welcome back to school a child
who has been out with the death of a loved one. Treating the friend as "normal" as possible and try including him/her
in activities. Do not tell children not to ask questions. Children will naturally ask questions and that helps to make things
as normal as possible. Children who have had a loss, often want to talk about their loved one.
When families join
together to face a crisis and the adults are willing and open to talk to the children and answer their questions, the crisis
becomes more manageable. This is true even if the death is accompanied by stigma and sometimes guilt and shame. Research has
been done on children who have lost parents to AIDS. It was found that stigma and multiple loss were factors that complicated
the children's grief process. Factors that helped with the healing process were: sustained care and support for the children,
open family communication, consistency and environmental stability.
Other studies show that children who
have lost a parent through suicide were more likely to experience anxiety, anger and shame on a greater level than by a child
who lost a parent not by suicide. However these children didn't differ from the other children in terms of depression and
suicidality or psychosocial functioning. ( Doka, Disenfranchised Grief).
Worden(1996, Harvard)
found that only 1/3 of the children who were followed up after a parental death showed serious levels of emotional disturbance
over time. Children actually stayed connected to their deceased parents by talking to them, dreaming of them, keeping
special linking objects and feeling watched by them. Children in this way can draw a timeless attachment to the deceased parent.
Children who adjusted the best following the death of a parent were those who had experienced the fewest disruptions and changes
in their lives.
According to Worden there is a late effect for some grieving children. Some of the negative grief
reactions don't show up until the second year. Don't assume that children who are grieving are okay but rather continue to
monitor them. Children can be resilient and cope when provided with support and facilitation of their grief. Therefore don't
assume that a parent's death, even by suicide or AIDS will always result in trauma for a child or else this may become
a self-fulfilling prophecy. (adapted from K. Doka, Disenfranchised Grief, 2002)
Some
children fear acknowledging grief, much like some adults for fear of emotional flooding. Grief is powerful and the emotions
felt can be overwhelming. Many choose to avoid thinking or talking about the loss as they worry that if they were to feel
fully their grief, they may never stop crying. Children need direct encouragement to express their grief and acknowledge their
pain. They need to be reassured by adults that this is a good thing to do. Some children fear disappointing their loved ones
by showing their true feelings. Some fear being chastised for crying. It is important for adults in children's lives to let
the children know that all of their feelings will be understood and accepted. Giving children permission to grieve as well
as healthy opportunities to express that grief in safe ways is all part of helping children to cope and grow through life's
losses and transitions. Children who learn that feelings are simply feelings and that they don't have to hide them or feel
ashamed or embarrassed by them, are that much better at learning about the life long process of healthy mourning.