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 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 to grieve and express their emotional responses about the loss. A loss can be anticipated as well.  Children need to be validated. "I understand that you are angry that dad died. It makes me pretty angry too sometimes."  Teach your children to cry by letting them see you cry. Let them know that anger is okay. Also some children don't feel upset and then feel guilty for not feeling much. They do not need to pretend to be upset.  Often the child wasn't even that close to the person who has died.

Help children to make sense out of what has happened.  Tell the truth. Name the disease and let them know that not all diseases are as serious as this one. Children feel less confused and scared when we tell them what to expect in the course of treatment of a disease. If there was an accident also please let them know what has happened and what will happen next. The more prepared they are the less out of control they feel.

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. 

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