How to Talk with Children And Adolescents - About Grief, Loss and Bereavement For more information
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How to Talk with Children
And Adolescents
About Grief, Loss and
Bereavement
For more information:
Sarah Hopkins, MSW
Department of Social Work
Winthrop University
139 Bancroft Hall
Rock Hill, SC 29733
Hopkinss@winthrop.edu
(803)323-3384How to have tough conversations with children and adolescents: Terminal Diagnosis When a loved one is given a terminal diagnosis, families often struggle about whether or not to tell the children in the family. Families need to consider the developmental capacity of the child and be as honest with the child as they possibly can. Death is out of all of our control- children need to be included and allowed to experience anticipatory grief and say goodbye to loved ones when possible. When explaining a terminal diagnosis to a child, use real words- illness titles. DO NOT say sick or ill, rather say cancer, heart disease, etc. If you simply say sick or ill, the next time that child has a cold and is sick, they may think that they themselves are dying. Adults often think that they are having conversations that children are not hearing. Even if a child seems to be pre-occupied playing in another room, chances are good that they are still hearing what the adults are talking about in the home. The children may hear about their loved one's illness through the adults' conversations but never ask questions they may have as they have not been invited into the conversation. By not telling a child about a loved one's terminal illness, you run the risk of creating a secondary loss for that child, as they may no longer trust you. When explaining the terminal diagnosis to a child, do not hesitate to shed tears. You are not protecting a child but keeping your grief from them. We teach children to walk and talk, we also need to teach them how to grief, and by shedding tears in front of them, you are teaching them that tears are ok and a normal part of the grief process. Death Telling a child that a loved one has died is a hard thing to do. Adults are always looking for the right words, the right time, the right space. There is no such thing when it comes to talking about death- it is a tough conversation. Remember the Word CHILD when talking to children about death: C- Consider Consider the age and developmental capacity of the child, the support the child has, and their relationship to the person who has died. See attached chart on age and developmental understanding, but consider that the chart is only a guide for how a lot of children that age or in that stage may display their grief.
Children's Understanding of Death Based on Age
Age Piaget's Stages Understanding Expression of Grief
Infancy to 2 years old Have little -More Crying
understanding of -Fussiness
death, but they sense -Clinginess
separation and -Decreased Activity
abandonment -Change in Sleep schedule
-Weight Loss
2 to 6 years old Pre-operational stage Death is viewed as -May ask many questions
(2 to 7 years old) sleeping and may be -Fear of abandonment
seen as temporary or -Tantrums
-Magical Thinking reversible -Regression
-Egocentricity -Bowel/bladder changes
-Reversibility -sleep changes
-Causality
6 to 9 years old Death is thought of as -Curious about death
a person or spirit and -Asks specific questions
is final -Feelings of abandonment
-Difficulty putting grief into
Concrete Operations words
(7-12 years old) -Psychosomatic symptoms
(headaches, stomaches)
-Logical Thoughts -Takes on caregiving role
9 to 12 years old -Can conceptualize Concrete reasoning -Intensified emotions such
about why and how as guilt, anger and shame
death occurs, -Mood swings
understands that -Regressive behaviors such
everyone will die as loss of interest in outside
activities
-Feel guilty about surviving
Older than 12 years Operational Stage Have an -Anger
old understanding that all -Defiance
(13 years and older) people must die but -Risk-taking
believe that their own -Increased sexual activity
death is in the distant -Aggression
future -Substance AbuseH-Honesty
Use the "d" words. Adults attempt to protect children by saying things such as passed
away, lost, sleeping - use the "d" words death, dying, die - the other words may feel
gentler, but they are confusing for children. If something is lost, it can be found. For
example, if you and your child are searching for lost keys - eventually, the keys are
found. If you are searching for a lost relative who has died, then, of course, they would
not be found. If Grandpa is sleeping and will never wake up, that child may fear going to
sleep again. Avoid using euphuisms.
I-Involve
Whenever possible, prepare the child for the approaching death, give them the
opportunity to say goodbye to their loved one. Let them choose whether or not they
will attend calling hours and funerals. Give them as much information as you can and
allow them to make choices. Allow them to ask questions and answer the questions as
honestly as you can; questions may include:
o Who will take care of me if you die too?
o Will you and daddy die too?
o What is heaven?
o Can I die if I go to sleep?
o Where did grandpa go?
o Will it ever stop hurting?
o Why did God kill my mom?
o Will Grandpa come back?
o Will I forget them?
o Did my person suffer?
o Was it my fault?
L-Listen
Allow the child to share their feelings. Remember, especially with adolescents, that
conversations are often a challenge. Start the conversation about your feelings and then
invite them in. For example, "I’m going to really miss Aunt Sally - especially on vacation
she was so much fun to play board games with. What will you miss the most about
her?” Provide the child with other ways to express their grief- drawing, painting,
physical activity. Remember that if a child is not talking to you, that does not mean that
they are not talking- they may be talking to peers and teachers. Be in contact with the
school so that they know that the child has lost a loved one. Be involved in your child’s
social media - adolescents' main way of expressing grief today is on Facebook, Twitter,
and youtube.
D-Do it over and over again
Share your grief with your child when appropriate - again, children need role models on
how to grieve. Remember that as a child progresses and grows into new developmental
stages that they understand and can handle their grief differently cognitively and
emotionally. Do not be surprised if the grief becomes raw and intense again.Myths about Children’s Grief:
o Children do not grieve
o Children experience few losses
o Children recover quickly from grief
o Children grieve in a linear fashion
o If a child experiences grief, they will grow up to be maladjusted adults
o Children should not attend funerals
Realities of Children’s Grief:
o Children may not express their feelings of grief verbally; rather, the
expression may come out through behaviors
o Children experience many losses, i.e., loss of a friend at school, loss of a
soccer game, death of a pet, moving, etc.
o Children’s grief is related to their developmental stage
o Everyone grieves in their own way
o If a child is supported through the bereavement process with compassion
and care, then they can heal and grow from the experience
o The funeral allows for a child to experience how others grieve, be
comforted, comfort others, and honor the loved one that they lost
How to best support grieving children:
Structure and routine are best. When the child is ready, get them back into school,
daycare, or whatever their normal routine is as soon as possible. Reassure them that
there are people in these places, such as teachers and social workers, who are available
to talk to them. Stick to bedtimes and mealtimes. Again death is out of control. Children
need routine and structure to know that the world is still a safe place and that there still
is consistency for them.
Calling Hours and Funerals:
When possible, give the child a choice about attending. If the child does decide to
attend, explain to them what to expect. For example - many people may be crying, and
there will be incense burning, pictures of the deceased, etc. Plan for a caregiver at the
calling hours or funeral; let the child know that if they decide that they no longer can
handle being at the services that Aunt Sally is there and will take them home. If the child
decides not to attend, that is ok as well. Bring them home a prayer card and tell them
about the service afterward. Explain to other family members who ask where the child is
that you let them choose and have control of their grief.Activities for grieving children:
• Read a book or Watch a Movie - Attached you will find a book /movie list about
death and grief that you can use with children. It is often easier for a child to talk
about grief through a character rather than to talk about their own feelings of
grief
• Artwork - Have the child draw a picture of a favorite time that they had with the
deceased
• Journaling - Explain to the child what a journal is and have them write about
their loved one or even a letter to their loved one
• Make a scrapbook or a memory frame: Have the child pick out pictures of their
loved one and make them into a book or put them into a frame
• Get moving - Physical activity is great for both children and adults while grieving-
take a walk, ride a bike, etc.
• Filling a Memory box with the deceased favorite items
• Finding special ways to commemorate holidays, birthdays, etc.
o example writing on a balloon and releasing it to heaven on the person’s
birthday
The most important thing that you can do for a grieving child is to be yourself and start
where that child is at. Let the child lead you where they need to be. Children grieve in
their own way - often grieving for short periods, then taking a break, allowing
themselves to be children again and playing, and then going back to grieving. Share your
own grief feelings as honestly and appropriately as you can.Children’s Grief Booklist
Sad Isn’t Bad: A Good-Grief Guidebook for Kids Dealing With Loss (Elf-Help Books for Kids) by
Michaelene Mundy
Help Me Say Goodbye: Activities for Helping Kids Cope When a Special Person Dies
(Paperback)by Janis Silverman
When Dinosaurs Die: A Guide to Understanding Death. by Laurie Krasny Brown and Marc
Brown.
Where Do Balloons Go?: An Uplifting Mystery by Jamie Lee Curtis
The Fall of Freddie the Leaf. by Leo Buscaglia, Ph.D.
Lifetimes
A Taste of Blackberries by Doris Buchanan Smith
The Tenth Good Thing About Barney by Judith Viorst
What’s Heaven by Maria Shriver
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Adolescent Booklist
Healing Your Grieving Heart for Teens: 100 Practical Ideas (Healing Your Grieving Heart
series) by Alan D. Wolfelt PhD
Weird is Normal by Jenny Wheeler
Help for the Hard Times Getting Through Loss by Earl Hipp
When a Friend Dies: A Book for Teens About Grieving & Healing by Marilyn E. Gootman
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Movies
Disney Movies: The Lion King, Up, Bambi, Up, The Good Dinosaur
Charlotte’s Web, My GirlYou can also read
