Children & Young People

The attitude may be that death is a taboo subject and not to be talked about as part of everyday conversation. Sadly it could mean that the child will be poorly prepared for grief in adulthood. The attitude may also incorporate some unnecessary guilt. Young children see themselves as being at the centre of their world, and in the event of a death close to them it is common for them to believe they are at fault.

How do we prevent such ideas forming? How on earth does one begin to explain to a child what death is? If the child has lost a parent or someone else close to them, how can they be helped through the grief they will be feeling? These are hard issues to address, especially if the person closest to the bereaved child is suffering the same loss and is not therefore in the best of conditions to handle the feelings of anyone else.

If at all possible, the key is to acknowledge the shared loss and grieve together. Where possible we must mourn together, and deal honestly and gently with the child concerned.

Even though children may not understand the meaning of death until they are three or four years old, they feel the loss of close relatives in much the same way as adults. It is clear that, even from infancy, children grieve and feel great distress.

However, they have a different experience of time from adults and may go through the stages of mourning quite rapidly. In their early school years children may feel responsible for the death of a close relative and so may need to be reassured. Young people may not speak of their grief for fear of adding extra burdens to the grown-ups around them. The grief of children and adolescents, and their need for mourning, should not be overlooked when a member of the family has died. They could for instance, be included in the funeral arrangements.

It is important that a child is told as quickly as possible when there is a death in the family. The news should be broken by the person closest to them in as simple and straightforward a manner as possible. Try not to use too many euphemisms. For instance “Grandfather’s gone on a long sleep” could instil in the child a fear of sleep. They may also wonder when Grandfather will wake up. The child should be encouraged to talk about the deceased and any questions answered briefly but truthfully.

Bereavement Care – A Guide for Adults Supporting Children

The baby would be aware that a person is missing and this may cause behavioural changes. They will acknowledge and miss the touch, sound, smell etc. of this person, but they will not understand why they have gone. A baby would identify that someone different was taking care of them. If the baby’s parent is grieving the baby may pick up on their emotions and any changes in their daily routine, although they will not understand why.

They can feel strong emotions but they are unaware of what these are or what is causing them.

12 months to 3 years

By this age a baby is able to identify their main carers. If that main carer is not present, behaviour changes may include loud crying, angry tears, and a lack of interest in food and play interaction. They may be aware that someone is missing, but will not fully understand why.

At the 2 year stage a child may even look for the deceased person in hopes they will find them. They will not understand the finality of death and so may expect the person who has died to come back.

They will notice the changes in their life caused by the death, particularly changes relating to their routines and care. They will react to other people’s emotional states, which they may not understand.

3 to 5 years

Children between these ages may understand death but not that it is irreversible. They will miss the person who has died but may still expect them to return. They might react with little interest to hearing of a family death due to their level of cognitive ability.

What a child is told about the person’s death can impact hugely on their behaviour, for example, telling a child that the person who has died has gone to sleep may cause sleep issues, saying they have gone on a long journey may cause worries about travelling.

A child’s imagination at this age is very active: they may believe that something they have done has caused the person to die. It is important to explain why the person died, making this age specific, for example: Grandad’s heart attack was due to Grandad’s heart getting worn out and not working properly, this sometimes happens when people get old.

A child at the top end of this developmental level may understand some of the physical reasons behind a death but will still find it difficult to grasp.

5 to 10 years

It is not uncommon for children at this developmental level/age group to think of death as something spooky, like a monster or a spirit that comes to get you.

They will begin to develop an understanding that death is irreversible and will understand it is something that happens to all living things, but they may still be confused about it and have many questions. From approximately 7 years a child will recognise that we can all die, even themselves. Children may ask peers for their understanding of a person dying and could be given misinformation. It is a good idea to include a child at this age range in the funeral process in some way, giving factual information about it.

Children at this age may be confused with how adults are showing emotions and may even mimic what they see, perhaps hiding their own emotions. They may not be sure whether they can talk about how they are feeling. Allowing the child to show emotions is an important part of their grieving process. Hiding emotions may cause complications as the child gets older

10 to 13 years

Children will now become much more aware of the finality of death and the impact it has on them, and start to think about the longer-term consequences of the loss of the relationship.

The young person may reflect that there will be further grief in the future – as the person who has died will not be with them for important milestones or occasions.

SN or AN

For a child with special needs or additional needs, their functional level of understanding (rather than actual chronological age) will be the biggest factor in how the child reacts to a death, and what they will be able to understand.

Children with SN or AN can often have spiky developmental profiles and therefore do not always fit neatly into one box. The bereaved child you are supporting may display aspects of one or more of the age groups/developmental stages described above.

Behaviour and mood

Some bereaved children and young people may exhibit certain physical reactions to the death of a loved one. Again, the behaviours and physical responses that some children and young people might demonstrate whilst they are grieving will differ and no two children or young people will react physically to a death in the same way.

Some bereaved children may use behaviours not normally used or seen such as throw tantrums, shout and scream. This type of behaviour is most commonly directed at their caregiver or the person they feel most comfortable with. In younger bereaved children such responses can be common. The bereaved child is struggling to process and articulate their emotions and as a result they can display angry outbursts due to feeling frustrated and misunderstood and not know any other way to communicate what is happening for them.

Although it is important to allow the bereaved child or young person to vent their emotions it is also vital that appropriate boundaries are put in place. For example, explain to the grieving child that it is OK to feel sad, mad or angry, but it is not OK to hit or hurt someone including themselves when they feel this way.

Older children and adolescents may exhibit mood swings that are frequent and unpredictable. This may be how the adolescent behaved prior to the bereavement due to hormonal changes and puberty; however the mood swings which occur through grieving are more heightened in their intensity.

How to help?

• Acknowledge that the behaviours and moods of the bereaved child or young person will differ from how they were prior to the death. Remember that behaviours and moods experienced during whilst the child or young person grieves can alter over time.
• Reassure the child or young person that feeling angry, guilty, confused and distressed is normal and encourage them to talk about how they are feeling.
• Put in place boundaries to prevent or discourage the bereaved child or young person from hurting themselves or others. Speak with the school / college if you are concerned about the child or young person becoming physically or verbally abusive.
• Contact Bereavement Care or your local GP if you are worried about the bereaved child or young person’s behaviour or moods.

Appetite and eating

Bereaved children and young people can sometimes experience difficulties with eating and their appetite following the loss of a loved one.

A bereaved child or young person may have a distinct lack of appetite and state that they “Can’t face food / eating”. Even favourite foods or treats can prove unappealing to the grieving child or young person. Bereaved children and young people can also be observed becoming fussy over food and about what they eat. Similarly a grieving child or young person can have a tendency to overeat or turn to food to self soothe.

Difficulties concerning appetite and eating can be further compounded by changes in routine and altered meal times as a result of the bereavement. For instance, if the person who has died was the primary provider of meals to the child or young person, difficulties can occur when someone else takes over this task. If the bereaved child or young person is eating at different times and in different places following the death, this too can prove problematic.

If you suspect that there are drastic and sustained changes in the bereaved child or young person’s eating habits, particularly if they are losing weight dramatically through refusing to eat, a discussion with your GP might be needed. Remember to gently encourage the bereaved child or young person to eat and try to keep meal times as structured as possible.

How to help?

• Understand that increases / decreases in appetite in response to someone dying are common.
• Try to keep meal times as routine as possible to promote normality.
• Some bereaved children and young people might state that they cannot physically face the idea of eating, encourage them where possible to eat little and often.
• If the bereaved child or young person appears to be eating much more than they would normally, try not to restrict their diet or chastise them. Food can, for some bereaved children and young people, be a comfort and afford temporary respite from their grief.

Sleep and sleep patterns

It is essential that the bereaved child or young person receives plenty of rest. Sleep is crucial for the mental, emotional and physical well being of the child or young person. In the aftermath of the death of someone close, the sleep patterns of a bereaved child or young person can change significantly.

A bereaved child or young person, irrespective of how tired they are, might not be able to fall asleep easily or may wake throughout the night and have difficulty falling asleep again. Nightmares and bad dreams are not uncommon in bereaved children and young people and time must be given for children and young people to discuss these.

Sometimes a bereaved child or young person may be afraid to fall asleep stating that they are scared they won’t wake up again. Sometimes a bereaved child or young person may insist that the light is left on and they may display hyper vigilance which means they purposely stay awake in the hope of ensuring no one else dies or anything bad happens during the night.

If a bereaved child or young person has had the nature of their loved one’s death explained to them as “falling asleep” this can increase problems around sleep and sleep patterns.

How to help?

Some children and young people will find it easier to sleep if you talk with them whilst they are in bed and preparing to go to sleep. Story books and books to help the bereaved child or young person better understand their feelings can be useful too. A list of books for bereaved children and young people of different ages can be found on our website.

Snuggle comfort or weighted blankets can also be used by children and young people alike. Some bereaved children and young people feel more secure at night time if they can wrap themselves in a particular blanket that is special to them.

The use of certain calming oils such as lavender can be used to aid sleep and promote restfulness. A few drops on to the pillow can be used, but do not place straight on to the skin.

Sometimes sitting with the bereaved child or young person (particularly those engaging in hyper vigilance) until they fall asleep can help them feel safer.

If your bereaved child or young person tells you that they are experiencing nightmares, encourage them to share them and help the child or young person to talk about any fears or worries they might have.

Some children and young people who slept in the dark prior to the person dying might now want to sleep with the light on. Leave the light on whilst reassuring the child or young person that you will always be close by during the night should they need you.

Regression or reverting back

The death of someone close robs the bereaved child or young person of their sense of security and protection, particularly if the person who has died was the child or young person’s primary caregiver.

With this feeling of insecurity the bereaved child or young person may regress or revert back to behaviours and speech that were first exhibited in previous developmental stages. It is not uncommon for a bereaved child or young person to suck their thumb, use baby talk, wet / soil the bed or to eat with their fingers.

This is not a sign that the bereaved child or young person will not be able to develop intellectually or mentally, it is the child or young person enacting behaviours which occurred at a time when everything was secure in their world, pre bereavement.

Prior to the bereavement, the child or young person would most likely have felt safe and secure and now that this security has been challenged, the child or young person seeks to “go back in time” to when things were safe and normal. Generally speaking, as the journey through bereavement progresses and the child or young person begins to feel secure again, regressive behaviour should diminish.

How to help?

• Try not to become alarmed if your child or young person appears to be unable to perform tasks that they were easily able to do prior to the person dying.
• If you have concerns that your child or young person appears to be regressing academically, letting their school know could be helpful.
• Try not to show frustration with your child or young person if they have become absent minded or forgetful, these are common responses experienced by grieving children and young people and should disappear in time.
• If the bereaved child or young person is bed wetting and are frustrated and ashamed with themselves, reassure them that it isn’t their fault and is a normal response when someone they were close to dies.
• If you are worried that your child or young person is displaying regressive behaviours over a long period of time contact your GP, Bereavement Care or any support agency you feel may help.

Illness – Real and Psychosomatic

When a child or young person is bereaved it can sometimes be observed that they complain of illnesses or physical ailments in response to the emotional trauma they are experiencing. Sometimes these illnesses can be real manifestations brought on by eating too little / too much or from not getting enough sleep.

Commonly some bereaved children and young people experience psychosomatic illnesses in response to the death of a loved one. This does not mean that the ailment or discomfort that the child or young person complains of is “all in the mind” but rather that the discomfort parallels the emotional pain they are feeling.

For example, a bereaved child might complain of a headache or upset stomach when actually they are trying to convey their emotional pain in physical terms. Sometimes a bereaved child or young person can become anxious and fretful over the idea that they or someone close to them might fall ill and die. This is a natural response to the perceived lack of security felt by the child or young person following the bereavement.

A number of bereaved children and young people might start to complain of symptoms similar to those experienced by the person who has died prior to death. If you are finding it difficult to reassure a bereaved child or young person that they do not have a brain tumour, HIV or terminal illness it might be worth taking the child or young person to see their doctor who can explain to them that they don’t have such illnesses. Also if the bereaved child or young person is becoming obsessive about a particular illness and it is dramatically affecting their daily lives (not being able to touch door handles, compulsive hand washing, for fear of possible contamination) discussion with your GP might also be helpful.

How to help?

• If your child or young person is convinced that they have a serious illness or terminal illness encourage them to see their GP so that he / she can address such fears and put the child or young person’s mind at ease.
• Be aware that your child or young person may describe symptoms that the person who has died experienced prior to death.
• Providing a healthy balanced diet and ensuring the bereaved child or young person gets quality sleep can help to prevent infections and colds that can occur whilst the child or young person grieves. The child or young person’s immune system can be weakened as a result of too little food or too little sleep so nutritious food is important where possible.
• If your bereaved child or young person is complaining of a particular ailment encourage them to discuss how and where it hurts as they might be trying to explain the emotional pain they feel in physical terms.

The fact that everyone grieves in their own time and way can also play into this volatile situation, but knowing this, and understanding other common reasons why this shift in family dynamics occurs, can help to diffuse problems before they tear your family apart.

What fuels the fire of family feuds at funerals?

Here are 5 common factors:

1. Varying stages of grief

Because grief is a very individualised process, family members are likely coping in many different ways, which can easily lead to misinterpreted behaviour and misunderstandings. If one person is ready to go through a loved one’s belongings and another can’t imagine doing so just yet, this can definitely cause tension and conflict.

2. A sudden change in roles

With the death of a loved one, roles within the family are often impacted. For instance, an older sibling may suddenly feel pressure to be “in charge” or a widowed mom might be overwhelmed with her new role as a single parent. These changes can understandably lead to increased angst and arguments.

3. Elevated emotions

Understandably everyone’s emotions are heightened during such a difficult time and this often results in people saying things or behaving in ways not typical. It is difficult to be rational with elevated emotions, so not only can behaviours be out of the ordinary, but reactions to others may be unusual as well. It’s important to consider the emotional state everyone is in before getting angry or frustrated. So, our own emotions and behaviours are not understood or correlating with others which can cause conflict.

4. Relationship with the deceased

Different family members have different types of connections with their loved ones, so when there is a death in the family, each member is affected in a different way. An elderly cousin who has years of memories is going to react differently than a younger relative with less shared experiences, for example.

5. Underlying issues

When family members are suddenly thrust together, it is not unusual for irritability to rise, along with unresolved issues from the past. If emotions are running high, underlying problems often resurface, whether from a childhood incident or from recent resentment. If this occurs, it’s important to try your best to keep an eye on the big picture — saying goodbye to your loved one in a way that fulfils his or her wishes.

These are just some of the sources that can cause family dynamics to change after a loved one’s death. Knowing the reasons behind family behaviours can help to keep tempers from flaring and conflicts from arising.

Adults seeking to support a young person should be aware that a wide range of responses are considered ‘normal’, and there is no one support formula that fits all. The best way to support a grieving adolescent is to be there for them. You can ‘be there’ for a teen by listening, talking openly and honestly, and allowing them to grieve how they want.

Yes, this does sound a lot like supporting adults. And, although they may still have some work to do emotionally and developmentally, older teens (approximately 16-18) who are able to understand complex relationships and other’s points of view, are likely to grieve in a similar way that adults do.

For children of any age you could do the following:

• Acknowledge their presence, their importance, their opinions, thoughts, and feelings
• Be patient and open-minded. Allow them to grieve in their own way
• Be available – Sit with the child, listen to them, and answer their questions.
• Let them know that a range of different emotions is normal
• Validate their feelings and do not minimize them
• Check in with other adults involved in their life – teachers, school counsellors, coaches
• Find age-appropriate resources.

We should acknowledge that teenagers do come with their own set of grief considerations. When supporting an adolescent we should bear the following in mind:

For many children, this might be their first experience with death. They may come to define their lives in terms of ‘before’ the death and ‘after’ the death. The following may be experienced by the child for the first time:

• End of life rituals and etiquette: Many children have yet to attend a funeral or memorial service well into their teen years. Rituals and etiquette may cause anxiety for adolescents, especially if they don’t know what to expect or how to act. Additionally, teens may be uncomfortable with the feeling of being on stage as everyone watches to see how they’re coping. It’s worth preparing the child for what to expect, depending on the type of service you are going to have. Include them in the planning. Talk about any elements they would like to be a part of and if there are any they can opt out of. Encourage them to participate but don’t force.
• This will also be the first time they experience the overwhelming emotions related to grief. This can be frightening and many adolescents don’t have the self-awareness to know what types of coping strategies will help. Normalizing the range of emotions grievers are likely to experience will help prepare them for shifts in emotion, and give them permission to laugh and feel happy when they feel like it. Help them brainstorm coping strategies based on their personality and strengths. Offer options such as counselling, journaling, and workbooks, but again, don’t push.
• Not all teens are ready to ponder life’s complex existential questions, but they are certainly old enough to contemplate the ‘why’s and ‘what fors’ in the face of a death. This may be the first time their worldview, religious views, or sense of immortality has been challenged.
• Do allow for open dialogue about life’s philosophical, theological, and logistical questions if required. Don’t minimize their questions but do help them find their own answers. Support them in talking to religious leaders if appropriate. Try and remember that while you’ve had years to ponder the meaning of life and death, these are questions they are only just beginning to ask.

Most teens are dependent on adults and/or their family members for many basic needs. A death in the primary support system can cause anxiety and worry for them because there’s the potential for things family dynamics to change. A death can weaken the primary support system/family structure in the following ways:

• If the deceased was their same gender parent, think about other male/female adults who could have a positive influence on them.
• Following a death, teens may witness the adults in charge really struggle. Grieving parents and caregivers may present as extremely emotional, unable to care for the child’s needs, or unable to fill parental roles (perhaps their own or perhaps those of a deceased parent). It’s absolutely okay to grieve and show emotion in front of an adolescent, this normalizes feelings and sets a good example for expressing oneself. But be self-aware, if your emotion is extreme it could cause anxiety for the adolescent and/or put them in the position of having to support you. If you feel that you are losing control, have look at your own coping strategies and support network.
• Grief can strain relationships. As a result of grief parents may withdraw from one another, argue, get their feelings hurt, and/or break up/divorce. Complications in a relationship can have a profound impact on the child. Families experiencing extreme discord might consider seeing a Couples Therapist or a Marriage and Family Therapist. If breakup/divorce is inevitable, be aware this comes with its own set of complications for an adolescent and may well feel like a secondary loss.

Children have their whole lives ahead of them and this means a life full of milestones and rituals like weddings, graduations, learning to drive, birthdays, and first jobs that they probably imagined their loved one would be a part of. It’s common for children to grieve these future rites of passage, and then feel the loss all over again when they occur.

As these events roll around, acknowledge the impact of the deceased person’s absence. Let the teen (or maybe adult by then) know it’s okay to feel sadness even though it’s also a happy day. Discuss and encourage creative ways to incorporate your loved one’s memory in the day/event.

They are now the kid whose [insert relation] died: It’s common for a teen to be the only person in their peer group to have experienced the death of someone important. As such, they may feel alone in their experience and/or like a novelty to teens who are clueless about grief and death. Don’t take offence if they try to ignore the loss and act like nothing has happened. To teens, peer relationships can feel more important than adult relationships so they may prefer to talk to trusted friends rather than adults. Offer them the opportunity to spend time with other teens who have had similar experiences, through teen support groups or similar.

Teens experience and express emotions differently than adults do. Your teen’s emotional expressions may surprise you, they may seem over dramatic, or they may appear repressed. Adolescents often just want to fit in and go unnoticed. ‘Grieving’ may differentiate them in a way they’re not comfortable with. Younger teens especially (12-14) tend to feel there is something of an imaginary audience watching what they do; for this reason, they may be cautious about how and when they express emotions. They may choose to grieve privately and downplay their grief in the presence of others. It’s best to follow their lead here and allow them to express their emotions when and how they like. They shouldn’t be made to feel guilty for acting as though nothing is wrong, it doesn’t mean they don’t care. You could help them find ways to grieve they’re comfortable with, if they’ll let you.

Adolescents, in general, can appear very self-focused. Younger teens especially (12-14) have a hard time taking others’ perspectives into account. This is a skill that has to be learned as their brain develops, and so they can appear self-centered and lacking in empathy. It follows that younger teens will have difficulty understanding others’ grief reactions when they are different from their own. Mum’s things are important to me, how could Dad clean out her room? I’m still sad, how could Mum possibly think about dating? The key here is to be patient.

Sometimes when a child experiences the unthinkable pain of grief, adults feel compelled to go easy on them in ways that are overly permissible and enabling. Sometimes adults are too distracted by their own grief to notice what’s going on with their children. Be aware and try not to let this happen – don’t hesitate to ask questions and interfere when you feel it’s necessary. Remember, as a parent, caregiver, or concerned adult it is your job to draw lines and set limits. You won’t have control of them for much longer, so set limits while you can.

Not being allowed to go may raise all kinds of worries in their mind about what is happening and why they are being kept away.

If you take a child to a funeral it is important to prepare them beforehand by telling them what to expect. Someone close to the child should stay with them throughout the service to comfort them when it is needed.

Why can’t we stop people from dying?
Doctors often can. Illnesses that would have killed people years ago can now be cured. Most people who go to hospital come out better. Sometimes when there are a lot of things wrong or parts of the body wear out, despite the efforts of the doctors and nurses, people die.

When someone dies are they being punished?
No. Death is never a punishment. People die because the most important parts of their body stop working, either because they have simply worn out, as happens with old people, or they have damaged them because of an accident. Most people live a long time but sometimes people die when they are younger because of an accident or bad illness. This does not mean, though, that if you become ill you die.

Why didn’t someone else die instead?
All over the world people die every day. Their time had come; it would not have made any difference if someone else had died – the person you loved would still have died too.

Why did they go and leave me?
Their spirit is still here. I know it does not seem fair but they still love you and would be with you if they could.

Where do dead people go?
Different people believe different things. Many people believe that the spirit goes up to heaven. The spirit is often called the soul. It is the spark of life that never goes out.

How long will I live?
Probably a very long time. If you look around there are lots of old people. We all have to die at some time and as you get older you worry less about it. Most old people are very happy.

Why do we have a funeral?
To give everyone who loved them a chance to come together to share their sadness and to remember all the good things about the person who died.

What happens at the cremation?
When someone dies they no longer need their body, so we may take it to the crematorium, where it is turned into ashes. We can scatter the ashes in the gardens at the crematorium or in a churchyard or other favourite place.

• Boundaries still need to be in place if the child is hurting themselves or hurting others
• They may say they are unwell. This may be real or perceived. It’s important not to dismiss their feelings. Talk things through in an open and honest manner
• It may help the child to identify a “memorial” to the person who has died, especially if they were very close. Opinions vary, but most people believe it is better to help the child remember someone they knew than expect them to forget.
• It is not failure to get professional support if your child needs it