Children's grief

The core of grief is the same for all those closely affected, regardless of their age. What distinguishes the grief of children from that of adults is simply that children have different ways of expressing their thoughts and feelings. Children don't act out their grief in the way adults do, which can be both confusing and worrying to parents who, often, are attempting to deal with their own grief at the same time.

Cultural differences

Cultural differences are also relevant with children. The way children grieve will depend, among other things, on how they see the adults around them grieving. This can be challenging for young people who are growing up in two cultures at the same time. Rules of dress and behaviour may be very different from that of their peers from other backgrounds. For children, who need to fit in, this can be an added stress during an already stressful time.

Many people gain enormous comfort and help from their traditions and beliefs. It is simply another thing to keep in mind when you are looking at how young people in your care are coping.

Helping children with grief

Different ages have different ways of expressing their emotions and children can differ even within their age groups. Some general principles which hold true for all children from birth to late adolescence are:

• Children are sensitive to the emotions of the adults around them. There is no point trying to hide your own grief from young people. They will know there is something wrong.
• Children, like adults, will use their imaginations to fill in knowledge gaps. In other words, if they don't know the details about the death, they will make them up. Often this invention can be more distressing for them than the facts.
• Children tend to see themselves as having a vital impact on the world and the people around them. In a way, they tend to think that they are at the centre of all events. One of the results of this is that they can believe that the death has resulted from something they have said, thought or done. This can lead to them taking on a heavy burden of unreasonable guilt, sometimes for many years.
• The best way to help children deal with grief is to give them as much accurate information as possible. Adults find unanswered questions one of the hardest things to deal with when they are grieving. Children are no different.
• Every child needs security and reassurance following a sudden death. Routines and surroundings need to be kept as familiar as possible. The message needs to be repeated over and over that the rest of the family are safe and are not going to leave.
• Children of all ages need to be reminded (or reassured) that the death was not their fault. No matter what the circumstances. It needs to be stressed that the deceased person knew the child loved them and that nothing the child did or didn't do can change that fact.

It's a natural response for parents to see their child's safety and health as paramount. It's important to remember that we can only care for our children if we ourselves are coping. As much as children need special care, it's a mistake to neglect your own needs. Children need their parents to be well.

Children 0–3

Children in this age group easily pick up on the emotions around them. They are able to sense when there are feelings of sadness, anxiety, anger or tension. Children aged between 0 and 3 years are able to sense that a significant person is missing and that there has been a change at home. All of these are deeply unsettling for young children and babies.

It is common for children to express this by:

• changing their eating and sleeping routines
• increasing irritability
• regressing (for example, using 'baby talk' after they have grown out of this form of expression)
• becoming distressed when separated from parents.

Very young children tend to think in concrete, immediate ways. Consequently, death is only meaningful to them in terms of the effects of a sudden death on their environment such as absence and the distress of others. They will experience 'grief' themselves as a time of unease, confusion and insecurity. This makes it very important that they receive a great deal of attention and reassurance. Ways of reassuring this is done include keeping their routines as normal as possible and providing lots of reassurance and comfort, both verbally and physically.

Children 3–6

Children from 3 to 6 years are aware of death as a life-changing, upsetting event. They are able to recognise and articulate the confusion and sadness which can result from the absence of someone they love.

Generally they will relate this absence to their experience of temporary separations such as holidays. As a result, it is common for children to ask repeatedly for information about where the deceased person has gone and when they will return.

This is also an age group which enjoys a rich and vivid fantasy life. Many parents become disturbed when children tell them about having seen and spoken with the person who has died, yet this is a very common experience. There is nothing 'supernatural' about this—the child is simply developing an understanding of death and at the same time working through their feelings for the person who has died.

There are a number of ways to help children in this age group deal with grief, including:

• being clear with them about what death means, particularly that it is permanent
• reassuring them that they are safe and that you will stay with them
• keeping their routines as normal as possible
• emphasising that they are not in any way to blame for the death and that the deceased person was aware that he or she was loved by the child.

Children 6–9

Children between the ages of 6 to 9 years are beginning to understand that death is something that will happen to everyone; although they tend to think of it in terms of it happening to others, not themselves. They will sort out their ideas about death and what it means through play. Often children who have been to a funeral will play funerals at home.

It is important for the child in this age group to know that emotions are a normal way for people to express their sadness about a person's death. It will be helpful for your child if you tell them about the emotions you are feeling. This gives a positive message and models a healthy way of grieving.

Children at this age group often ask for detailed explanations, sometimes about very complex medical matters. Your GP or the school nurse are both useful resources here, for explaining the medical issues and for suggesting ways to explain them in language a child will find helpful.

There are some things that you can do to make the transition for your child easier such as:

• letting the school know what has happened
• talking with your child about some of the questions that their friends may ask about what has happened in the family
• reminding your child that they do not need to tell people what happened if they feel uncomfortable.

Children 9–13

Children in this age group are aware of the finality of death and the impact of the death on them as an individual. Death is more real for them.

Children between 9 and 13 years will ask questions about the impact of the death on them and their routine. They are working out for themselves how their world has changed and what parts of life are still the same. A common example is for them to become concerned about how the family will manage financially and how it may affect their relationships with their friends.

Often, these young people think deeply about issues before obviously responding. They will appear to have a delayed reaction to the person's death; they may not ask questions initially, seeming to act as if nothing has happened. It helps to allow them time to process the death.

You can support the child by:

• encouraging discussion
• providing them with opportunities to express their feelings in different ways including art
• addressing any behaviour that is seen as acting out or aggressive as these are good times to talk about how they are feeling
• grieving openly with your child and talking about the deceased person together
• being honest with your child—if you do not know the answer to a question, tell them
• being prepared for them to regress in their behaviours while they make sense of their changing world.