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    Bereavement
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Bereavement

Responding helpfully to a child or young person who has experienced bereavement

 

The capacity to care is the thing which gives life its deepest meaning and significance...

 
 
Pablo Casals
 

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About bereavement                                                                                                printable pdf

The term ‘bereavement’ refers to the whole process of grieving and mourning, and is associated with a deep sense of loss and sadness.  It is a natural process, but its effects can be overwhelming.

Many children and young people will experience bereavement, through the loss of a parent, sibling, grandparent, friend or pet.  There is little coordination of information about numbers of bereaved children, but one estimate suggests that every 30 minutes in the UK a child is bereaved of a parent.  This equals 20,000 children a year (Winston's Wish).

The death of a person you love is a major life change and children will need to be supported by the people around them.  They will need to feel safe and secure, to be able to ask questions, to be given clear, simple information and to talk about how they are feeling.

There is a common misconception that children don't grieve in the same way that adults do.  All children will grieve when someone they love dies, although each child’s reactions will be different. Grief is often disorganised and doesn’t always follow a set pattern of responses.  Their reactions will depend on many things, including their age and their level of development.

Children younger than 2 years old do not understand the concept of death.  The death of someone close is likely to result in behaviours associated with separation anxiety, for example searching and crying.  For children up to about the age of 5, death is often seen as temporary and they often believe that people who die can come to life again.  Between 5 and 9 years old, children start to understand the permanence of death, but some may still think it is reversible.  By about age 10, children are likely to have a full understanding.  Understanding is typically ahead of ability to express what is believed to have occurred.

Children’s reactions will also vary due to factors such as:

  • Their relationship with the person who died

  • The nature of the death

  • The family circumstances

  • Their religion or culture

  • Their previous experience

  • The behaviour of adults around them.

There are many reactions that children may experience in response to death, some of which are:


Things to think about                                                                                           top of page

During bereavement, children and young people can experience a great number of emotions, all of which are completely natural and normal.  However, the way children react to death may be very different to the way adults react.  Some of their reactions may be unexpected or surprising, and may even seem inappropriate.  For example, a child may be deeply distressed one minute and then ask if they can go outside to play.  Although this can be quite shocking or upsetting to adults, it is a normal response and doesn’t mean that the child doesn’t care or isn’t grieving.

Children may show concern for the safety of other family members, in the form of clinging or being reluctant to leave them.

No cause of death is easier than another for a child to deal with.  However, there may be differences in their reactions depending on whether the death was expected or sudden.  For example, if the death was expected, the family may have had time to prepare for it and one of the feelings experienced may even be relief.  This contrasts with the shock and disbelief of a sudden death.  A death as a result of suicide may be harder for a child to talk about and they may experience more feelings of guilt.

Families will often have their own ideas about whether they want children to attend the funeral or see the body.  These views should always be respected.  Children should also be given the opportunity to decide for themselves.  To do this, they will need plenty of information so they know exactly what is involved and what to expect.  These rituals are designed to be helpful in the bereavement process, and children can often benefit from being included.  For example, they can help the child accept that the death has happened and allow them to say goodbye to the person who has died.  Research shows that the majority of children will choose to be involved with the funeral if they are adequately prepared.  However, children should never be forced to participate in anything they don’t feel happy with.

Adults often try to protect children from things they think will upset or distress them.  However, children need to be given information and to be included.  They can feel more anxious or lonely if they don’t know what is happening.

Be aware that a child may be more at ease talking to a relative or family friend (or counsellor) than to their parent/carer. The child may be frightened of causing upset within the family. It is important that if this is the case, parents/carers do not take this personally. Encourage the parents to allow the child to talk to others if this is felt to be beneficial.

Children may not express grief directly, but indirectly through play and behaviour.

When a child's parent dies, children often experience a loss of confidence.  If a child loses a sibling, they may feel neglected as all attention is likely to be focussed on the dead child.

Bereaved children may experience difficulties with other children.  They may feel different and distant from their friends.  At school they may be teased or asked difficult questions.  Children may leave bereaved children alone because they don’t know what to say to them, or because they are worried in case they get upset by the child’s grief.

Consider accompanying losses, for example a house move may initially have more impact than the death.

Children’s needs are likely to change with time.  Different feelings are experienced at different stages of life and, as children get older, they may need to go over the details of the death again.

Remember that children can struggle with adapting to a death several years after the event. Families may simply not 'deal with it' at the time and it may be an apparently unconnected event at a later date that highlights a child's need to reconnect with the deceased.

 

"The [worker] gave her someone to talk to, saw a significant change in her attitude. She was very angry after the death of her mum and granddad; she became calmer after working with [worker] and was more able to talk about things"

 
 
Carer
 


Think about yourself                                                                                             top of page

Talking to a child about the death of someone close may be among the hardest things you have ever done or will do.  Supporting a bereaved child can be exhausting and bewildering.  This may bring back painful memories of your own.  Do what you can to support the child, but don’t expect too much of yourself and talk to someone if you need support. 

For more information, see section on being aware of yourself and your own response.


What you can do                                                                                                   top of page

  • It is important to adjust your approach depending on the child, their level of development and their understanding of death.
  • Ask the child how they are feeling.  Children’s reactions are often different to those of adults, so how they are feeling may not always be obvious.  Children may feel isolated during their grief experience if they think that nobody understands their feelings.
  • Spend time with the child and listen to what they have to say.
  • Give children information to help them make sense of what has happened.  Use simple, clear language and words they will understand.  Ask them questions to ensure they have understood what you have said.
  • Encourage children to talk and to ask questions.  Answer their questions honestly and simply, in a way that is appropriate to the child’s level of development.  Some questions will be easy, and some will be more difficult. If you don’t know the answer, don’t be afraid to say so.
  • Give concrete information.  For example, if you need to give children information about the dead person’s body, it can be helpful to explain that when a person has died, their body doesn’t breathe, doesn’t need to eat or drink, can’t feel pain and won’t ever wake up.  If children ask what happens to a person when they die, you could tell them that different people have different ideas about what happens, although nobody really knows for sure.
  • Recognise that these conversations with children and young people may feel uncomfortable or awkward, but try to put these feelings aside and discuss things openly and freely - this will reassure children that these issues are OK to talk about.
  • Reassure children that whatever they are feeling is OK.  People have many different reactions to death, and all are normal and natural.
  • Help children to name and understand their feelings, especially yearning, and to understand that overwhelming emotion comes in waves and will pass if allowed out.
  • If you are upset, don’t be afraid to show it.  This can help children see that it’s OK to show how you are feeling.
  • Ensure that children and young people know that it is OK to cry.  However, it is also important to be accepting if children don’t cry.
  • Reassure children that it is OK to feel happy, and that they shouldn’t feel guilty if there are times when they don’t think about the person who has died.
  • Help children to find appropriate ways to express their feelings.  Children need acceptable safe ways for expressing anger and other feelings, for example, sport, physical exercise, shouting or noisy play, cushions or punch bag, or messy painting session.
  • Children often think that they are to blame for the person’s death, for example because they had been naughty, or even because they had thoughts about someone dying.  You should explain that it was something else that caused the death and help them to understand that it is not their fault.
  • Some children may be concerned about what life will be like now, and what will happen to them.  Try to make them feel secure and reassure them that they will still be loved and looked after.
  • Address any fears the child may have about being abandoned, or about other people or themselves dying.
  • Respect the religious and cultural beliefs of the child or young person’s family.
  • Respect the family’s views about whether the child should see the body or attend the funeral, but if they are asking, encourage them to include the child.
  • There are some practical things that children can do to help them in the grieving process and to help keep a connection with the person who has died. Some suggestions are:

    - Filling a memory box with special memorable items.

    - Making a scrapbook of photos and other keepsakes.

    - Writing things down that they would like to say to the person.

    - Visiting a special place/cemetery.

  • Provide parents with resources to help them explain death and bereavement to their children.
  • Try to maintain the child’s normal routine as far as possible.
  • The child’s school will play an important role in supporting them.  It can be useful for a teacher to contact the family before the child returns to school to find out how the child is doing.  The child should be involved in deciding how to tell other children about what has happened.  They may find coming back to school difficult, so it can be helpful to talk to them about what additional support they might like.  The child should be encouraged to talk to their teacher or a special friend if they feel upset or alone at school.
  • Children find pets and soft toys comforting.  Many children are soothed by physical contact, such as a gentle massage or a cuddle.  Relaxing music, story tape or relaxation tape can be helpful, especially if children are having difficulty sleeping.
  • Be patient.  The child will need time to learn to cope with what has happened.
  • Expect some behavioural changes, for example expression of anxiety and possible behaviour problems or lack of attention.
  • Encourage children to keep on talking about the person who has died.  A while after the death, people often stop asking bereaved people how they are, and bereaved people find this period very difficult.  Children sometimes need to be told that even after a long period of time it’s OK to continue to talk about the dead person and to show their feelings.
  • Children can sometimes benefit from meeting other bereaved children.  It can be helpful to realise that they are not alone, and that other people have had similar experiences.
 

"We wrote stories together, wrote things down that we did before they died.  We all did it together.  We were able to talk about how we were feeling, we got to take our work home, and then we had a recall to see how we were getting on"

 
 
Young Person
 

 

What not to do                                                                                                       top of page

  • Don’t avoid the subject of the death, even though this might be your natural reaction.  The majority of children will really appreciate the chance to talk about what has happened and it will help them deal with it.  Avoiding the topic is likely to give the impression that you don’t care or even that it has never actually happened.
  • Don’t worry that you might make things worse by talking about the death.  The child has just experienced a terrible life-changing event.  It is unlikely that things can get very much worse for them.  Children will benefit from talking.
  • Don’t use language that may confuse children.  For example, saying that "we have lost Daddy" may make the child wonder why nobody is looking for him.  A child who is told that heaven is in the sky may want to visit the dead person in an aeroplane.
  • Don’t encourage children to suppress their emotions by telling them to be "big and brave" - children need to be able to express their emotions.  Comments such as this are likely to make children keep their feelings inside.
  • Don’t tell children that they will now be "man/lady of the house" or that they will "have to look after their mum/dad".  This will put unnecessary pressure on them and worry them with unrealistic responsibilities.
  • If you don’t feel very confident or comfortable talking about death, try not to show it.  The child might pick up on your feelings and get the message that death is a subject that shouldn’t be discussed.
  • Don’t punish or criticise children if they display reactions that seem inappropriate to you.


When to contact a mental health specialist                                                    top of page

Following a death, the reactions of children and young people may cause a great deal of concern, and some families feel they should get specialist help immediately.  However, with the right support from the people around them, most children will be able to cope with the death of a loved one.  Gradually they will learn to deal with all the changes.

If the reactions of children or young people persist or become more severe, it may be necessary to seek specialist help or advice.

The child or young person should get specialist help if they are experiencing any of the following:

  • Extended period of disrupted relationships with family and friends.

  • Inability of parent to meet child's needs (due to parental grief).

  • Prolonged lack of interest in activities they used to be involved in.

  • Prolonged refusal to attend school or poor academic performance.

  • Continuing problems with sleeping.

  • Persistent low confidence, shame or guilt.

  • Persistent aggression, anxiety, physical complaints or eating disturbances.

  • Prolonged fear of being alone.

  • Signs of chronic depression.

  • Risk-taking behaviour, for example, drug or alcohol abuse, sexual experimentation, fighting, reckless driving.

  • Repeated desires to join the dead person, copying symptoms/behaviour of the deceased or repeatedly dreaming of their own death.

  • They are convinced they have caused harm/death.

  • The death of their parent or sibling was by suicide.

  • They were directly/indirectly responsible for the death.


How to contact a mental health specialist

You should get in touch with your local health centre or hospital to obtain a contact number for the appropriate children and young people's mental health specialists.

Remember - you can contact your local mental health specialists for a number of reasons, for example:

  • For advice on how to make a referral about a named child.

  • For advice about whether or not to make a referral (it is normal practice to seek this advice without naming the child in the first instance).

  • For advice about what to do (once again there should be no necessity to name the child).

By not naming the child you are protecting their right to confidentiality. This method of seeking advice also has the advantage that you do not need to get anyone’s consent in advance of your contact phone call.

 

 

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Life events