Lighting a Child’s Journey Through Grief A Guide for Parents, Teachers and Caregivers: How to Help Children and Adolescents Cope with Feelings of Grief and Loss Provided by:
HPH Hospice Children’s Assistance Program (CAP)
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hat you have in your hands is a compilation of information from HPH Hospice grief and loss counselors who have spent thousands of hours listening to the stories of children and youth. Our intention is that you benefit from the experience we have gathered counseling children in grief and mourning. These kids hurt. They cry. They have fears. They are confused. Often children and youth do not bring up the illness or death, even to their own families. They fear causing more hurt or reopening wounds that have not healed. Where is it safe for them to talk? Whom will they trust to reveal their pain? Where can they go to express the feelings they have?
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his information is for you…the adult. We are sorry you are going through a death or are grieving. That means you are about to lose a loved one or already have. It also means you are not the same person you were yesterday. Be assured, neither is your child.
“To integrate loss and to move forward with a life of meaning and love, you must have hope. Hope is a belief in a good that is yet to be.” – Dr. Alan Wolfelt
A Note About Suicide Prevention While this booklet can serve as a guide to the grief and healing process, it is not intended to replace the assistance of grief counselors and other mental health professionals. If your child is in crisis, please contact the Suicide Prevention Lifeline at 1-800-273-TALK or www.suicidepreventionhotline.org.
“Time does not heal a painful loss...grieving does.”
—Anonymous
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ave you ever had to explain death or dying to a child? Have you experienced the pain, frustration and confusion of a small child who has never even known the death of a goldfish, yet now grandpa lies dying in a hospital? What do you say? Where do you start? Do you dare bring up the subject first, or do you wait for a question? What if the child acts out of anger or fear and tries to keep his feelings hidden inside? This is a taboo subject because nobody wants to talk about death. However, you are now confronted with the task of broaching this subject with a child…maybe your own. Where in the world do you start? Sections of this booklet cover children’s understanding of and specific age-related responses to grief. There is no right way or wrong way to grieve and working through your grief is necessary for healing. This healing can be a turning point for positive growth and lead to finding greater meaning and purpose in life. We believe you can be the loving anchor that will encourage the healing process and this booklet may be used as a compass to steer your course through this journey now unfolding before you.
Teenagers participate in a weekend grief camp. Using activities such as expressive art therapy, team building and memorializing, teens experience support from other teens and normalization of their thoughts and feelings surrounding their loss.
Pre-Bereavement and Bereavement Responses to the Anticipated Loss or Loss of a Loved One Hearing a loved one has a terminal life expectancy and/or the death of their loved one can turn the emotional life of a child or teen upside-down. Common responses include: • Shock/disbelief/numbness • Sadness & loneliness • Searching for answers • Confusion/difficulty concentrating • Guilt and bargaining • Anger/resentment/acting out • Acceptance & relief • Uncertain how to ask a question or talk about “it” How to help: • Answer questions about the illness and condition of the loved one as honestly as possible. • Give the child the opportunity to spend time with the ill person or communicate with him or her. • When possible, create opportunities for memories your child can hold onto after their loved one has died. • Be aware that children hear and see much more than adults realize and they may be looking for signs that the illness or death is not real. • Don’t be alarmed if the child seems to be “rehearsing” the death. Pretend games can help young children prepare for coping with the complex feelings of grief and loss. • After the death, avoid using vague language such as “passed away,” “gone” or “no longer with us” because sometimes young children cling to the hope that their loved one can return from death. Death should be explained in simple and direct language. • Allow children to tell their story and express their feelings. Remember, your child will learn from seeing your grief too. It’s important to explain that this is a very painful time for you as well. • Explain potential rituals or ceremonies: wake, funeral, burial/cremation and memorial.
“Nobody had any control over anything that was happening. We were powerless to stop the cancer. I was angry that my parents and the doctor couldn’t stop it.”
As you read the following information, remember that not all children will display the same reactions. The absence of a grief reaction may not mean that your child is not grieving. Each child will feel, and express feelings, in his or her own way.
The Pre-School Child The pre-school child may not understand what death means and words like “passed away,” “no longer with us” or “sleeping” may be confusing and frightening. Magical thinking may cause a young child to believe the death of a loved one is temporary. Many children continue to play and laugh and don’t seem to be reacting to the death. Happiness, laughter and play do not mean the child is not grieving.
Some common grief reactions in pre-school age children include: • Clingy behavior • Regression to thumb sucking and bedwetting • Nightmares and fear of the dark • Tantrums and unruly behavior
How to help: • Use simple, honest words when talking about what has happened. • Give reassurance, hugs and comfort. • Keep or establish a normal routine. • Encourage the child to draw or talk about the loved one who has died. • Set limits for inappropriate behavior. • Be patient with questions that may be repeated over and over again as the child tries to understand what has happened. Don’t worry if you don’t have all the answers.
Primary School Child Children in this age group may have a better understanding of death and its consequences, but they can still struggle with the finality. They sometimes worry about their own well-being/death along with the health and safety of surviving loved ones. To avoid appearing helpless and immature, they may hide their sadness and not cry or show other signs of grief.
“After Mom died, I worried about Dad. If he also died, where would I go? Who would love me and take care of me?” Some common grief reactions in primary-school age children include: • Being easily upset, crying, whining, worrying or fearful. • Irritability, frustration and aggression (may cause disruptions at school). • Tendency to feel responsible for, or blame someone else, for the death. • Vague physical complaints such as headaches, stomachaches, pains, changes in appetite or sleep habits • Difficulty paying attention in class or following directions.
“I remember thinking my Dad’s dying was a punishment on me. I had broken some things in his office so I thought since I had done these bad things, then his dying was a punishment for what I had done.”
How to help: • Give the child permission to cry, but also tell them it is okay not to cry. There is a wide range of emotions that accompany grief and it’s okay to express all of them in front of your child. • Be honest about the death and include the child in funeral or memorial service plans when possible. Allow the child to decide if he or she wants to attend the funeral. • Set limits on acting-out behaviors and be patient with regressive behaviors. • Be a good listener and tell your child that all feelings are okay.
“I hope my father doesn’t remarry. Mom can never be replaced.”
The Adolescent Many adolescents have an understanding of death and dying but may be so overwhelmed with feelings of grief they pretend to be “unfazed” by the death. A grieving adolescent may become depressed or withdrawn and may need help with making healthy coping choices. The death of a loved one may also temporarily affect a teen’s ability to focus in school and grades may drop.
“After my brother died, I had a lot of bad dreams, like his ghost would come back and haunt me for all the bad things I had said to him.” Some common grief reactions in adolescents include: • Sadness • Shock/numbness • Disbelief
• May assume a more adult role at school or home • Changes in peer group
• Anger/moodiness, testing limits, recklessness
How to help: • Provide opportunities for the teen to talk about the death and ways to cope. • Include the teen in planning and decision-making for the funeral or memorial service. • Maintain the teen’s routine/ schedule and set limits on unacceptable behavior. • Be willing to listen to what your teen has to say about his or her feelings and be open to your teen receiving help from others including teen support groups in the community. • Encourage your teen to express feelings through journaling, poetry and expressive art.
“Going back to school was really hard because nobody would say anything. I guess they didn’t know what to say.”
Sadness is a natural reaction to death. But in rare cases, it may turn into debilitating depression. Teens that are not able to cope with school, peers and family relationships, and, therefore, talk of suicide, need the help of a mental health professional immediately. If you have concerns about your child or youth, contact your family doctor.
The HPH Hospice Children’s Assistance Program (CAP) provides bereavement support to children of HPH Hospice patient families and to the community. Services are provided by experienced, professional counselors in one-to-one or group settings. The CAP program also offers annual bereavement camps where children have fun while learning to express and cope with grief and loss. For more information please contact: Administration Office 12107 Majestic Blvd. Hudson, FL 34667 (727) 863-7971
West Pasco 6807 Rowan Rd. New Port Richey, FL 34653 (727) 848-7160
Hernando 12260 Cortez Blvd. Brooksville, FL 34613 (352) 597-1882
East Pasco 37445 Clinton Ave. Dade City, FL 33525 (813) 780-6797 (352) 518-1400
Citrus 3545 N. Lecanto Hwy. Beverly Hills, FL 34465 (352) 527-4600
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