Children do not react to loss in the same ways as adults. They may seem to show grief only once in a while and for short times, possibly because a child is not able to feel strong emotions for long periods of time. A grieving child may be sad one minute and playful the next. Often, families think the child doesn't really understand the loss or has gotten over it quickly. Usually, neither is true. Children's minds protect them from what is too much for them to handle emotionally.
Mourning is a process that continues for children over the years. Feelings of loss may occur again and again as the child gets older. It is common, at important times in their lives, to feel a wave of grief, even many years after the death. Events such as going to camp, graduating from school, getting married or having their own children may trigger these feelings. Grieving children may not show their feelings as openly as adults; instead, they may throw themselves into activities instead of withdrawing or showing grief.
It's important to remember that children cannot think through their thoughts and feelings like adults. Thus, they will likely have trouble putting their feelings about grief into words. Strong feelings of anger and fears of death or being left alone may show up in their behavior instead. Children often play death games to work out their feelings and worries. These games give children a safe way to express their feelings.
Additionally, while adults may withdraw and not talk to other people about the loss, children often talk to the people around them (even strangers). They usually do this to see how these people react and get clues for how they should respond to the loss. During it all, children may ask confusing questions. For example, a child may ask, "I know grandpa died, but when will he come home?" This is a way of testing reality and ensuring the death story has not changed.
Several factors that can affect how a child will cope
Although grief is different for each child, several factors can affect the grief process of a child, including:
Age and stage of development
Their personality
Any previous experiences with death
The relationship with the deceased
Cause of death
How they act and communicate within the family
Stability of family life after the loss
How the child continues to be cared for and by whom
Whether the child is given the chance to share and express feelings and memories
How the parents cope with stress
Whether the child has ongoing relationships with other adults
Children at different stages of development have different understandings of death and the events near death:
Infants. Infants do not recognize death, but feelings of loss and separation are part of developing an awareness of death. Children who have been separated from their mother may be sluggish and quiet, may not respond to a smile or a coo, may have physical symptoms (such as weight loss) and may sleep less.
Age 2-3 years. Children at this age often confuse death with sleep and may feel anxiety as early as age three. They may stop talking and appear to feel overall distress.
Age 3-6 years. At this age, children see death as a kind of sleep; the person is alive, but only in a limited way. The child cannot fully separate death from life. Children may think that the person is still living, even though they might have witnessed them being buried. The child may ask questions about the deceased (for example, how does the deceased eat, go to the toilet, breathe or play?). Young children know that death is physical but think it is not final. The child's understanding of death may involve "magical thinking." For example, the child may believe that their thoughts can cause another person to become sick or die. Grieving children under five years of age may have trouble eating, sleeping and controlling the bladder and bowel.
Age 6-9 years. Children at this age are often very curious about death and may ask questions about what happens to the body when it dies. Death is thought of as a person or spirit separate from the person who was alive, such as a skeleton, ghost, angel or bogeyman. They may see death as final and scary but as something that happens mostly to older people (and not to themselves). Grieving children can become afraid of school, have learning problems, show antisocial or aggressive behavior or become overly worried about their own health and complain of imaginary symptoms. Children this age may either withdraw from others or become too attached and clingy. Boys often become more aggressive and destructive (for example, acting out in school) instead of showing their sadness openly. When one parent dies, children may feel abandoned by both the deceased parent and the living parent, whose grief may make them unable to support the child emotionally.
Age 9 and older. Children aged nine and older know that death cannot be avoided and do not see it as a punishment. By the time a child is 12 years old, death is understood as final and something that happens to everyone.
Common concerns
Most children who have experienced a loss have common concerns about death:
Did I make the death happen? Children often think that they have "magical powers." If a mother is irritated and says, "You'll be the death of me," and later dies, her child may wonder if they actually caused the mother's death. Also, when children argue, one may say (or think), "I wish you were dead." If that child dies, the surviving child may believe that those thoughts caused the death.
Is it going to happen to me? The death of another child may be very difficult for a child. If the child thinks that the death may have been prevented (by either a parent or a doctor), the child may fear that they could also die.
Who is going to take care of me? Since children depend on parents and other adults to take care of them, a grieving child may wonder who will care for them after the death of an important person.
Talking honestly about the death and including the child in rituals may help the grieving child.
Explain the death and answer questions. Talking about death helps children learn to cope with loss. When talking about death with children, describe it simply. Each child should be told the truth using as much detail as they are able to understand. Answer questions in language the child can understand.
Remind them that they are safe. Children often worry that they will also die or that their surviving parent will go away. They need to be told that they will be safe and taken care of.
Use the correct language. When talking with the child about death, include the proper words, such as "cancer," "died" and "death." Using other words or phrases (for example, "he passed away," "he is sleeping," or "we lost him") can confuse children and cause them to misunderstand.
Include the child in planning and attending memorial ceremonies. Children may feel better if they are included in planning and attending memorial ceremonies when a death occurs. These events help children remember their loved ones. Children should not be forced to be involved in these ceremonies, but encouraged to take part when they feel comfortable doing so. Before a child attends a funeral, wake or memorial service, give the child a full explanation of what to expect. A familiar adult or family member may help with this if the surviving parent's grief makes them unable to.
Death, grief and mourning are natural life events. All cultures have practices that best meet their needs for dealing with death. Caregivers who understand how different cultures respond to death can help patients of these cultures work through their own grieving process.
Source: National Cancer Institute: www.cancer.gov
