Grief in Children

1. Grief in Children Holly Clendenin, RN Child Care Health Consultation Lexington-Fayette Co. Health Department.

2. Objectives • Do babies and children grieve? • What does grief look like in children? • How do you recognize abnormal grief? • What can you do to help children in your center and their families cope with grief?

3. Do Young Children Really Grieve? Many adults think because young children are not completely aware of what is going on around them that they are not effected by death and they do not mourn the loss of a loved one.

4. It is true that infants and toddlers are not developmentally mature enough to fully understand the concept of death. • Children do not understand the inevitability and permanence of death until sometime around their teenage years.

5. But understanding death and being affected by death are two different things. • When a primary caregiver dies, even tiny babies notice and react to loss. • They might not know what happened, but they do know someone very important is missing from their world.

6. Any child old enough to love is old enough to mourn. ~Dr Alan Wolfet

7. How Do You Know an Infant is Grieving?

8. Birth to 3 Years • Crying more than usual, fussy and irritable • Changes in eating or sleeping patterns • Clinginess, whining, other symptoms of separation anxiety • Regressive behavior

9. 3 to 6 Years • Wake more often during the night • Formerly potty trained now needing diapers • Regress to thumb sucking or demanding a bottle • They may stop talking • They may be inconsolable

10. What Can You Do? • Offer comfort by picking them up when they cry and do not worry about spoiling them. • Give them a gentle baby massage to soothe them when they are upset. • Try to maintain their schedule. • Try to meet their needs whatever they might be, quickly and lovingly in the weeks and months to come.

11. More Serious Symptoms of Grief

12. Detachment in Young Children • Young children at risk for this are typically infants and toddlers who do not receive enough love and attention after a loss. • They learn not to trust or love. • They may unconsciously decide the separation is too painful, so they detach.

13. Symptoms of Detachment • It is very obvious that something is wrong • Lack of ability to give or receive affection • Speech disorders • No eye contact • Extreme behavior problems • Cruelty to others or pets

14. Diagnosis of Detachment • Accurate diagnosis can only be made by a mental health specialist with training in this area. • Early detection and treatment is essential. The older the child becomes, the more difficult the treatment.

15. 6 to 10 Years • They have had more time to form bonds in the relationship with the primary caregiver. • They are curious about death, but fear they will die too. • They may have some understanding of death, but little experience.

16. Grieving Children 6 to10 Years • Sadness, irritability, anger and acting out • Regression or withdrawal • Difficulty sleeping • Fear of abandonment • Guilt

17. Losses Other Than TheirPrimary Caregiver

18. Children mourn the loss of a sibling as their playmate and friend. They may feel guilt for fighting with their sibling. They need to know fighting and negative feelings did not cause death. Death of a Sibling

19. Death of a Grandparent • The closer a child is to grandparent the more grief you will see. If they live long distances apart, grief may be slight. • The child’s concern may be more for their parents.

20. Use this as an opportunity to discuss death. Involve child in decision as to where to bury pet. Don’t immediately replace pet. Don’t buy a replica. Don’t name pet by the deceased pet’s name. Let child know his heart is big enough for two or three pets. Death of a Pet

21. How to Discuss Death With Children Provide children with clear an simple answers. Use correct terminology. If you say “death is just like sleep” they may think they will never wake up when they go to sleep. They may hear that their family has “lost grandma” and may think she has just disappeared and she will return sometime.

22. Physical activity and play Drawing Tape recorders Writing Puppets Books Put together a memory box with photos and help them write down their memories they have of the deceased. Coping Techniques for Grief

23. More Than Grief • Extended period of depression • Inability to sleep, loss of appetite, prolonged fear of being abandoned • Acting much younger or regressing for an extended period • Excessively imitating the dead person • Repeated statements of wanting to join the dead person • Poor concentration or drop in grades

24. Depression • A period of depression almost always follows a major loss, but prolonged depression is abnormal. • Poor concentration • Withdrawal • Change in eating or sleeping habits • Less interest in appearance • Drop in grades

25. Get Help for Depression • Seek the advice of the child’s pediatrician to deal with prolonged depression. • They may need a referral to a childhood mental health specialist or counselor.

26. Hospice as a Resource • Seek out information to help children with the grief process at you local Hospice. They have counselors, support groups and an abundance of written information. • Hospice of the Bluegrass 502-223-1744 http://www.hospice.org\

27. How adults handle the loss The developmental stage of the child The relationship between the child and the deceased Circumstances sudden vs. prolonged The support system available to the child Prior experience with death Cultural and religious systems Information provided Factors Affecting Grief Responses

28. Explanations that May Not Help • “Grandma will sleep in peace forever” • “It is God’s will.” • “God took him because he was so good.” • “Daddy went on a trip and won’t be back for a long time.” • “John was sick and went to the hospital where he died.”

29. Suggestions for Teachers and School Counselors • Face your own feelings about death. • Hear with your ears, your eyes and your heart. • Be open and honest. • Don’t rescue the child or class.

30. Teachers and Counselors • Respect a student’s need to grieve. • Expose students to death as a natural part of life. Teach about the Cycle of Life.

31. Grief in the Classroom • Create a safe and caring atmosphere. • Try not to single out the grieving child for special privileges or compensations. • Help student’s friends to be supportive. • Make available books on death.

32. They Need You! Remember, any child old enough to love is old enough to mourn. When someone they love dies, children of all ages need our time and attention if they are to heal and grow up to be emotionally healthy adults.

33. Sources • Talking to your Children About Death, by Fred Rodgers • Infants and Toddlers, When Someone They Love Dies, by Dr. Alan D Wolfet • Talking to Children About Death; How Can I Help Young Surviving Children; Children’s Understanding of Death: Hospice website: http://www.hospice.org • Grief in Children: PP by Cindy Wilson RN, BSN

34. Thanks for all that you do for the children in your care. You are important to them and what you do makes a difference in their lives!