Death is a concept that is difficult for a child to understand. Grieving adults are often confused and unsure how to respond supportively. Most children require many explanations and have many questions regarding death. "What happens when people die?" and "Where do they go?" are among the most common.
Discussing death is extremely difficult for many adults. It requires recognition that death is a natural process for all people. Children may have problems visualizing death. They may develop fears about what happens after death, what death feels like, or what would happen to them if their parents died. Parents should attempt to openly discuss death with their children if they ask about it or if the situation requires.
Death should be discussed honestly and in language that children can understand at their stage of development. A child's concept of death varies with age, and this must be taken into consideration.
Age 0 - 2 years:
Age 2 - 6 years:
Age 6 - 11 years:
Age 11 years or older:
Family members should know that showing feelings such as shock, disbelief, guilt, sadness, and anger are not only normal, but helpful. Sharing these feelings and memories of the person who died reduces the child's sense of isolation. Children need lots of reassurance that they will be loved and cared for by a consistent adult. They also must be assured that they did not cause the death, nor could they have prevented it.
Grief is a process that unfolds over time. The initial shock and denial may change into sadness and anger that can last from weeks to months. Some children seem to show no emotional response to death, which can be disconcerting to family members. Some normal behaviors include:
Signs of a problem or disorder include:
Take your child to a doctor, mental health specialist, or clergyperson if any of these signs appear or persist.
RECOMMENDED BOOKS ABOUT BEREAVEMENT
GUIDELINES FOR CAREGIVERS
Levetown M. Communicating with children and families: from everyday interactions to skill in conveying distressing information. Pediatrics. 2008;121:e1441-e1460.
Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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