THE DEATH OF A LOVED ONE is difficult for anyone. But for children, such a loss can be devastating.

“For children, the loss of a parent, sibling, relative or friend can affect their sense of security,” says Kathy HoganBruen, senior director of prevention at the National Mental Health Association (NMHA) in Alexandria, Va. “Helping children cope with their loss is crucial in enabling them to resume their lives fully at home and school.”

Children deal with death in many different ways, and not necessarily in the same manner as adults. Preschoolers have difficulty understanding that death isn’t temporary, but children between the ages of 5 and 9 begin to experience grief more like adults.

The ways children respond to death include:

• Denial, shock and confusion
• Anger and irritability
• Inability to sleep or nightmares
• Loss of appetite
• Fear of being alone
• Physical complaints, such as stomachaches and headaches
• Loss of concentration
• Guilt over failure to prevent the loss
• Depression or a loss of interest in daily activities and events
• Reverting to outgrown behaviors (e.g., bed-wetting, “baby talk” or thumb-sucking)
• Withdrawal from friends
• Excessively imitating or asking questions about the deceased or making repeated statements of wanting to join the deceased
• Inventing games about dying

“Don’t be alarmed if your child reacts in any of these ways to a loss,” says HoganBruen. “These are normal responses, and, in time, most children will return to the behaviors they had before the person died.”

Helping Children Heal
“Children, like adults, need time to grieve and be upset,” says HoganBruen. “One of the most important things you can do is to let them know you’re ready to listen, and provide reassurance they aren’t alone in their pain.”

Here are some issues to consider when helping children resume normal activities after a death:

• CHILDREN ARE CONCRETE IN THEIR THINKING. To lessen confusion, avoid expressions such as “passed on” or “went to sleep.”

  “Answer their questions about death simply and honestly,” says HoganBruen. “But only offer details they can absorb. Don’t overload them with information.”

• DEATH CAN MAKE CHILDREN FEARFUL ABOUT THE FUTURE. Give them a chance to talk about their fears and validate their feelings. Share happy memories about the person who died. Offer a simple expression of sorrow and take time to listen.
• CHILDREN NEED CHOICES. Whenever possible, offer choices in what they do or don’t do to memorialize the deceased and how they express their feelings about the death. You might offer to help them plant a tree or dedicate a place in memory of the person.
• CHILDREN TEND TO BLAME THEMSELVES. Emphasize to them that the death wasn’t their fault and there was nothing they could have done differently to prevent it. Explain that the person who died loved them and would want them to be happy.
• CHILDREN MAY NEED OUTSIDE HELP. Seek help from a school counselor, clergy or family and child counselor in your area if you feel your child needs more help dealing with the loss. If you recognize any possible signs of depression or suicidal behavior, seek help immediately from a mental health professional or your doctor.

“It can take children a long time to recover from the loss of someone they love,” says HoganBruen. “Their grief may return in cycles throughout their childhood or adolescence. A strong reminder, such as the anniversary of a death, may reawaken grief. However, making yourself available to talk can make a substantial difference.”

Barbara Floria spoke with Kathy HoganBruen, senior director of prevention at the National Mental Health Association (NMHA) in Alexandria, Va. For more information, call 800-969-6642 or visit www.nmha.org.

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