Children react differently

The reactions of children to death are highly personal. One child might quietly and sadly express his grief. Another might become rambunctious and oppositional. Still another might become extremely anxious. Children often take their cues from watching the reactions of other family members, particularly their parents. In some families, death is a taboo subject, and children sense that they should not talk about it; in others, death is discussed openly, and children feel comfortable expressing their sadness.

Here are examples of how children may respond to the death of someone in their lives.

Death of a pet. If a child is attached to her pet, she may find its death quite difficult. Even so, this event will prepare her for later encounters with death by giving her experience and understanding.

Death of a grandparent. When a grandparent dies, children may not find it as devastating as the loss of a parent or a sibling. To them, their grandparent is an older person, and when people get old, they die. However, if the grandparent has provided day-to-day companionship for the child, perhaps even living with the family or residing nearby, the death will be much harder.

With the passing away of a grandparent, children often think, "Now that my dad's dad is dead, does that mean that my dad is going to die next?" If you sense this kind of reaction, reassure your child that you and your spouse are healthy and will live for a long time.

Death of a parent. Whenever a child loses a parent, the event is traumatic and alters the course of her development. You cannot protect the child from what has happened, but you can help her face the reality of it.

If you are a surviving parent, in addition to dealing with your own feelings of loss, you need to help your child through this experience. Expect reactions ranging from regression and anxiety to anger and depression. Be honest and open about what has taken place. Provide your child with comfort, both verbal and nonverbal. Reassure her that you are not going to leave her too, and that life will get back into a routine as soon as possible.

If the parent who is the primary caretaker has died and the other parent must return to work, find someone to assume a caretaking, nurturing role—perhaps a relative or a nanny. While these substitutes can assist with day-to-day functions, the surviving parent will still need to spend more time with and give more attention to his child to help her adjust to their new life. Talk with your pediatrician, as all family members would benefit from professional counseling at this time.

Death of a sibling. When a brother or a sister dies, children can find it just as difficult as losing a parent, sometimes even more so. In some ways a sibling is the person to whom a child is closest. They have been constant companions, sharing many life experiences. Perhaps they even shared a bedroom. When a sibling dies, children may feel guilty, as all siblings have had arguments at some point. Or they may have survival guilt ("Why did he die and I didn't?"). They may even feel guilty because of the jealousy they experienced if their sibling was ill and got extra parental attention.

If one of your children dies, make sure the other children are not sidelined during the grieving process. You may be overwhelmed with your own sadness, yet your other children will also need a lot of attention, comforting and understanding. Mobilize other extended-family members and friends to help give your children support. Try to avoid putting the deceased child on a pedestal, or your other children may feel they can never be as perfect or as good in your eyes. Talk to your pediatrician to ensure everyone in your family is receiving appropriate professional counseling during this difficult time.

Do not shield your children

Some adults believe that children should be shielded from death. They keep children away from funerals. They try not to cry in front of their children. They may make up stories in an attempt to protect children from sadness and grief. They may avoid all discussions of the deceased. Despite good intentions, though, these "shielding" actions are counterproductive. As with most topics, communicating with children about death should be honest and direct. Children need to grieve as much as adults do. They need to be able to share their feelings with others (particularly with their parents and other trusted adults), tell stories from the person's life, and talk about how they are going to miss the person who has died. By school age, children have already been exposed to death, even if only indirectly, through media or hearing about it from friends. Hiding death only makes it more mysterious and scary for children, and can inadvertently leave the children feeling alone in their sadness and grief.

To help your child, you need to feel comfortable with your own grief reaction over the death of a loved one. It is appropriate for your child to see you cry when you feel sad; he will take comfort knowing that you are expressing your feelings so openly. This will make it easier for him to do the same.

For more information

American Academy of Pediatrics

www.aap.org and www.HealthyChildren.org