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bereavement, grief services for families experiencing the loss of a child or sibling 

Helping kids cope 

Dealing with the death of a family member, especially a child, can be one of the most difficult events to face. Even more difficult, is how to tell your children about a death. It is important to explain these difficult events to children in order to help them cope effectively and avoid feelings of guilt, fear or anxiety.

Child Life Specialists can help children and their families cope with the death of a loved one.  A Certified Child Life Specialist is a trained professional with a Bachelors or Masters, who helps pediatric patients and their families overcome some of life’s most stressful events. We have a strong background in child development and promote effective coping through play, preparation, education and self-expression activities. We provide emotional support for families, and encourage optimal development of children facing a broad range of challenging experiences, particularly those related to healthcare and hospitalization.

The role of a Certified Child Life Specialist, during the death of a patient, is focused on education, memory making, and sibling support.

For kids of all ages, words and actions matter

A Child Life Specialist can help siblings understand the concept of death, cope with death and create memory items to keep. If a Child Life Specialist is not available, the parents, family members, nurses, chaplains and other medical staff members can explain death to siblings and other young family members.

Each developmental age group understands death in a different way, but here are some guidelines for everyone:

  • Use the words “Dead” and “Dying”. They may sound harsh, or be hard to say, but they are concrete terms and don’t allow for misconceptions. Avoid euphemisms like:
    • “He went to sleep and wont’ wake up”
      This can cause children to fear going to sleep
    • “God needed an angel”
    •  “She went on a trip and can’t come back”
      This phrase can make children fear family trips or vacations
  • Listen to your children’s questions and feelings. Be prepared for such questions as:
    • “Where does the body go”
    • “How will we get along after they are gone?”
    • “Where do all of his/her things go?”
    • “Did I cause them to die?”
    • “When/if will they come back?”
    • “Is there life after heaven? What is that like?”
  • Help your child say goodbye to the dying person. You can help your child say goodbye by sharing a special memory.
  • Involve your child in the funeral arrangements, if possible.
    • Siblings can help by:
      • Choosing special items to keep
      • Write a letter to the sibling
      • Choose photographs or items to be included in the funeral
    • Including a child in the funeral is very important to:
      • Confirm and reinforce the reality of the death
      • Create a strong family structure (a funeral is a life event just like a wedding or graduation)
      • Share and remember the loved one
  • Provide opportunities to share emotions and feelings. There will be moments when your family is happy and creating new memories, and then there will be moments of sadness and remembrance.  Communicate with your children that it is ok to be happy and sad and to remember your loved one.

Age-specific information

Each age group understands death differently. Here is an age breakdown of what children understand, possible related behaviors, and what you can do to help children cope.

 Age group Understanding of death Possible related behaviors What you can say/do
Infancy

This age has no understanding of death but babies react to:

Fear of separation

Parents’ emotions

Fussiness

Crying

Clinging

Talk about your feelings

Let family and friends help

Spend time with your baby to keep the feeling of security

Provide comfort (hugging, cuddling, patting)

Keep baby’s routine as consistent as possible to prevent the feeling of loss of control

Preschool (2 1/2 - 5 years old)

Death is not seen as permanent but temporary

Death can be confused with sleeping –It is very important to use the word “dead” in order to help children understand permanency

Can see this death as their fault (either a thought or action)

Can think that they will “catch” death

May show little concern at times

May have regressive behaviors-such as bedwetting, thumb sucking, baby talk or fear of the dark

Separation anxiety, especially at night and when leaving for school

May need to talk about the death frequently –This helps children remember that it happened and creates an understanding of permanency (The child may say things like “Sister doesn’t need shoes, she’s dead” And while this may seem inappropriate, it is helping them to understand)

Prepare them for funeral arrangements (a lot of people crying, regular routines broken)

Tell family members to use the words “dead” and “died”

Respond to your child’s needs for security/routine

Keep explanations short and truthful. For example: “Brother was very sick. The doctors tried everything they could to make him better, but brother’s body could NOT work. His heart stopped working and he died.”

School age (5 - 11 years old) 

Death is seen as possible, but only for other people

Death may start to be seen as permanent

Death becomes more real and final

Children may show more interest in exactly what happened inside the body

Children may show more interest in details of the funeral

Crying

Anxiety

Headaches or other body pains
Separation anxiety

Denial of death

Poor grades

Daydreaming

Fear of continuing friendships for fear of losing them

Trying to fix things or find a solution

Explain that everyone has different reactions to death and at different times

Give permission to cry or show emotions

Give an honest explanation of how the sibling died

Encourage participation in the funeral and arrangements

Listen and support feelings

Adolescents (12 - 18 years old)

Children being to think more like an adult

Can understand the full implications of death

Can acknowledge that life is fragile

Want to assume more of an adult role in life

Anger

Preoccupation with death

Denial of death by risk taking

Encourage communication within the family but also encourage communication with a trusted friend or counselor

Important to have physical touch and to hear “I love you”

Discuss role changes within the family

 

Moving forward

As you cope with the loss of your child, you will notice that there are times when your family is sad and sorrowful, but other times when you are happy. It is ok to have new happy memories as a family and to remember your child. Here are a few ideas on how to remember your child during special holidays or moments:

  • Listen to your child’s favorite song
  • Cook your child’s favorite meal
  • Plan a small memorial where the siblings and family members share fond memories of the child who passed
  • Gather memory items (clothes, handprints, photos) and remember those times
  • Light a special candle to remember your child during holidays or special events

By sharing memories, you can help your children learn to cope with death, learn to share/identify emotions, and create a stronger family bond.

 

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