Death is a universal experience. But that doesn't make it an easy one. Children, especially, can have a hard time understanding and coping with death. Unresolved grief can result in unhealthy physical and emotional consequences, says Glen O. Jenson, family and human development specialist with the Utah State University Extension Service.
It is important for parents to talk about death and resolve some of these feelings long before a crisis occurs, he says. "Family discussions about what death means should be a regular thing. A death of a friend or neighbor, a tragedy in the community - there are lots of things that can be used to start a conversation. Don't just call children in and say, `We're going to talk about death,' " he advises.Most likely the first experience a child will have a human death will involve an elderly person - a neighbor, a grandparent, an older relative. This gives children a chance to experience death in a more remote circumstance than if it involved a parent or sibling.
"It is helpful to involve children as much as you can in these events. We occasionally get calls asking at what age you can take children to a funeral home. I say take them whenever the children want to go - but then talk about the experience later to see what they understood and what they still have questions about."
In his own family, he recalls a time when his children were about 6 or 7 and were taken to a funeral home. "We thought we had explained everything. Later, we found they didn't understand why, if Grandma died in her sleep, she was not still in her pajamas. And they didn't realize that dead people can't talk."
Parents do need to be careful they don't say things that are not helpful, such as "Grandma has gone to sleep" - this puts the child in an awkward position when it is time for him to go to sleep. Or, "Grandpa was so good, God took him home" or "Aunt Mary has gone on a long, long trip." Be careful not to use terms that are close to what the child himself does.
"It is better to be more straightforward," says Jenson. "Convey that death is a natural process; that as you get old, the body gets tired; that sometimes things happen to younger people but the chances are not very great.
"Above all, children need to be reassured that they will be taken care of, that preparations have been made in case something happens."
With the events going on in the Mideast and all the talk of war, he says, it is important to separate troops being in the gulf from death. "A lot will go over and a lot will come back. Kids need to realize that. It is important that kids understand about defending the country and patriotism and the unfortunate aspects of it all. They need to know that some people will die, but that a lot will come home as well."
If the child seems to be overly concerned, is having behavior problems, is not eating or sleeping, you may want to find out what is bothering him. "Try to get the child to express his own feelings. Tell him `I feel bad and worry sometimes, but I find it helps to talk about it.' "
The checklist and guidelines on page C-1, prepared by Richard M. Eberst, chairman of health studies at Adelphi University in New York, and Susan Eberst, associate director of the Center for Family Resources in Hempstead, N.Y., can be helpful in talking to children about death.
Experiences with pets - particularly fish and birds, which have shorter life spans than dogs and cats - can also be useful in helping children understand about life cycles.
The important thing, says Jenson, is to have established a background long before death comes. "You don't want to lead them to believe their loved ones are at a high risk of dying, but they need to understand that death is a natural part of life."
What Children need to know about death
- Children age 5-6 years old need to know:
- There are many abstract feelings.
- The emotions can be expressed in words.
- Happy and sad feelings are a normal part of life.
- Body parts and their functions.
- What physical body changes occur after death.
- The relationship between the spirit of a person and the physical body.
- How growth and change occur in nature.
- Simple physical reasons for death.
- They are not the cause of the death of anything.
- Sad feelings accompanying death are natural.
- Living goes on despite the grief caused by the death.
- Children age 7-9 need to know:
- The inevitability of death through the study of cycles of nature.
- What happens to the physical body after death (death of a pet is a very good example).
- The importance of listening to someone's problem.
- Crying and expressing one's feelings are not signs of immaturity.
- Living goes on in spite of the grief.
- Children age 10-12 need to know:
- Analogies between plant-animal life cycles and the human life cycle.
- How grief feelings may create self-conflict.
- How characters in novels deal with grief feelings when a significant person or animal dies.
- Answers to questions about the process of living and dying.
- Their own values and attitudes about death.
- Some of the causes of death.
- The importance of sharing one's feelings about separation from the person who died.
- Different people react differently to death.
Common childhood responses to death
- Denial: The lack of response by children may be an indication they have found the death too traumatic to accept. Therefore, the child secretly pretends that the person is still alive or is going to return in the near future. Parents and teachers may feel that the child is unaffected or unconcerned, but the child is actually trying to protect himself or herself from the death by denying it ever happened.
- Bodily distress. Some of the same physical responses found in the normal grieving process of adults are found in children. The anxiety over the death of a friend or relative often expresses itself in physical and emotional symptoms, such as 1) A tightness in the throat or difficulty in swallowing. 2) Difficulty in breathing. 3) A need to sigh. 4) Lack of appetite. 5) A weak or exhausted feeling. 6) An inability to sleep.
- Hostility toward the deceased: Children may believe that the deceased has deserted or abandoned them. They may express this anger by saying "How could Mommy leave me alone like this?" or "If Daddy really cared for me, he would not have left." These hostile reactions toward the deceased may be compounded by parents who tell children that the deceased went on a long trip. Going on such a trip implies that the person has gone voluntarily and could return at any time but has chosen instead to remain away.
- Hostility toward others: The child may perceive that someone else is responsible for the death. The child may believe "The doctors didn't do all they could to make Grandma well" or "If mother would have taken better care of Grandma, she wouldn't have died." Projecting these feelings of resentment and hostility on others may help to ease the child's feelings of guilt.
- Replacement: The child may seek someone to take the place of or at least assume the role of the deceased. The child may seek the affections of other adult friends or relatives as a substitute for a parent who has died. The child may also seek others to assume the roles of the deceased parent, such as playing ball, reading stories and helping with homework.
- Assumption of mannerisms of the deceased: The child may attempt to imitate the characteristics of the deceased. The child may even try to assume some of the roles commonly performed by the deceased.
- Idealization: In an attempt to eliminate unpleasant thoughts of the deceased, children may be obsessed with only the good qualities of the deceased. This idealization is often not an accurate characterization of the real-life behavior traits of the deceased.
- Panic: Children may wonder who is going to take care of them now that Mommy or Daddy is gone. Children need to be assured that they are still loved and will be taken care of in the same fashion in which they have grown accustomed.
- Guilt: Children often believe something they did or did not do may have caused the death because they have learned from past experience that bad things seem to happen when children are naughty. The mother who says, "Johnny, clean your room . . . you're going to be the death of me" may cause the child to develop the notion that his or her behavior can have an influence on death.
Explaining the death of a loved one
- The child should be told immediately in order to prevent hearing it from someone else. Use a normal tone of voice, avoiding hushed, unnatural whispers that may convey an undesirable message of death being unreal or spooky.
- The child should be told by someone close to him or her, preferably in familiar surroundings that afford some security.
- Convey to the child that he or she is loved and will continue to be taken care of.
- Predict for the child that he or she may feel sad and even have strange or different feelings for a while. Let him or her know that this is natural and that he or she should talk about those feelings. Convey that such feelings will not last forever.
- Include the child in funerals and other rituals of mourning. Children often are sheltered from the grief expressions of adults, yet they need to be included.
- Give the child permission to mourn. Do not deny feelings or disallow mourning even if it is painful to you.
- Model appropriate grieving behavior. Do not be afraid to let the child see you cry or express feelings related to the grief.
- Recognize that the grief of children may be evidenced only intermittently. A lack of observable grieving behavior does not indicate that mourning is not occurring.
- Understand that much of the child's grief will be expressed through play, acting-out behaviors or artistic creation.
- Look for magical thinking involved in the child's explanations of the death and correct it to avoid guilt and inappropriate grief reactions.
- Recognize that children "grow up with the loss" and often will require additional information or working through of the original grief at later points in life.
- Work to make sure that the roles that are reassigned after the death of a family member are appropriate for everyone involved, especially the children. Educate the adults about the harm done by assigning inappropriate responsibilities to a child. To expect a child to be "the man around the house" or "the little mother" is unfair to the child, detrimental to the child's further development and often limiting to the mourning process.
- Recognize the normalcy of idealization of the deceased person and work to gently prevent this from causing problems with relationships with survivors.
- Recognize that children are not born afraid of death and that their fears are instilled in them by adults. "Protecting" a child from death and loss is unrealistic and only serves to predispose the child to future problems.
- Help the very young child remember the deceased and integrate these memories appropriately into his or her life. Provide mementos and stimulate recollections.
- Recognize that if children lack opportunities to express feelings and raise questions about the death or to explore fantasies and concerns about mbtheir future care, they will be unable to complete mourning and feel secure.