Supporting Children Through Grief
Losing a loved one can be difficult at any age, but for children who have yet to fully understand the concepts of life and death, the impact of loss and complex feelings of grief can be overwhelming. On average, 1 in every 5 children will experience the death of someone they are close to prior to their 19th birthday, and grieving that loss will be a lifelong journey that follows kids into adulthood.
While grief is a complex topic to discuss, professional insights into this unique journey can help caregivers facilitate healthy conversations related to loss and death. We sat down with Child Grief Specialist Patrick McKelvey, MS, LPC, NCC from the Highmark Caring Place in Western PA to discuss the topic of childhood grief. In this guide, you will find resources and tips along with a summary of Patrick’s professional insights into the lifelong journey that is grief.
This guide includes a summary of our conversation with Patrick, and quotes have been edited for brevity and clarity. A full interview transcript can be found here.
Discussing Death
“There is a desire of caregivers to withhold information from children out of not wanting to hurt, scare, or confuse them. But what we've heard children say is they wish they would have known sooner. It’s important that the caregivers inform (children) of the situation early on, not only to avoid hurt feelings down the line, but to provide (children) with the opportunity to cope with the news.”
When it comes to discussing death with a child, it can be difficult to know what you should and should not say. In general the best strategy is to be simple, direct, and speak to the child at a developmentally appropriate level.
Children will likely have a lot of questions following the loss of a loved one. These two guides, questions grieving children ask and questions grieving teens may ask, offer suggested answers and approaches to those conversations. And this guide, speaking to preschool aged children about death, can help you to frame conversations with the youngest children in your life.
The manner of death, and whether it was expected or unexpected can also impact the conversation.
Death from a long or even sudden illness may require you to have conversations about death with a child before their loved one actually dies. This guide talks about discussing a life-limiting diagnosis with children and how to deal with the anticipatory grief they will experience as they prepare for loss.
Other deaths are sudden and do not allow for any preparation prior to loss. These guides can help you to navigate the specific challenges related to suicide loss, homicide loss, and opioid overdose loss.
The Landscape of Grief
“Some of us have this big forest of sadness, and some of us have this stream of feeling detached and overwhelmed. Mountains in the distance might be what we thought our future was, and the path to get up there might be much more rocky now. That landscape is never going to be the same for another person or another death experience.”
Though it may look different from person to person, grief impacts every aspect of an individual's life. Factors such as age, gender, birth order, and the relationship shared with the person who died can impact the way we cope with and process grief. Children grieve differently than adults. Unlike adults, the grief of a child may appear less obvious, and may present itself through behavioral, social, and educational challenges as a child ages, and the grief of a child may look different tomorrow than it does today. It’s important for caregivers of grieving children to be aware of such changes in order to provide them with the love and support needed as they navigate grief’s tough emotions as they age.
This article from WhatsYourGrief.com helps explain how age, gender, birth order and relationships/family dynamics can effect the way a person grieves.
This guide from Highmark Caring Place can help adults understand why a child’s grief may look different from that of an adult.
Grief’s Tough Emotions
“There are so many emotions that get wrapped up in it (grief) . . . anger, sadness, depression, confusion, denial, and maybe for some families, relief. Imagine being seven years old, and trying to figure out what relief and anger, or jealousy, feels like simultaneously.”
For children, grieving the death of a loved one can be a confusing and scary time. Openly discussing and modeling safe expressions of simple emotions like sadness and anger, as well as more complex emotions like guilt, shame, jealousy and confusion, can help kids learn to express their own feelings in a healthy way. While an adult may need to scream and yell while working through their own grief, witnessing this can be scary and overwhelming to children. It is important to make sure that the expressions of emotions surrounding a child are happening in an appropriate manner.
This article from the American Academy of Pediatrics covers many of the complexities of emotions experienced by grieving children, offers simple terms to explain death to children, and tips for helping children walk through grief over time.
Counseling and peer support can be beneficial for children who need additional support in dealing with their emotions. Connecting with an online or local support group immediately after the death of a loved one can help a child get on a path towards healthy grieving.
The Highmark Caring Place offers in-person and virtual peer support groups.
Grief camps offer children an opportunity to socialize and have fun with other children who have experienced loss.
The Dougy Center has a variety of resources for grieving children and their family, including a searchable directory to help you locate local support and resources.
When it comes to grief, adults should also be aware of signs and symptoms that may indicate a shift from normal grief to a mental health crisis. While grieving a loss is normal and healthy, it is important to continue to monitor a child’s emotions as they work through the grieving process and to seek professional help when they are struggling to return to their normal life and activities.
This article from Arnold Palmer Hospital outlines the differences between grief and depression, and this article from KidsHealth.org covers symptoms of depression in children.
This article from the Mayo Clinic offers insight on how to recognize the warning signs of mental illness in children.
This article from the CDC gives an overview of some of the more common mental illnesses that children may experience.
Returning to normal activities after a loss often means returning to school. It can be especially hard for children to return to their classroom routine when they are struggling with grief.
The Grieving Child in the Classroom is a guide that looks specifically at the challenges related to returning to the classroom after a loss, and the Coalition to Support Grieving Students is an organization that looks to specifically support the needs of school-aged children experiencing grief and loss.
If you find that your child is experiencing prolonged challenges with their mental health, it is important to partner with their school to make sure that their needs are being met in the classroom. This guide from the HSC Foundation offers helpful information for those looking to partner with their child’s school counselors and educators.
Milestones, Holidays, & Special Events
“It’s important for caregivers to be really acutely aware of milestones, anniversaries, and holidays, both big and small. So what's really most supportive for a caregiver is to continue the conversation and create space where children and teens feel like they can talk about the death over time. Whether they knew (the person who died) in life, or didn't have a chance to know them, there's this pervasive fear that they're going to forget their person. It’s helpful for children to understand that death severs that physical connection to the person, not the emotional one.”
Whether it’s Christmas, prom, or their sweet sixteen, special events can be especially hard for grieving children as they age.
Making videos, writing letters, and spending time with a person as they are dying can be especially helpful for making lifelong memories that the child can reflect on as they age. This resource can help those anticipating a loss prepare for future celebrations and events where their loved one will not be present.
The National Alliance for Grieving Children’s Holiday Toolkit is a great resource to help you prepare for the winter holiday season from Thanksgiving on into the New Year.
Holidays such as Mother’s and Father’s Day can be especially challenging when a child is grieving the loss of a parent. These resources can help you deal with those special days:
Keeping Communication Open
“If there's one myth that we can dispel, or try and destigmatize, it's that not talking about (death) is just going to make everything fine and that talking about it is going to make things worse. What we do know is that talking about it, writing about it, drawing it, sharing stories about it, or to just have someone that they can connect to, can make us feel more supported.”
Movies and books where loss is a theme can be challenging or beneficial for children depending on where they are in their grief experience. Watching, reading, or participating in activities found in some of the following resources may help you build ongoing conversations about loss and grief with your children.
These articles discuss why Disney Pixar's Coco and Disney Pixar's Onward are revered as some of the best films on children’s grief.
Songs That Inspire Hope: Disney Edition is a playlist on Spotify from Highmark’s Grief Tracks.
Play is the Work of Children is a guide all about using play to help children work through their grief.
Chocolate Chipped: A Smelly Book About Grief is a scratch and sniff book for young children.
The Invisible String is a children’s story designed to help kids cope with loss and the separation from their loved one.
Sesame Street in Communities: Helping Kids Grieve is a resource from Sesame Workshop.
Additional information and resources that can help you as the caregiver of a grieving child can be found here:
Helping Children Cope with Grief from ChildMind.org
Sometimes Nights are the Hardest is a resource that specifically focuses on grieving in the nighttime hours which is a time of day that is often hard for children experiencing grief.
Preparing a Child for a Funeral or Cremation is a resource designed to help children prepare for memorial experiences.
This guide and the resources listed are not meant to replace consultation with medical professionals or to diagnose a medical condition. If you or someone you know is struggling with complex grief or showing signs of a mental illness, please reach out to a professional for advice and assistance. Immediate support is available from the National Crisis Text Line (text HOME to 741-741) and the 988 Suicide and Crisis Lifeline (call 988).
Need help finding a mental health provider for your child or yourself? Check out the following resources:
Contributed by Emily Gambino-Walker, a graduate student pursuing her Master of Science in Psychology and a member of the Red Shoe Society at Ronald McDonald House Charities of Pittsburgh and Morgantown.
Special thanks to Patrick McKelvey, MS, LPC, NCC and the Highmark Caring Place for their contributions to this guide.