Developmentally Appropriate Support for Children at a Death

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Understanding of Death:

Infants

  • No real comprehension, but reacts to emotions/changes
  • Disturbed by the loss of parental presence/bond
  • Aware of parent’s emotions and anxiety

Children 2–5 years

  • Aware that something has happened
  • Realizes that people are sad and crying
  • Aware of increasing activity
  • Believe that death is temporary
  • Concept of death is linked to sleeping
  • Magical thinking, believe that they caused the death
  • Fear that death is contagious or is a punishment
  • May appear ambivalent to situation
  • May believe that people live underground after death

Children 5–9 years

  • Believe that death only happens to others

Children 9–12 years

  • Beginning to understand the concept of death
  • May be superstitious about death
  • Beginning to understand the concept of irreversibility
  • Likely to need detailed explanations
  • May be uncomfortable expressing their emotions
  • Understand that death is final and a part of life
  • May have a personal fear of death

Children 12–18 years

  • Can think abstractly
  • Focused on the present
  • Developing strong philosophical views
  • Deny vulnerability
  • Questions the existence of life after death

Normal Reactions:

Children 0–3 years

  • Feelings of separation anxiety
  • Changes in eating, sleeping, toileting patterns
  • Feeling sad or irritable
  • May experience regression

Children 3-5 years

  • Feeling curious or confused
  • May be withdrawn or more aggressive
  • Changes in eating, sleeping, toileting patterns
  • May ask questions about the physical body
  • May experience regressive behaviors such as bedwetting or babyishness

Children 5-9 years

  • Denial of death
  • May display separation anxiety at time of going away to school or camp
  • May display lack of attention or frequent day dreaming
  • May act out at home or school
  • Fear they may die at same age or hesitates to continue friendships in fear of losing friend
  • May try to fix things and find solution to death

Children 9–12 years

  • May act tough or pretend to be funny
  • May show an interest in religion
  • May act out at home or school
  • May act adult-like but display regressive behaviors

Children 12–18 years

  • May exhibit risk-taking behaviors
  • May think about suicide
  • May appear withdrawn or aggressive
  • Seeks peer support rather than family
  • May act impulsively or without common sense

What to say or do at the time of death:

Infant/Toddler

  • Maintain as normal a routine as possible
  • Parents should spend time with the child each day to provide a feeling of security
  • Parents should provide extra holdings, hugs and reassuring touches
  • Allow opportunities for play time to help process their feelings

Preschool Age

  • Explain what to expect
  • Encourage all adults to avoid using euphemisms for death
  • Respond to the child’s need for security
  • Keep explanations short, simple, and truthful
  • Repeat conversations if necessary
  • Allow opportunities for play time to help process their feelings

School Age

  • Will display different reactions to death
  • May experience crying
    • Parents should model that crying is acceptable
    • Parents should not attempt to appear strong and protective but model that sadness is acceptable
  • Speak honesty about the death and avoid euphemisms
  • Encourage the child to attend the funeral
  • Offer techniques in saying good-bye
  • Allow opportunities for play time to help process their feelings

Adolescents

  • Continue the same interventions as those for school-aged children
  • Ask a counselor, teacher, or friend to support them
  • Provide physical touch and say “I love you”
  • Discuss their concerns regarding role changes and taking care of each other
  • Provide an appropriate outlet
  • Remain involved with them and their feelings
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