This article was originally published on HospiceNet.org
When a Parent Dies
A guide for patients and their families
Facts and feelings
Children need help to cope with their grief when a parent dies. The surviving parent is usually the main person who must provide the help a child needs in coming to terms with the death of the other parent. However, often the surviving parent is so involved and even incapacitated by their own grief that support from friends and relatives proves essential.
It is important that all those close to a bereaved child should be able to discuss how it was and how it is. Children need to have the facts and the feelings surrounding their loss confirmed often; for this reason it is also important to listen to what they have to say. They will probably need to hear and discuss things over and over again.
Check out what they think, correct and confirm the facts, help them accept their feelings. Above all accept their time scale – a child’s grief can be spread over many years. It may also resurface in adulthood, especially at a time of crisis and/or celebration.
There are no hard and fast rules when it comes to grief and expressing loss, but being honest with children is essential in order to avoid them becoming confused by half-truths and fears.
Children in different age groups grieve in different ways so the help given may need to change to suit the age and personality of the child. This information aims to provide guidelines for parents or caregivers to help them meet the needs of grieving children.
Tell it how it is
If a parent or loved relative is dying of cancer then the children will usually be aware of the illness for some time. In most cases there will be time to talk to the children about illness and death.
Don’t try to protect them by discouraging visiting or being present when the parent is dying. Children are often more accepting and down to earth than adults about death. If they are not there when the parent dies, tell them of the death as soon as possible, preferably quietly at home. Ideally, the surviving parent should tell the children so they can start the grieving process together. Letting them see the body may help establish the reality that a parent will not return.
Listen carefully to what the children say about things. Sometimes their grief is not obvious. If the children are very young you may not realize that they, too, are suffering badly, but in a different way, from the loss. Try to encourage children to express their grief. It may be by drawing pictures of the dead parent; it may be by talking about death. Make sure children understand that all sickness does not end in death. Fears and fantasies should be dealt with.
Tell them how sad you feel and that you understand how they feel, too. But, don’t expect children to bear your burden or become a substitute for the partner you have lost. Children will ask some basic questions – like:
Did Mum/Dad die because of something I did? Will I die like she/he did? Who will look after me now? Will Dad/Mum die too? A guide to answering these sort of questions is included in this information. Remember that age groups don’t end abruptly and problems can span across the ages given here.
It is good for children of any age to be included in the funeral service unless they say they don’t want to attend. Children as young as two and a half understand the idea of saying goodbye.
You can explain even to small children something about the service and what it means. They may be concerned about the casket, or the burial, or the cremation. These may need to be explained up to the level of the child’s understanding.
Some families find it helpful to have the casket and body at home before the service. You can ask the children if they would like to say goodbye in a very special way by placing a momento in the casket – a drawing, a letter or a flower.
It may also be helpful if a trusted adult cares for young children during the service. After the funeral, children may, in play, reenact the funeral and/or pretend to be sick or dying. This playing out of the illness and the funeral is quite normal.
Age groups and their reactions
Up to two years
The death of a parent will not be understood. However, the child will notice the absence of a parent and the emotional changes in those providing care. Even a small baby may become irritable, crying more; eating habits may change; there may be bowel or bladder upsets.
Two to three years
At about two years, children know that if people are out of sight they can be called back or looked for. Looking for a parent who has died is a typical expression of grief in this age group. It may take time before a child even as young as 18 months realizes that the parent is not coming back. These children need a secure, stable environment. Try to keep to the normal routine of eating and sleeping. They will need attention and love. If you are concerned about your child’s behavior, talk to the doctor or health professional.
Three to five years
The child’s understanding of death at this age is still limited. The child is used to being away from parents while attending kindergarten, school or a party. However, they are confident those parents will return. As with the younger children, behavioral patterns may change.
Though times of sadness are likely to be short, there may be problems with the bowel or bladder, stomach aches, headaches, rashes, temper tantrums, reversion to baby habits (thumb sucking, comfort blanket etc.). They may suddenly be afraid of the dark, suffer periods of sadness, anger, anxiety, crying.
It is important to contact the child’s kindergarten teacher, day care supervisor or school teacher so they can be alert to any problems facing the child. If worrying behavior or distress persists get professional help and support.
Children in this age group need to know that death is nothing like sleeping. They will talk when Mum or Dad is coming back. From this age, children can also think something they’ve done or have not done may has caused the death, for example not giving the parent a toy, drawing, gift etc. This reasoning may not be immediately evident so talk about any concerns the child has. He or she needs to be reassured that this was not so.
You will have to explain gently that Mum or Dad died and will never come back. Be reassuring. Make sure children know they will be looked after, that the family will stay together. The odds of anything happening to you are not high, but try to ensure children know the person well who would take responsibility for them should this unlikely occurrence arise. Discuss this with the children.
Children in this age group can also understand how a person ‘lives on’ by the fact that they wouldn’t be who they are without the parent’s influence. It will be helpful to recall with the children some of the things the parent did with them – such as the games played, holidays enjoyed and so on.
Six to eight years
At this age children will still have difficulty in understanding the reality of death. Serious illness or death of a parent can set these children apart from friends and other classmates. However, their grieving will be spasmodic and they will suffer many of the preschool age group’s problems.
They will face the extra stress of questions about the death from classmates when they return to school. You should have spoken to the key teachers before the children return to school and their school mates should have been told how to handle it. Some of the children’s friends may want to come to the funeral and this is fine.
Prepare the children for questions. Tell them to say simply, ‘My Mum/Dad died.’ They need to be told it is okay not to go into any details about their parent’s death. Let the child decide who they want to open up to. Ask the teacher to let you know if your child has any problems at school. Grieving children may behave out of character in class, or show anger against a teacher or classmates. School work may suffer because they cannot concentrate and are preoccupied with their loss. They may also suffer with headaches or stomach aches before going to school or at school. Accept these as normal and that they should pass.
There will be feelings of uncertainty and insecurity and children will tend to cling to the surviving parent. At special times of the year (Mother’s/Father’s Day, Christmas, summer holidays, for instance) children may be especially upset.
As with the younger age group, primary school children need to be reassured that there are also other people who will help look after and protect them. Show them you love them. Again, you can talk with them about the positive and special things they did with their parent.
Be careful not to tell children God has ‘taken’ the parent to live in heaven. If children seem angry with others (doctor, nurse, minister, God) blaming them for causing the death, help them work through their anger. This anger is normal and tends to show in primary school age children.
If any behavioral problems persist get professional help from therapists specializing in bereavement and grief. This can usually be arranged by approaching your own doctor, school principal or local Cancer Society.
Preadolescent (9 – 12 years)
It is generally accepted that most children have developed a mature concept of death by the age of eight or nine years. However, some of the behavior shown by younger primary school children will inevitably overlap into this age group.
Bereavement at this stage can lead to feelings of helplessness – something that directly contradicts the drive to be more independent at this stage. These children can develop an identity problem. They can have feelings of helplessness yet show a brave face to friends and school mates, and another to family and friends.
They may hide their emotions yet be hurt by remarks made at school; they may not reach expected educational levels, fight at school or rebel against authority. However, school can be a stable place in what may have become a chaotic world. At the extreme, these reactions are a cry for HELP; this makes it important to deal with any concerns about school.
Children in this age group may also try to assume the role of the mother and father. This shouldn’t be encouraged, especially emotionally, but be aware that the family ‘structure’ has changed and the family members who are left will have to regroup and sort out their rules. There will need to be some sharing of responsibility in terms of helping out.
Make sure there is still plenty of time for play, sport and leisure activities, and that children have friends of their own age. Let them know it is okay still to be happy and excited about events. If there are problems, discuss them. Talk them through. If behavior problems continue get professional help.
For these young people, facing death can be frightening. They are already coping with physical and mental changes as they move from childhood to adulthood. Bereavement presents an added layer to complicate the already difficult picture that adolescence presents.
It is not uncommon for teenagers to confide or find help for their grief outside the home; as the remaining parent, you should not feel this is a reflection of you.
Conversely some young people will feel isolated because they feel friends shun them or are embarrassed and don’t know what to say to them. You may also find school work is affected. A teenager may behave out of character. In extreme cases they may suffer depression, run away, change friends, use drugs, become sexually promiscuous or even suicidal. If they are in any way concerned, get expert help promptly.
Teaching staff and youth leaders involved with the children should always be told of the death and be quietly on the look out for any worrying behavior changes.
Although grieving teenagers may hide their emotions, these emotions can still be intense. Let them know it is okay to be upset and cry. Teenagers can try to protect the parent by keeping quiet about their own feelings; they may need to be given ‘permission’ to express what they think and feel. They need to know it is okay to talk about their dead parent and can be helped by the remaining parent giving a lead in this direction. Encourage healthy ways to release emotions through sporting or cultural activities.
Teenagers should never be told that they will be taking the place of the parent who has died, rather you should help them focus on their needs for the future, such as education or training for work. However, again it is natural for the remaining members of the family to regroup and some sharing of responsibilities needs to take place.
If you feel you are not able to help the teenager cope with grief and the problems reflecting that grief, then seek professional help.
Older teenagers will see clearly how the death of a parent affects the family and their own life. They may think they should now care for Mum/Dad and other family members. They may be confused about what they should do. As with younger teenagers, help them make decisions which focus on their own needs. It sometimes takes a number of years for a teenager to work through the emotional grieving.
Children with special needs
Grieving for some of these children may be difficult. They do not always understand the disruption to their lives. They can become emotionally very unstable and revert to very childish behavior.
Their needs are the same as for other children, but more patience and understanding is required to help them work through the grief.
Milestones in accepting death
Grief has various patterns and may continue on and off for many years, though the intensity may get less. The surviving parent will know when the children are coming to terms with the death when they show they are accepting the reality of the death.
They will be reorganizing life to cope without the dead parent; returning to their normal round of activities and relationships.
Partnerships have different stages of happiness. Be careful not to over-glorify or run down your partner. Children need good, realistic memories on which to build their future.
Your needs are as great as those of your children. Yet, along with your deep sorrow you must cope with the grief of your children. You are the most important person in their life. To help cope with the added responsibility, don’t be afraid to take up offers of help from family and friends. Exercise and eat well. Maintain contact with family, friends and support groups who understand your needs. These people can help both you and your children through the grieving period.
If religion is an important part of your life, share your beliefs with your children. This may provide them with answers which may help now in the future.
Original material is provided by Cancer Society of New Zealand – see more at http://www.hospicenet.org/html/parent.html