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Helping Siblings Grieve

How do children understand death?

Children understand death differently, depending on their age. Early on, they may think it is not permanent. Only later will they understand it is more final. Young children tend to personify death, viewing it as a monster, for example. After about age 10, they start to understand death and realize they too can die.

The following provides a basic understanding of children's concepts of death and dying.

Baby

Death has the least significance to babies. Their reaction to death is related to the absence of familiar persons or attachment to a consistent caregiver and is demonstrated by stranger anxiety. The baby becomes increasingly aware of the absence of people or objects, and reacts to the separation or loss.

Toddler

Egocentricity (self-centredness) and not yet being able to separate fact and fantasy make it impossible for toddlers to understand death. They may repeat what sounds like a correct definition of death such as, “Grandpa is dead. He went to heaven.” However, they may later talk about going fishing with him. Toddlers can think about events only in terms of their frame of reference, which is living.

Early childhood

In early childhood, children have usually heard the word death and have some sense of its meaning as a departure or a kind of sleep. They may recognize the fact of physical death but they don’t separate it from living activities. They think that the dead person in the coffin still eats, sleeps, and breathes.

For these children, life and death are interchangeable. There is no real understanding of universality and irreversibility. Egocentricity and magical thinking may cause them to believe their thoughts are sufficient to cause events.

School age

School-aged children may attempt to personify death as a ghost, bogeyman, or devil. They may still associate bad thoughts and deeds with the cause of death. Therefore, they feel intense responsibility and guilt. However, they have more developed cognitive abilities and may respond well to logical explanations.

By nine or 10 years of age, most children have an adult concept of death as inevitable, universal, and irreversible. Their attitudes towards death are influenced by the reactions of others. Some researchers have found that children with a religious orientation that stresses a relationship with a greater being and reunion after death have less anxiety and fear than those who equate death with sin, punishment, and hell.

Later school age and adolescence

Older children and teenagers have the most difficulty coping with death. They are least likely to accept the cessation of life.

How do children react to a sibling's death?

The death of a sibling often leaves remaining siblings feeling guilty. They may assume that they did something to cause the death. It's important to simply explain the details of the death and reassure them they had nothing to do with it. Children may also be angry at their sibling for leaving, or angry at the doctors for not being able to save the sibling. Younger children may be very irritable, have nightmares, play very vigorously, or do things that are self destructive. Older children may deny their pain, withdraw, or act in self destructive ways. All of these responses are normal.

Through all this, continually tell your surviving children that they are loved, that it's okay to feel the way they do, and that the intensity of their feelings will ease a bit over time. Resist the urge to chastise children for their feelings; instead, allow them to react naturally.

How do you help your other children grieve?

Have frank discussions about their sibling's death and let them talk about their feelings. Answer their questions honestly, in order to help them make sense of a very troubling and painful experience. Give them information that is age-appropriate and specific.

Talk about the child who died and share memories. Try to avoid idealizing the child who died and making her larger than life or comparing surviving children to her. By the same token, resist the urge to overprotect your surviving children. Involve your children in decision making following their sibling's death, such as funeral planning, even if they are very young. Find out whether having a special keepsake from their sibling would be comforting.

Make sure that your children are eating and sleeping a reasonable amount, doing okay at school, and keeping up with friends. Withdrawal and excessive crying are a concern, as is a complete lack of response or emotion. If a surviving child won't talk about the child who died, try drawing them out; for example, try saying: "We haven't talk about [name] for awhile. What are you thinking?"

Surviving children may need someone other than a parent to talk to. If your child gets along well with his grandmother or a close family friend, for example, they might be in a position to offer comfort and also be on the lookout for serious adjustment problems.

Should siblings come to the funeral?

The experts suggest that children of any age can handle attending a funeral if they are well prepared. Age should not be the deciding factor. The key thing is that the decision is theirs to make. Before having your surviving children decide whether to attend the funeral, explain to them what a funeral is, what it's for, how it will take place, where it will take place, what they will see, and who will be there.

Armed with that information, they can decide whether to participate or not. It's important to respect their choice either way. They need to participate in the grieving process too, to be consoled, loved, and supported. Often parents are concerned that it will be too overwhelming for a child. However younger children tend not to have the issues with death that adults do.

If they decide to attend, prepare them to see their sibling dead in the casket and people very sad and crying. Reassure them that this is normal and that what they will feel is normal, that it's okay to cry and be expressive. Be aware that some children may only show grief later as they age and better understand what happened.

If you are worried you won't be able to give your children the attention they need during the funeral, arrange to have someone else with whom the children have a good relationship accompany them.

How can you help your other children return to school?

Returning to school after the death of a sibling can be a very difficult adjustment. Children worry that they will be upset in front of others or that their school mates will treat them differently.

As a parent, you can help ease the process by going to the school ahead of your child’s return and talking to your child’s teachers and classmates. Ask your child’s teachers to provide extra support when your child returns, either in the form of academic support or in terms of time alone as needed or time away from class. See if a counsellor can be available if your child needs someone to talk to.

Ask that the school arrange to have someone prepare your child’s classmates for your child’s return to school. This can help prevent your child from having to answer questions from curious classmates. This will also give them time to think about doing something to make your child feel welcome, for example, with handcrafted cards or pictures. Recognize that there will be some questions from classmates, and it would helpful to prepare your child to answer them ahead of time.

Laura Beaune, RN

Christine Newman, MD, FRCPC

5/19/2010




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