8: Death and bereavement: a childs understanding

“How can I help a child who is facing bereavement?”

Angela Thompson answers. (Angela is a community paediatrician working with children with life-limiting conditions and, at times, supporting families through bereavement.)

The world of young children expands quickly before them, as their development changes at an equally rapid rate. Within this ever-changing world, they need security. They have little concept of time, and no real understanding of permanence. Yet now they begin to encounter the concept of death – the dead worm, the wilting flower, and sometimes the death of a precious pet. Sadly, some have to face the death of a significant person in their lives. What can we expect of their understanding, reactions and needs at such a time?

My daughter was four years old when her much loved guinea pig, Rosie, died. We tried to help her to understand what had happened, and held a funeral, burying Rosie in the garden with prayers, poems and special memories. But two months later, when we were about to move house, she became horrified about 'leaving Rosie behind'. 'We must dig her up and take her with us,' she said. Much explaining later, she settled, and we promised to plant a 'rosy red' apple tree in the new garden in Rosie's memory. My daughter didn't forget!

This incident reminded me of how children cannot grasp the permanence of death. To them, death is not irreversible. After all, we plant and leave dead looking bulbs in the garden, and next year, the beautiful flower appears. What confusing messages children receive!

Young children also find it hard to distinguish between fact and fantasy. They are moving into 'magical thinking', believing that they can influence what happens by their thoughts and words – 'Bang, bang, you're dead!' they shout in play but later, when they hear someone has died, they may believe they somehow caused the death.

Preschool children also tend to take statements literally: 'lost' means simply that, not 'dead'. This misuse of vocabulary, which is often thought to soften the language of dying, greatly affects the child's understanding of, and reaction to, death.

Young children do grieve. However, they express their grief in their behaviour, acting out their feelings and emotions. Children will, to some extent, all respond differently. Some will withdraw, while others will become aggressive. In almost all cases though, fears will be intensified, and this may result, for example, in sleep disturbances or in difficulty coping with new routines. In the church group setting, fears of abandonment may cause them to become clingy, to cry and to demand their parents' attention. The once-a-week pattern of the session may heighten this, as it gives little opportunity for the routine to be built upon, unlike a day-nursery or school.

Young children often search repeatedly for the dead person. They may regress in their development, perhaps wetting and soiling, or revert to thumb sucking. Children also experience increased problems with concentration, their short attention span being further shortened. Their behaviour may appear erratic: being distressed one minute, and then playing happily the next. They cannot attend to the overwhelming feeling of grief for long.

If you only see the child for one hour or so a week in your church group, can you do anything to help?

• Be patient and understanding!
• Try talking to the parent(s) or carers before the session, about how the child is reacting, and how they would like you to manage this. Consistency is so important to re-establish their security. Try to discuss this beforehand, when the child is not listening!
• Keep a careful eye on the bereaved child, but try not to single them out for special privileges. Every child needs to feel special through times of focused attention, and this can often help a grieving child.
• Check if the child has a favourite cuddly toy as they may need a hug if they become upset, and the toy may be best for this. It's worth thinking how child protection issues apply here: you may want to give an upset, grieving child a hug, but this may not be wise in the church group setting.
• Be careful about the words you use to talk about death. Children do sometimes bring up the subject unexpectedly. Try to have established what the parent or carer would want if this arises. Phrases like 'lost your sister' can produce real fears of being lost themselves. 'Mummy's gone to sleep' may cause fears of going to sleep. There is also a big difference between saying 'God's taken Daddy to be with him' and 'Daddy died in a crash, but now God is taking care of him in heaven'. In the former God appears arbitrary and cruel; in the latter, kind and caring.
• Always be honest. Be willing to say 'I don't know, but I'll try to find out'.
• Be willing to listen. You may be able to explain that God wants to listen to them too, and that we can talk to him about it.
• Offer to pray for the child and family – this may be a real, support for them.
• Remember God's power to meet the needs of a child! The child's unsophisticated faith may result in a peace far beyond our expectations!

It may simply be right just to be there, providing the security of an ongoing, stable part of the child's life, showing God's love to the child, at this crucial time. And in it all, look to God for the wisdom he wants to give to you as you care for these, his precious children.

Books to help children: 'A letter from Rachel' from Tingling Tums by M Barfield, SU, The Cherry Blossom Tree , Jan Godfrey, SU.

To help you: Children and grieving J Goodall, SU.

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