Death in the family

Death in the family affects everyone. Children, in particular, need to be thought about even if it is a

difficult time for the whole family. How they react depends on a number of factors, for example:

How close the person who died was to the child, and the family, is important. How involved the

person was in their lives is also a factor.

Whether the death was expected or the person had been ill.

The child’s age and level of understanding and how the death affects their life. Infants may feel the

loss mainly because it affects the way in which they are looked after and their daily routine. They

are very sensitive to the unhappy feelings of those around them, and may become anxious, difficult

to settle and more needy of attention. Pre-school children usually see death as temporary and

reversible – a belief reinforced by cartoon characters that ‘die’ and ‘come to life’ again.

Children from about the age of 5 are able to understand basic facts about death:

• it happens to all living things

• it has a cause

• it involves permanent separation.

They can also understand that dead people do not need to eat or drink and do not see, hear, speak

or feel. Teenagers are able to understand death much more like adults, and are very aware of the

feelings of others.

Most children get angry and worried, as well as sad, about death. Anger is a natural reaction to

the loss of someone who was essential to the child’s sense of stability and safety. A child may show

this anger in boisterous play, by being irritable, or in nightmares. Anxiety is shown in ‘babyish’ talk

and behaviour, and demanding food, comfort and cuddles.

Younger children believe that they cause what happens around them. They may worry that they

caused the death by being naughty. Teenagers may find it difficult to put their feelings into words,

and may not show their feelings openly, for fear of upsetting others.

The circumstances of the death also affect the impact on the child. Each family responds in its own

way to death. Religion and culture will have an important influence on what happens. Other factors

that can make a big difference from the child’s point of view are:

• how traumatic the death was – a traumatic death can be harder to cope with

• whether the death was sudden or expected, a relief from suffering or a ‘crushing blow’

• the effect of grief on other family members, especially if they are not able to cope with giving the

child the care they need

• how much practical support is available to help the family cope.

Helping a child to cope with death

Being aware of how children normally respond to death makes it easier for an adult to help. It also

makes it easier to identify that a child is finding it particularly hard to cope with.
 
Early stages


Adults sometimes try to protect children from pain by not telling them what has happened.

Experience shows that children benefit from knowing the truth at an early stage. They may

even want to see the dead relative. The closer the relationship, the more important this is. Adults

can also help children to cope by listening to the  child’s experience of the death, answering their

questions, and reassuring them. Children often  worry that they will be abandoned by loved ones,

or fear that they are to blame for the death. If they  can talk about this, and express themselves

through play, they can cope better and are less   likely to have emotional disturbances later in life.

Young children often find it difficult to recall  memories of a dead person without first being

reminded of them. They can be very upset by  not having these memories. A photograph can

be a great source of comfort. Children usually  find it helpful to be included in family activities,

such as attending the funeral. Thought should be  given as to how to support and prepare a child

for this. A child who is frightened about attending  a funeral should not be forced to go. However,

except for very young children, it is usually  important to find a way to enable them to say

goodbye. For example, they can light a candle,   say a prayer, or visit the grave.
 
Later on


Once children accept the death, they are likely  to display their feelings of sadness, anger and

anxiety on and off, over a long period of time,  and often at unexpected moments. The

surviving relatives should spend as much time  as possible with the child, making it clear that

they can show their feelings openly, without fear  of upsetting others. Sometimes a child may

‘forget’ that the family member has died, or  persist in the belief that they are still alive. This

is normal in the first few weeks following a death,  but may cause problems if it continues.

Warning signs that a child is not coping

• a long period of depression, with loss of interest  in daily activities and events

• inability to sleep, loss of appetite, prolonged fear of being alone

• acting like a much younger child for a long time

• denying that the family member has died

• imitating the dead person all the time

• talking repeatedly about wanting to join the  dead person

• withdrawing from friends

• a sharp drop in school performance, or refusal  to attend school.

These warning signs indicate that professional   help may be needed. A child and adolescent

psychiatrist or child psychotherapist can help the   child to accept the death, and also assist the

survivors to find ways of helping the child  through the mourning process. Your general

practitioner will be able to offer you help and  advice, and can refer you and your child to your

local child and adolescent mental health  service. The team includes child psychiatrists,

psychologists, social workers, psychotherapists  and specialist nurses.