Bereavement

About bereavement

Bereavement refers to the whole process of grieving and mourning following the death of someone in your life, and is associated with a deep sense of grief and sadness. It is a natural process, but its impact can be overwhelming.

Many children and young people will experience the death of a family member, friend or pet. An estimate suggests that more than 100 children are bereaved of a parent every day in the UK (Winston's Wish).

All children and young people will grieve when someone dies. It is important to remember that each child and young person’s reaction will be different and may change over time. Grief doesn’t follow a set pattern of responses, and reactions will depend on many things including:

their age and stage of development
their relationship with the person who died
the family circumstances
the nature of the death
their religion or culture
their previous experience
the behaviour of adults around them.

How children and young people understand death

Children younger than 2 years old do not understand the concept of death. When someone dies, they are likely to show behaviours associated with separation anxiety, e.g. looking for the person and crying.

Between around 2 and 4 years old, death is often seen as temporary and they may believe that people who die can come to life again.

Between around 5 and 9 years old, children start to understand that death is permanent, but some may still think it is reversible.

By around 10 years old, children and young people are likely to have a full understanding of death but may not be able to express their grief.

Things to think about

The reactions of children and young people to a death may cause a great deal of concern, and some families feel they should get extra help immediately. However, with the right support from the people around them, most children and young people will be able to cope and adapt to the changes.

Children and young people may experience a wide range of reactions in response to death, which are all natural and normal, including:

emotional reactions - sadness, anger, guilt, anxiety, confusion, disbelief
behavioural changes - sleep, appetite
separation anxiety - worrying that something will happen to other family members means they won’t leave them.

Some reactions to death may appear contradictory, e.g. they may be upset one minute and then ask if they can go outside to play the next. This is normal and doesn’t mean that they don’t care or aren’t grieving. Remember that some children and young people may cry, whereas others may not.

A child or young person’s reactions to death are likely to be different depending on the circumstances. For example:

if a death was expected, they may have been more prepared, and may feel relief
a sudden death may come with shock and disbelief
for a suicide, different emotions may be experienced, including guilt and blame.

Children and young people may want to get support from someone not directly affected by the bereavement, e.g. if their dad has died, they may talk to their teacher if they’re worried they’ll upset their mum.

Bereaved children and young people may also experience difficulties with their peers, e.g. they may be teased or asked difficult questions. Or, their peers may be worried about upsetting them or not knowing what to say to them.

When someone dies, families will have their own views about whether they want children and young people to be involved in the formalities, e.g. funeral, viewing the body. Formalities may help the child or young person to: accept the death, say goodbye, not be scared, feel included or share memories. Where appropriate, children and young people should be given information about the formalities, and supported in making decisions about their own involvement. It is important that they are not forced to do anything they are uncomfortable with.

Think about your response

Supporting a bereaved child or young person can be difficult, exhausting and overwhelming. Your experiences of how you or others have coped with bereavement may affect your response. To best support the child or young person, it is important to respond to them and their unique situation. If you are grieving yourself, make sure you also talk to someone if you need support.

What you can do

Be patient. The child or young person will need time to adapt to what has happened.

Spend time with them and listen to what they have to say when they are ready to talk.

If you’re upset, don’t be afraid to show it. This can help the child or young person see that it’s ok for them to show how they're feeling.
Talk openly as this will reassure them that it is ok to talk about death.
Respect the views of the child or young person’s family.

Help them understand and express feelings

Reassure them that whatever they are feeling is ok.

Help them to name and understand their feelings and explain that overwhelming emotions can come in waves.

Reassure them that it’s ok to feel happy and remind them that it’s ok if there are times when they don’t think about the person who has died.

If they are feeling angry, or experiencing similar emotions, help them find acceptable ways to express these feelings e.g. physical exercise, punching cushions or messy play.

If a child or young person feels they are to blame for the death, e.g. because they’ve been naughty, or because they had thoughts about the person dying, you should help them to understand that it is not their fault.

Address any fears they may have about being abandoned, or about other people dying.

They may be concerned about what life will be like now, and what will happen to them. Try to make them feel secure and reassure them that they will still be loved and looked after.

Help them understand the death

Use simple, clear language and words they will understand to help them make sense of what has happened. If appropriate, ask them questions to check they’ve understood.

Answer the child or young person's questions honestly and simply. Some questions will be easy, and some will be more difficult. If you don’t know the answer, don’t be afraid to say so.

Give concrete information. For example, if they ask about the person’s body, it can be helpful to explain that when people die they don’t breathe, they don’t need to eat or drink, they can’t feel pain and they won’t ever be alive again.

If they ask what happens to a person when they die, you could tell them that different people have different ideas about what happens, although nobody really knows for sure.

Help them cope and adapt

Try to stick to their normal routine as much as possible.

Children and young people may be comforted and soothed by:
- having a cuddle
- pets or soft toys
- being read stories
- relaxation or calming music.

School will play an important role in supporting the child or young person and they should be encouraged to speak to someone if they feel upset or alone at school. They should also be involved in deciding how to tell their peers about what has happened.

If they have had time off school, it can be useful for a teacher to contact the family before they come back to school. They may find coming back to school difficult, so it can be helpful to talk to them about what support they might need.

It can be helpful for them to meet other bereaved children and young people, as this can help them realise that they are not alone, and that other people have had similar experiences.

To help them through the grieving process and keep a connection with the person who has died, some examples of things they could do are:
- fill a memory box with special items
- make a scrapbook of photos and other keepsakes
- write down what they would like to say to the person
- visit a special place or the cemetery.

Even a long period of time after the death, they may benefit from talking about the person who has died.

What not to do

Don’t avoid talking about the death, even though this might be your natural reaction.

Don’t worry that you might make things worse by talking about the death, you won’t.

Don’t use ambiguous language that may confuse them e.g. “granddad has gone to sleep”.

Don’t lead them to suppress their emotions by telling them to be "strong” or “brave".

Don’t put pressure on them by saying they are now "in charge" or that they should "take care of their family”.

Don’t react negatively to them if they behave in a way that you find inappropriate.

Where to go for more support

Remember that with the right support from the people around them, most children and young people will be able to cope with bereavement. However you might also want to consider extra help or support:

AtaLoss.org, providing links to support and resources:
www.ataloss.org

Bereavement information from Association of Child Psychotherapists: https://childpsychotherapy.org.uk/resources-families/understanding-childhood/bereavement-helping-parents-children-cope-when-someone

Child Bereavement UK, self-help website and helpline:
www.childbereavementuk.org

Childhood Bereavement Network, self-help website:
www.childhoodbereavementnetwork.org.uk

Cruse Scotland, support for bereaved children and young people, with helpline:
www.crusescotland.org.uk

Hope Again, Cruse's website for young people, with email and phone helplines:
www.hopeagain.org.uk

Petal, support for people affected by homicide or suicide:
www.petalsupport.com

Winston’s Wish UK, self-help website with helpline:
www.winstonswish.org

Who to contact if you're still concerned

For parents and carers

Please contact your health visitor, school, GP or other professional involved with your family.

For professionals

Please consult with other professionals involved or the named person, and to help identify the most appropriate support, go to: www.nhsfife.org/camhs-choosingtherightsupport