Dealing with Death and Bereavement in Families

The death of a loved one is always a traumatic event. Family members will react differently depending on their relationship to the deceased and their age.  A young child will react differently from an older teenager. Children will usually grieve the loss of a sibling or parent more intensely than a grandfather or uncle. The way the family member died will make a difference.  For instance, if the death is unexpected and unpleasant there will be more trauma. If a death was expected and plans and discussions have taken place, it can be easier to deal with.  Children's ability to cope will be influenced by how well their parents manage their own bereavement.

Planning for a death

No one likes to think about death.  For this reason, parents avoid making plans for it or discussing it with their children, their partners or extended family.  But death is inevitable and a normal part of life.  However unpleasant it may be, it is useful to discuss what you would do as parents if one of you died. Discussing death with children from an early age can help them make better sense of it when it occurs.

How would you deal with the death of your spouse?  What would the needs of the children be and how would they be met?  What difference will it make if it is the mother or father who dies first or if you both are killed?  What will happen to the children if you are divorced and remarried and you die?

Would it be wise to take out life insurance policies to provide for your loved ones in the event of your death?  Have you written a will?  Consider what would happen to the children if you both died as parents?  If you don't plan for these situations, someone else will have to do this for you.  They may not do what you would have wished.

Issues such as the type of funeral service you require, whether it should be a religious service or not, are important to consider.  Decisions about organ donation are more easily dealt with if you have discussed this as a family and know the views of individual members.

Children can be helped to understand death and cope with it better if you discuss this with them when deaths occur.  The subject of death can be raised when a pet dies, when it is mentioned in a story they might be reading or when the children see TV news features about murders etc.

If you know you are dying, or you have a child who is dying, it is important to discuss what will happen. Try to be open and honest and not to deny it is going to happen.  You may need some professional help to do this, but many families manage these situations well on their own.  Professional help is there because there is a need for it - you have not failed in any way if you take it up.

How to help children make sense of death

Children react differently to death according to their age. Young babies may miss the handling and closeness a mother offered.  Changes in routine can upset children and make them more difficult to deal with at a time when parents and siblings are already distressed.  Very young children may not understand death.  They believe people can come back from the dead like in a cartoon.  They may become agitated because the dead person does not come back.

Children of primary school age understand death better.  They may have experienced the death of pets or have killed insects.  They are more likely to understand that death is permanent.  Although older children may rationally understand the process of death better, the loss they feel can be very frightening and distressing.  They may feel insecure and become clingy and demanding.  It is common for children to "regress" - that is to go back to an early way of being.  This is a way of connecting back to a time when they felt safer and more secure.  If your child starts acting in a babyish way, try to connect with this behaviour rather than criticising it. You can connect by cuddling more and joining in their behaviour.

Children can feel angry that they have been abandoned and may blame themselves or feel responsible in a direct or unexplainable way for the death.  Young children tend to act out their feelings, portraying through demanding and 'naughty behaviour', their inner feelings of hurt.  This behaviour, at a very difficult time for parents and siblings, may appear callous and uncaring.  Try to keep calm and remember that even though you may be low and distressed, that children need reassurance and security to make them feel safe at such a time.  Seek help and support if the behaviour of one or more of the children becomes too difficult to manage.  You can ask relatives or friends to help out at such a time.  They will understand your need.  You may need support with your own feelings of grief at such a difficult time.

Older children and teenagers have a more adult response to death and are more aware of the psychological, emotional and practical implications of death. Like adults, they can be severely traumatised.  Because they are more emotionally aware they can sometimes keep their feelings to themselves in order not to cause more upset to parents or siblings.  If a same sexed parent has died, teenagers sometimes try to step into the breech.  They need to adapt to the changes the death of a parent may bring, without taking on a role that is inappropriate or brings them into conflict with their siblings or surviving parent.

Death of parents

This is very difficult for children.  Of particular concern is the mental health of the surviving parent.  Children need to know that they are safe and secure.  If the surviving parent becomes depressed, then there may be a double loss for children.  It is important that parents seek help for themselves and do not burden their children with issues they are not equipped to deal with such as managing a depressed parent on their own.

If a partner dies, parents may seek out new relationships. Consider your own psychological vulnerability at such a time.  Children may be very resistant to accepting new partners their mother or father meet, particularly if it is soon after the loss of their other parent.  They may feel they are betraying their dead parent if they accept this new person into their lives.  Talk to children about their feelings without burdening them. 

After a while children should return to a more psychologically balanced state.  If after what you consider to be a reasonable amount of time, a child become more socially withdrawn, seems to be often weepy and upset and appears to be not like their usual self they may be suffering from an unresolved grief reaction or even be depressed.  Try to offer support without getting upset yourself.  Other family members can help here too. Don't be afraid or embarrassed about asking for help.  If you feel your child is not recovering as expected, ask your doctor for some professional help.

Let the school know about the loss.  Children often talk to teachers. Teachers can keep a special eye out for difficulties and for bullying of a bereaved child by other children.

Grandparents and relatives

The death of a grandparent or other close family relative can be very traumatic - particularly if they played an active part in your children's lives. Children will observe how you respond to the death of your own parent. Death in relatives may raise fears in children of you dying too.  Talk to your children about your own feelings without overwhelming them.  What you say to them about the death of your own parent and how you handle it, will affect how they deal with the death of their own parents.  If you are traumatised about the death of your parent, seek some help.  Grief is a normal part of everyday life, but sometimes it becomes too difficult to cope with.

The death of a sibling

The death of a sibling can be very complicated for surviving children.  Their relationship with the sibling will have an important bearing on how they cope and react.  Whether the death was expected or not will also affect their feelings.  Many children have jealous and rivalrous feelings towards their siblings and this can leave them feeling guilty or responsible for the death of their sibling.   Make it clear to the surviving children that they are not to blame even if you feel angry yourself about how they behaved towards the deceased child.  If they were implicated in some way (for instance were out with them at the time or were involved in some risky behaviour with them), this will need careful handling.   You may benefit from professional help, particularly if you are angry or feel they were in some way to blame.

 Children's friends

The death of a friend can be very difficult for children to cope with.  Depending on their age, children will react differently.  How their friend died and whether your child was present or involved are important factors.  Consider that although you may not have been close to their friend, that this relationship may have been central to your child's social life.  Sometimes the loss of a best friend can have a devastating social impact. The loss of a girl-friend or boy-friend may need particularly sensitive handling.

Importance of pets

The death of pets can be a useful way of discussing issues of death with your children.  Children become strongly attached to their pets and may experience great distress when they die.  Try to have a ceremony of some sort, such as a burial to help the children come to terms with the death.  Don't treat the death of a pet lightly.  Spend some time discussing it with your child.  This experience may help a child cope better with death of another pet or a person in the future.

Arranging a funeral

A funeral is a difficult event to manage.  You may need help from another family member or friend to help arrange it.  As parents, you can discuss what to do in the event of a death before it happens. This way you will at know what your partner wanted if the situation arises.  Although it may appear distasteful, do get quotes from at least two funeral directors. A relative or friend may handle these negotiations better.  If you are expecting a death you could do this beforehand. The death of a spouse may mean less income for the family, so the cost of a funerals is an important consideration.  A good funeral company will make the process as easy as possible.  Let people know whether to send flowers or make a donation to a hospice or other  institution if you prefer.

Should you take the children?

Although as parents, you will want to spare the feelings of your children, research shows that they benefit from attending funerals even from an early age.  If they do attend, try to protect them from very overt expressions of grief, but if this is not possible, reassure them later that you are OK.

Older children will almost certainly benefit from attendance at a funeral, but do not make them attend if they don't want to.  If they don't want to, talk to them about it later.  If they don't attend the funeral they often benefit from visiting the grave or resting place, at a later date.

Death of a spouse

The death of a parent in a family is often the death of a spouse too.  It is important to remember your own grief when considering the needs of others.  Often, death can be followed by depression and despair.  It can be followed by anger and non-acceptance.  It takes a very long time (up to seven years) to recover from the powerful feelings surrounding the death of a very close person. It is normal within that time to have waves of grief, to imagine that the dead person has come back or has not really gone, to feel angry and resentful and to feel abandoned.  Even after a long period of time, anniversaries such as birthdays and Christmas can bring back upsetting memories.  If these feelings are very strong, persistent over time, and you feel you are not coping, you should seek help.  Contact your doctor and they will put you in touch with people who can help you. There are a number of charities who can offer help and support too. I have listed some below.

When to seek help for the children?

Look out for depression in your children.  This can show up in sleep difficulties, a loss of appetite, a loss of interest, withdrawal, denial of the death, becoming obsessive about the dead person, poor school performance and changes in their normal behaviour. Sometimes children have nightmares or become morbidly interested in wanting to join the dead person. 

Seek help from your doctor who can refer you to a child and adolescent mental health service.  Sometimes doctors have counsellors attached to their clinics who have specialist training in grief therapy.  Let the school know about the situation. If you have been in contact with a hospice, they often have counsellors available to talk to children.

Getting support from friends and family

Friends and family can be a great source of help.  Sometimes it is easier for a child to discuss their feelings with a relative who may be less distressed than you are.  For teenagers, friends are a source of support. Encourage them to continue social activities and to mix with their friends.  School teachers, nurses and counsellors can offer additional support for children.  Try not to be shy or embarrassed about asking for help.

If you have a religious faith your church will offer support and understanding.  Many churches have support groups and people who can help you in your grief.  Be aware that it is common for children and adults to feel the presence of their dead relatives for some time after death.  You may find your church helps you deal with such feelings better than some professional counsellors who may empathise with your feelings but cannot connect with your religious beliefs.

There are many professional and voluntary agencies who can offer help. Check out the Finding Help article to find out how to get additional support and information.

Web site:

Cruse bereavement care (UK) (An extensive site offering lots of advice and help)

http://www.cruse.org.uk

Pet Loss

http://www.bluecross.org.uk/2083/Pet-Bereavement-Support-Service.html

Dennis Neill

Family Therapist

Family Therapy UK

1st May 2008