‘Grieving in chunks’: helping kids cope with the death of a loved one

Gone are the days of thinking that kids don’t need to talk about death. Recently, Prince Harry revealed in the media how profoundly the grief from his mother’s death affected him. He said that he thought it necessary to be strong as a child, and never really allowed himself to experience his own feelings. Having big names like Prince Harry come forward about grief helps to normalize the experience, allows other children and teens to come forward and realize that they’re not alone. Grief is really hard work for everyone; children, adults, even a prince.  

November 16 marks Children’s Grief Awareness Day. As a Grief Support Coordinator in the Paediatric Advanced Care Team (PACT) at SickKids, I think about and talk about death and grief a lot.

For most people, however, it can feel intimidating or unnatural to talk to children about death and grief. Because we, as adults, feel uncomfortable, we often neglect to fully engage and support children in conversations around death and grief. However, what we’ve learned in working with families at the end of a child’s life is that by including the child and siblings in these conversations, we can reduce their sense of isolation and validate their feelings.

Often we meet parents who think that by not including their other children in funerals or conversations around their sibling’s death, they can spare that child the pain associated with death. Unfortunately, it usually has the opposite effect. It makes the children feel more isolated, and full of hard questions. By allowing children the opportunity to talk, they can get their questions answered and learn that their feelings matter, and are natural.

Children also look to their parents and other adults in their lives as role models, especially during hard times. It’s so important for them not to hide their feelings from children. If kids see their parents crying, they realize that it’s ok to be sad because death is hard and even after some time passes, everyone still really misses their sibling or grandma or other family member. If they don’t see their parents sad, or having a hard time, it may make them keep their feelings in, or feel like they’re far behind everyone else and shouldn’t be sad anymore. It’s also important that parents and adults continue to talk about the deceased person and bring them up in conversation. This allows the child to realize that it’s ok to talk about their loved one, who will be part of the family’s everyday conversation, and that nobody will ever forget them.

Children are extremely concrete and literal thinkers, which is why it’s imperative that adults use clear language around death. By using phrases like pass on, sick, gone to sleep and lost we confuse children, and they may be too afraid to ask for clarification. For example, we might say to a child ‘We lost your sister because she was so sick’. This sentence has two ambiguous words in it, lost and sick. This may cause the child to think that the sister is simply lost and they may wonder when she is coming home. As well, they may think that the next time they get sick with a cold that they too will get lost and die. Instead, we encourage parents to use sentences like ‘your sister has died because she had a disease called leukemia’. Labelling the disease gives the child the tools to fully understand why someone has died.

Children also grieve in chunks, as opposed to all at once. As adults, we might sit down with a friend or family member, and have a dedicated conversation about how we’re feeling. Children come in and out of grief as they continue to play and interact with the world around them. For example, a child could be happily playing with toys and then turn to his or her mother and ask a very intense question like ‘What happens to someone’s body when they die? ’ This often catches the adult off guard, but for the child it just felt like the right time to ask.Grieving in chunks can be compared to the way a child eats an apple, in little chunks and bites over time, while an adult would likely sit down and eat an apple all at once.

Grieving children don’t often need different support, they just need more of everything. They need more parental attention, more love, more reassurance, more understanding, more compassion, more chances and more opportunities to talk. Even with lots of preparation, education and tools, some children may simply not want to talk. In that case it’s just as important to make them aware that when they’re ready, there’s a safe space to do so.

At SickKids, we aim to provide the best possible bereavement experience for our patients and families. How can ‘best’ and ‘bereavement’ even be in the same sentence? Every family, regardless of the place or cause of their child’s death, has the opportunity to be connected with the Pathways Grief Support Program at SickKids. Pathways offers phone support, assistance with funeral planning, connection with resources in their community, and help with the more practical aspects of a child’s death. Every family also receives seven mailings throughout the first year of bereavement. These mailings contain psychosocial support and practical advice such as how to talk to grieving children, and how to reintegrate into school. Throughout the year we host several family events that allow bereaved siblings and parents the opportunity to come together with other bereaved families to celebrate and remember the children who have died. This support helps families cope and feel that they are not alone.  

For more information on SickKids Pathways Grief Support Program and other children’s grief resources, please visit the PACT website and check out our grief support resource map for support near you.

Norah Shaughnessy is a Grief Support Coordinator in the Paediatric Advanced Care Team (PACT) at SickKids.