Bereavement Fact Sheet

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​Bereavement Fact Sheet

Prevalence

The vast majority of children will experience the death of a family member or friend sometime during their childhood. Five percent of children will experience the death of a parent by age 16.

Risk Factors for Complicated Grief

  • ​Sudden and unanticipated death (especially if traumatic or violent, or the result of suicide or homicide) or death after a very long illness
  • ​Perception of death as being preventable
  • Death when the child is less than 5 or during adolescence
  • ​Other losses in the child's life or ongoing stressors
  • Angry, ambivalent or dependent relationship between the child and deceased​
  • If parent remarries and there is an unsupportive relationship between the child and stepparent
  • Pre-existing mental health problem in the child
  • ​Inadequate support within the family or community for the child
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How Can Pediatricians Provide Assistance?

Pediatricians can draw upon their established relationship with the child and family in order to:

  • ​Actively listen to the child and be with the child/family while they express their grief
  • ​Provide guidance on normal reactions to grief
  • Identify and address guilt reactions and misconceptions
  • ​Provide concrete advice on how to support children, such as issues relating to funeral attendance
  • Identify and address somatization​
  • Screen for rare but more serious reactions, such as depression
  • Provide referrals to community resources (e.g., children's bereavement support groups)
  • Provide follow-up - contact children after time has passed to see how they are doing

Examples of Comments to Avoid

DO NOT try to cheer-up children who are actively grieving (e.g., "I know it hurts very much right now, but I know you will feel better within a short period of time"). Allow children to grieve.​

DO NOT encourage the child or parent to cover up their emotions (e.g., "You need to be strong for your mother/son. You don't want them to see you crying, do you?").​

​​​Do express your own feelings and demonstrate empathy (e.g., "I realize this must be extremely difficult for you" or "I can only begin to imagine how painful this must be"), but AVOID statements such as: 
"I know exactly what you are going through" (You cannot know this.)
"You must be angry" (Let the individual express his/her own feelings. Do not tell him/her how to feel.)
"Both my parents died when I was your age" (Do not "compete" with the survivor for sympathy.)
 
​Advice to Give to Parents on Funeral Attendance
Children, just as adults, often benefit from participating in the funeral and other ceremonies. Explain to children concretely what to expect and invite them to participate to the level they feel comfortable. Do not coerce children to do something that makes them uncomfortable (e.g., kissing the deceased). Identify a "partner" to guide the child and monitor reactions throughout the event. He/She can answer the child's questions and allow the child to leave temporarily or permanently if the child so desires. He/She should be well known to the child, understand the child's developmental needs and preferably not be actively grieving so as to be able to attend to the child's needs.
Remember... ​​​​​Notify families that you are interested in learning about important events that may impact their child's life, such as the death of a family member or friend. Otherwise they may not contact you for support at such times.
Help parents find support for themselves, so they are ​​​​better able to support their children.
Be sure to follow-up with families over time since grieving is a​​​​ long-term process.

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