Supporting Children through Loss and Grief

As the COVID-19 pandemic continues, some families are unfortunately now coping with the loss of a loved one. When the grieving family includes a child, it’s important for parents and caregivers to be prepared to talk about this experience with young children as well as teenagers. Cynthia Moore, PhD, clinical psychologist and associate director of the Parenting at a Challenging Time (PACT) program at Mass General for Children, shares more about how children experience grief, as well as some thoughts for parents on how to process loss as a family.

How Children Express Grief

Grieving children experience different emotions at different times, often in waves. You might notice your child expressing some, or all, of the following:

• Yearning for/deeply missing their loved one
• Sadness
• Anxiety
• Anger
• Loneliness
• Guilt
• Shock, numbness
• Relief

Children and adults experience many of the same emotions after a loss, but often they will be more intense, impossible to ignore, and last for longer periods of time in older children and adults, and come in shorter bursts for younger children. Like adults, children may also have a mix of feelings that can be difficult for them to sort out and identify, or that don’t fit together easily, like feeling angry one minute then anxious the next. Parents can support children by helping them to identify and name all the feelings in the mix, and by working with children to find ways to safely “ride the waves” of strong emotions.

Along with having strong new feelings, children’s behavior may change in the early weeks after a loss.

“Children may cry when talking about the loved one or in response to even small frustrations,” says Dr. Moore. “Some have a hard time sleeping or settling down at bedtime, some become pickier eaters, and sometimes children get into more conflicts with their siblings or are otherwise more irritable.”

It is important to check with your pediatrician, a mental health clinician or another trusted health care provider if:

• Mood or behavior changes are noticeable for big parts of the day, and last for more than a few weeks
• Your child’s behavior is risky or puts them in danger (for example, reckless driving in a teenager)
• Mental health problems that your child had before the loss return or get noticeably worse
• Your child talks about wanting to die so they can be with the loved one (or for any other reason)

Different people in a family may have very different reactions to a loss. Each family member’s reactions are affected by their age and developmental stage, as well as their usual personality and day-to-day functioning. Sometimes teenagers, especially, become upset or angry about younger children’s expressions of grief. They may see their siblings playing happily with friends, or not looking intensely sad for long stretches of time, and feel that this is somehow disrespectful, or that the younger children just don’t “get” the seriousness of the loss.

It might be helpful to share information about how grief tends to look in different age groups. Resources like the ones found on the PACT program’s COVID-19 Parent Resources page can help parents and children cope at any age or stage.

Sharing Difficult News with Children

Referencing her experience working with parents coping with non-COVID-19 related loss, Dr. Moore advises against withholding the news that a loved one has died from children for fear of causing them pain. While not every family is able to do so, talking to children ahead of an expected loss can help children to prepare and process their feelings a little more gradually. Parents might hope they can protect children by not sharing difficult news with them, but this can have unintended effects.

“Parents’ first instinct is to protect their children and it can seem that the best way to do that is by insulating them, wrapping them in bubble wrap, but it’s usually more protective to give them a sort of a guide or map of what’s going on, by talking about it openly,” she says.

Children are often aware when adults are worried or upset and notice even small changes at home. This can lead children to feel anxious, but if they don’t feel comfortable asking questions or know exactly what questions to ask, they can end up worrying alone. And talking honestly can help even children who might not know that a loss is likely, to prepare for it more gradually and with support from loving adults.

This also gives children who wish to do so a final chance to say something to a loved one (often, simply “I love you”) which may bring comfort later. Telephone calls or voice recordings are helpful when children are not allowed, or do not wish to visit someone in the hospital.

When talking with children about an imminent loss, give them information about what has been happening and could happen shortly, an understanding of how these changes will affect them right away, and clear reassurance that there are adults who love them and will take care of them, no matter what. As much as you can, help children feel safe and secure.

Talking honestly, and then listening to children, keeps them in the loop, and allows them to get the support they need to get through even the most difficult situations. For ideas about words to try, see the PACT program’s COVID-19 Parent Resources.

Grieving in an Era of Physical Distancing

People are still finding opportunities to share memories and honor their loved ones—opportunities that should include children, too.

“Even in the short term before traditional ceremonies with larger groups can happen again, talking about all the people who loved the person who died can help create a sense of community as children grieve,” says Dr. Moore.

Children often appreciate being given a small memento, such as an article of clothing or jewelry, a framed photo, or other belonging to help them feel connected to their loved one. This might be even more meaningful if they are able to have a say in what they are given or if there is a story that goes along with the belonging.

As for creating connections with others in these times of grief, there are many avenues that can be explored, including:

• Cooking favorite family recipes
• Asking for letters that describe the writer’s relationship with the loved one and the qualities they loved about the person
• Coordinating with funeral homes to have memorial services shared virtually with people at a distance
• Sharing stories of loved ones on social media or tribute pages (but be aware that these pages may require a subscription to stay posted, or be taken down by the owner of the page in the future)
• Holding rituals and ceremonies at home to honor a loved one
• Making plans for future ceremonies

“It takes a lot of courage, frankly, for parents to talk with children about loss and grief especially when the adults are grieving too.” Dr. Moore says, “But talking and listening to children is one of the most important things we can do to help children come through these very sad and confusing times with resilience.”