• When a child has caring, involved parent(s), the parents are key. Respect the parents, finding out their wishes, needs and expectations of the child during this time of loss. Most parents when approached in this fashion share their traditions and expectations, and are open to assistance as well as suggestions.

• In the context of the above, ideally involved clergy, family members, health care providers, and teachers should work together, allowing themselves to be orchestrated by the parent(s). Who died, the nature of the death, and the ceremonies mandated by cultural and religious traditions will influence the appropriate timing of the different types of help.

• Do not try to fix anything. Death, loss and bereavement are realities that differ from the specific event of dying. They are realities of living; as such they take enormous amounts of time to become real for the sufferers as well as to be folded into the realities of the every day feelings, events, and behaviors of all of us. This is just such a powerful reality for children. They will, unlike adults, because they are growing and developing rapidly, more intensely re-digest the loss as they move to new stages of social and emotional and cognitive awareness.

• Following from the above, do not impose adult expectations about responses and emotional expressions to the ceremonies around the deceased or commemorating the deceased. But, do involve children in those ceremonies while guiding them in appropriate behaviors while there. Tell them that they can ask questions, ask them if they have questions, and "listen" to them - not infrequently a comment has within it a request for help in understanding. The balance between listening and not over-explaining.

• Be patient in your helping and be accepting of differences. Children, even within the same family and even when close in age, have very different personalities. As adults you may be more comfortable with a highly verbal child but that verbal sharing in and of itself does not necessarily say anything about that particular child's coping nor does the perhaps less attractive silence of his sibling mean that the quiet sibling should be of greater concern.

• The ceremonies for the deceased as well as the memorials are positive organizing experiences for the survivors. Children should attend them. They, whenever possible if the deceased is a parent, sibling, grandparent or peer, should be helped to participate in the ceremony in some appropriate way.

• Allow particularly young children to engage in play. Encourage them to draw and to tell stories; let stories with loss, bereavement and "re-constitution of life after loss" themes be read to them. As mentioned earlier, these are the ways that children over time "work through," integrate, and make some sense out of the separation and loss of control that death brings.

• For the older, school-age child, help him or her with her peer group. Learn from the child what he or she is saying, if anything, to peers about the death of the loved one. Listen and learn from the child what the responses are to this information from peers. Here is one frequent place for adult modulation, explanation, comforting and intervening since few in our culture have experience with death. As a result, the responses of peers and their parents can be awkward, even unhelpful. In some schools and with some children, parent and teacher might choose to work together to help the child make known his or her loss to the class group in a way that encourages their support while providing some education and sensitization of peers about death.

• Children are excellent observers. It is hard to fool them about feelings in particular. They will observe the behaviors, especially of the adults around them.  If there are examples of dramatic behaviors (explain them to the child briefly and do so in words appropriate for the child's developmental stage. Explain also tears, fatigue and irritability, especially your own. Such explaining comforts the child; it also helps the child to accept their feelings as well as the legitimacy of expressing them.

• Once past the ceremonies, the memorial services, ordinary reality takes over. Memories go up and down in intensity; confusion about time may occur. Anxiety may develop about forgetting. Here you can help the child in many ways. If, particularly, the pre-school or early school age child starts to ask questions or talk in ways that fly in the face of your adult perceptions that death, a permanent loss of presence, has occurred, do not challenge the child. Listen. Learn more by asking questions about play observed by you, drawings, questions posed by the child. Re-explain events and then begin a process of helping the child to organize his or her memories. This involves talk, mementos, pictures, visits perhaps to a gravesite. This is all a process to be repeated over and over as months and years go by. The process has some intense moments separated as time passes by first days, then weeks, then months, then years.

• Encourage learning about how to live with death and loss. Children, just as adults, need help in maintaining the courage to face their feelings of sadness, or anger, or helplessness. Children, as adults, need help in regaining after a major loss through death, their sense of hope. Learning about the experiences of others helps immensely over time. Many children and surviving parents find, for example, the photojournalist Jill Krementz' book How It Feels When a Parent Dies very helpful. It is composed of 18 interviews and photographs of children age 7 through 16 years talking about their feelings and reactions to the death of a parent (Alfred A. Knopf, New York 1986).

• Finally, when is professional help needed for children who have experienced death? In most situations, children do not need professional help individually or in groups. For the usual kinds of death from age or illness (any age), children cope, grow, and develop quite well with a loving, caring family, friends, community (including church or synagogue or temple) who follow common sense as well as the precepts listed above.

Author: Stephen P. Hersh. Originally published in "Children Mourning, Mourning Children." 

Published by Hospice Foundation of America; www.hospicefoundation.org or 1-800-854-3402.