mourning the death of a loved one (PDF)

The power of parenting during the covid-19 pandemic: mourning the death of a loved one  Helping your child cope with the death of a loved one at any time is a daunting task for any parent. Losing loved ones during the COVID19 pandemic, whether from coronavirus or another cause, is especially hard. This is because physical distancing interferes with mourning in ways that feel most comforting and normal to us. If you’ve lost a loved one recently, you may be struggling due to the sudden nature of the death, from being unable to say goodbye in person or from being unable to observe cultural or religious mourning rituals. Social support and the ability to say good-bye to a dying loved one are two of the most powerful protective factors for positive mental health outcomes after a loss. In this handout, we provide some concrete suggestions that others have found helpful for supporting children’s grief despite physical distancing. Remember, though, that each child is unique and you know your child best. Saying Good-bye When You Couldn’t Be There Restrictions or outright bans on visitation in hospitals mean that many people cannot be at the bedside of a sick loved one. Other family members report that a loved one who seemed mildly ill with COVID19 suddenly died in their sleep. There are other people facing end of life from diseases such as cancer who also cannot have their family members with them at this time of physical and social distancing. However, there are ways to help your child say good-bye by participating in remembrances or offering them choices of things they can do to celebrate the person’s life, even if you have to wait to have a formal service for your loved one. “ Jennifer’s death doesn’t feel real. Like, did it really happen? I don’t know what to do now.” — Mitzie, sibling, age 14 “ We brought my husband’s ashes home until we can have the funeral he deserves. I had lockets made online for my daughters to remember their dad too. We cried together when we chose the pictures to go inside of them. They each picked out their favorite.” —Drea, mother CAREGIVER RESPONSE: • Give your child permission to express their feelings and show yours; you two can grieve together. Ask your child about how they are feeling about not having had the chance to say good-bye in person. • Encourage your children to express feelings through drawing or other activities. If your child was not able to say good-bye to their loved one, offer to help your child write a letter to them, create a picture for them, or listen to music that reminds you both of your loved one. • Have an alternative ceremony or ritual at home, with your immediate family or through the use of technology, to gather extended relatives and friends. Invite your child to participate. For example, create a memory box or other space to display belongings and pictures of your loved one, choose a reading to share for an online service or create a website of photos and memories together. • If your state has begun to reopen, reach out to funeral homes, your place of worship, or other spiritual or cultural leaders to inquire how you could have a socially distant public remembrance. For example, some counties are allowing small gatherings of 10-25. While it may hurt to have to wait to have a funeral or a celebration of life for your loved one, the circumstance may also allow you more time to plan such a celebration. Understanding Developmental Differences Each child will react uniquely to loss and will grieve in different ways. Some children are outwardly expressive; they may cry, show sadness and/or have problems separating from you. Other children will quickly fall back into the routines of daily life for comfort, even in this “new normal.” Reactions may be different for different family members across age groups. How you respond to your child’s grief depends on your child’s developmental age (which may or may not match their chronological age). For children with disabilities or developmental delays, you may need to further customize your response given their particular needs.  “ Our children were 1 and 2 years old when my partner went into the hospital and didn’t come back. It’s been 3 months. They obviously don’t understand what’s going on, but they do notice his absence.” —Luke, father “ It makes me so angry when my sister, who has Asperger’s Syndrome, watches videos of Dad over and over again. She loops them all day. I don’t want to think about what happened or pretend he’s still here. I just want to be alone in my room. But Mom is always on me to come out and be with them. I just can’t right now.” —Channing, son, age 16 CAREGIVER RESPONSE: Reach out to your child’s pediatrician to help you understand where they are developmentally and how they may react. The chart below includes typical grief-related behaviors and related caregiver responses. Child’s Age/Stage Typical Behaviors Associated with Grief Caregiver Response Preschool • Developmental regressions are common like thumbsucking, bedwetting, using babytalk, temper tantrums, etc. • Sleep or appetite changes • Fear of the dark or fear of separation • Provide reassurance and stay physically close to your child • Provide stability of family routines • Talk with a grief counselor to identify appropriate picture books and language for talking about the loss School-age • Clinginess • Sleep disturbances • Asking concrete or very specific questions about the death • Externalizing or oppositional behavior • Help children connect to other family members and friends that bring them comfort (e.g., can a friend drop by with a mask for a porch visit?) • Answer questions truthfully without going into frightening details • Keep the conversation open; let your child know they can ask you anything about what is happening Adolescence • Sleeping or eating disturbances • Increase in physical complaints, conflict or disruptive behaviors • Separation from family • Anger or irritability • Give your teen space but let them know you are there to talk when they are ready • Consult a pediatrician or mental health professional if withdrawing for prolonged period, self- harming or extremely aggressive  Seeking Alternative Social Support “ Our community was incredible. The whole town turned out for a memorial car ride to our home when they found out Jim had died of COVID. Each family that came by stopped and left a letter of support or remembrance on our lawn. People lit candles and left flowers or little gifts for the children. We couldn’t stop smiling and crying at the same time.” — Jacinda, wife “ It’s been 3 months now. I had so much guilt in the beginning. If it hadn’t been for me, maybe she’d still be here? Talking to others helped. It seems like everyone feels guilty when a loved one dies. We are just starting to come out of our bubble and maybe out of the worst of our grief. I woke up one day and realized we are going to be okay. We have to be okay. It’s the first time the kids and I sat down and talked about what life could look like now.” —Denis, father While the death may occur in one day, grief does not. Mourning will be an ongoing process. Let your children lead the grief process as it is theirs. Witnessing your children’s grief and not trying to fix it, is one of the hardest things to do as a parent. So what can you do? Connect! Spend time with your children at any age, doing things that are comfortable as a family. Play together, take walks, share a meal - whatever fits your family’s style and feels good to your children. This may feel forced right now but if you involve your children in selecting the activity, it can help create a feeling of closeness. It’s a way to let them know you are there for them. For some children, play is the way that they cope and try to make sense of the world around them. Find time to connect outside in nature. For others, it might be sharing their hobby. For others, you may just want to let them choose activities that feel comforting to them such as binge-watching animal videos or bake-offs with a school age child or playing video games with an adolescent. Especially in the early days of loss, just being near each other can help provide comfort. Many families find it helpful to also seek religious/spiritual help or professional counseling for support. This may be available online or by telephone during the pandemic. Many play and art therapists are able to help children cope, even through a video screen, with materials you may already have around the home. Check in with your children on a regular basis during your family’s bereavement. Remember that there is no “right or wrong” way to grieve. Being present for your children and allowing them to grieve in their own way are two of the most important things you can do as a caregiver. Resources For more information, visit: >> https://www.newyorklife.com/newsroom/insights-on- covid-19 >> https://www.nctsn.org/what-is-child-trauma/trauma- types/disasters/pandemic-resources >> https://reachinstitute.asu.edu/programs/resilient- parenting-for-bereaved-families-from-science-to-service Extra Help Should reactions continue or at any point worry you or interfere with your children’s/ teens’ abilities to function contact your child’s doctor, a mental health professional, or your local bereavement center. If you need some extra help, seek similar services for yourself. There are helplines as well as mental health professionals providing their services through telehealth. One such hotline to get support regarding your anxiety or stress is the SAMHSA Disaster Distress Helpline at 1-800-985- 5990 or by texting TalkWithUs to 66746. This fact sheet was co-sponsored by the New York Life Foundation. Drawing from experiences of bereaved caregivers, researchers and mental health professionals, the developers of this fact sheet include Jeanette Koncikowski, John Hill, Julie Kaplow, Irwin Sandler, Shannon CrossBear, Sharon LeGore, Sarah Gardner, Diane Lanni, Chris Foreman, and Jill Harrington-LaMorie.   2995C