EYFS Best Practice - All about…bereavement

More than 100 children experience the death of a parent in the UK every day, and by primary school there is likely to be one child in every class who has experienced the death of an immediate family member. So, the chances are that during your professional life you will work directly with a child who is grieving. How you respond to and support these children and their families will directly influence how they learn to cope and live with their bereavement.

‘The death of a parent or sibling is one of the most fundamental losses a child will ever face. The lives of those who are left behind will change forever,’ says Rebekah Lawson, North West family services team leader for Winston’s Wish.

While children do not tend to understand the permanence of death until they are around seven years old, young children are no less affected by the death of a person close to them. Even babies can experience a general sense of loss when a carer dies without understanding what is behind it, explains Katie Koehler, assistant director of bereavement services at Child Bereavement UK.

‘By four years old, children are often very interested in death, ask lots of questions about death and can accurately tell if things are dead or alive. This shows a rudimentary understanding but it’s not complete. For example, they may think that people can come back from the dead,’ she adds.

RESPONSES TO GRIEF

The grief that children experience when someone close to them dies can differ widely. ‘Grief depends on the nature of the relationship and how they died. It depends on their previous experience of death, their understanding and developmental level,’ says Ms Koehler. ‘Also how adults in their environment manage it and what other support they’ve got.’

Responses to grief can be a mixture of feelings, behaviours or thoughts, with psychologist Atle Dyregrov identifying these common reactions:

• anxiety
• insecurity and worry about other family members
• vivid memories
• sleep difficulties
• sadness and longing
• anger and acting-out behaviour
• guilt, self-reproach and blame
• school difficulties
• physical health complaints.

It is common for a young child to regress when they have experienced a bereavement, such as reverting to baby talk, waking in the night or wetting themselves. Another normal but distressing reaction can be ‘searching behaviour’, says Ms Koehler. ‘Children can think that if they search for something it will return, so they may, for example, keep looking out of the window for their dad to come home.’

Children tend to move quickly through a range of emotions and reactions – intense crying interspersed with fun. ‘It is not at all unusual for children to be focused on their grief in one moment and in the next be asking if they can put on their favourite film. We call this “puddle jumping”,’ explains Ms Lawson.

Young children may also be struggling with the belief that they are somehow responsible for the death. ‘When I was in primary school, my friend’s brother died in a horrific accident. A few weeks before I had been unfriendly to him and I couldn’t separate those two things in my mind and felt very guilty,’ recalls Ms Lawson. ‘Children feel they have power over the people and events that matter to them; they will need reassurance that they are not to blame.’

MAKING SENSE OF DEATH

It used to be common to shield children from death, but professional opinion now is that we need to talk as honestly as possible about what has happened. They can’t deal with reality until they have got all the information.

‘If it is made taboo to talk about death then children will pick up on this quickly and stop asking questions, which is not helpful,’ says Ms Koehler. It is important to listen to children, ensure their voices are heard and explain what has happened clearly and consistently. If it is their first experience of death then they will also be trying to understand what dying is.

‘There are a mass of existential questions to deal with from children but concrete answers are helpful, such as understanding physically what “dead” means – that they can’t move, think, speak and that they no longer need food or drink,’ advises Alison Penny, co-ordinator of the Child Bereavement Network. ‘Euphemisms and particular explanations are easily misunderstood, such as the word “lost”, which brings the possibility of finding them again, or “gone to sleep”, which can be scary. Saying that they don’t need their body any more may lead to questions about their head. It’s important to tease out what children think because there is a lot of room for misinterpretation.’

Children need to be given the time and space to make sense of what has happened and then express their feelings. ‘They will need to go over and over what has happened in order to begin to understand that death is a permanent thing. Young children may see death as like being on holiday and may repeatedly ask, “When is daddy coming back?”,’ says Ms Lawson. ‘For a young child, grief will resurface with the onset of each developmental stage.’

Grief is not a finite process, and at times of transition children’s anxiety may come out and they may revisit their grief, cautions Ms Koehler. ‘If the change in behaviour is persistent then it is time to get the advice of a bereavement service,’ she adds.

If childhood grief is not addressed it can lead to a variety of short- and long-term problems. ‘At Winston’s Wish we see older children, who were bereaved before they started school, struggling with their emotional health and feelings of anger and anxiety,’ explains Ms Lawson. ‘Such difficult feelings can make the journey through school more challenging and mean that it is harder to make friends, achieve and, most importantly, feel happy again.’

IMPACT ON FAMILY

Unfortunately, children are experiencing bereavement at the same time as many of the adults on whom they rely for support. While some parents may withdraw emotionally, making it difficult to understand their children’s needs, others put their own grief on hold so that they can focus on the child – both responses are normal, says Ms Lawson.

Every family has its own culture and belief system about what happens after death. ‘It may be easier if a family is religious and believes that the person is in heaven and they will see them again,’ says Ms Koehler. ‘But sometimes after someone dies, families lose their religious beliefs, whereas some who are not religious gain beliefs because it helps them to make sense of what has happened.’

Added to the emotional toll can be other factors that a family needs to address. ‘Parents who lose their partner will face adapting to life as a single parent while learning to cope with feelings of grief,’ says Ms Lawson. ‘Most families do not prepare for the worst – without a will and insurance in place, the financial consequences can be extremely difficult. There are so many practical and difficult things to do when someone dies.’

Unmarried partners can face additional problems, such as not being entitled to some financial support and not having equal rights in registering paternity. Children can also experience ‘secondary losses’ such as a change of home, nursery and friends because of the death.

OFFERING SUPPORT

Anything that allows a bereaved child to continue in a secure routine is helpful, so nurseries can be incredibly valuable. Practitioners are also in an excellent position to support the child and family. This can be daunting, but there is a wealth of information available. Here are some key ways to help:

• Acknowledge the death to the child. Don’t leave it unspoken, which can stop potential conversations with the child about things they are worried about.
• Communicate with the family. Find out what the child knows and what the family is happy for the nursery to say.
• Be responsive and honest to questions, even repeated ones.
• Use story books to help explain death and dying.
• Support children with memory work, such as making memory boxes, or direct families to resources and bereavement services.
• Don’t try too much to mop up tears – children need to dip into their grief. A child may be inconsolable and then want their dinner.
• Parents may ask you whether the child should go to the funeral. Talk it through with them and discuss how to prepare the childif they go – such as have a particular caregiver if the parent is overwhelmed.
• Signpost families to bereavement and financial services, if needed.

‘Remember that nothing you say is going to make it worse – the worst has already happened,’ reassures Ms Lawson. ‘If it is hard for you, it is OK to stand back and ask a colleague or friend for support. Also, be gentle with yourself. Talking about death and dying can stir up very strong feelings in all of us relating to painful memories and fears for the future.’

CASE STUDIES

Joana and Marlene

Joana had a three-year-old daughter, Marlene, and was 37 weeks pregnant when her partner died suddenly last year

‘Marlene’s dad put her to bed as he always did, but he had a brain aneurism later that night and died three days later. I’m pleased that she was shielded from his actual death and the hospital were good at helping me to explain what had happened, honestly and clearly.

‘I told her that there was something wrong in his head and it couldn’t be fixed. His body now didn’t work and he couldn’t see, eat or feel pain. She didn’t react when I told her, just said that she wanted to see her auntie and left. It was at bedtime that she got upset, probably a combination of being tired and missing her dad tucking her up.

‘Marlene was at private nursery when it happened, with only a few weeks before she was finishing for the summer and then starting at the local pre-school because we’d moved away. They were so supportive. Marlene’s key worker picked her up every morning and dropped her off in person, which was a huge relief for us. I explained by email what I’d told Marlene so that they could do the same. The day of the funeral, Marlene went to nursery and her key worker brought her to the wake and helped by explaining what was happening.

‘We’ve relied on children’s books to help Marlene. Many say how it’s OK to be sad, but we also like the ones where the message is that you don’t have to be guilty if you feel happy. It doesn’t mean that she doesn’t miss her dad.

‘Her new pre-school let us take our time with settling in after her sister was born. They are less able to tell me changes in behaviour, but I think it has given Marlene a fresh start. Everyone knows her as Marlene, not as the one whose daddy died.

‘Staff were surprised that she still does drawings for her dad but I feel it’s important for her to do this and talk about him because it keeps his memory alive. Marlene still misses him but she hasn’t been abandoned, which hopefully makes it easier to deal with. He didn’t want to go.’

Joana was legally obliged to prove her newborn child’s parentage upon her partner’s death because they were unmarried. She is now campaigning against this costly and lengthy legal process: https://petition.parliament.uk/petitions/123667

Rose and Gus

Rose was four years old and Gus almost two when their mother died. Their father speaks about how it affected them

‘My wife’s death, just three weeks before Gus’s second birthday, was very painful and fast. Two and a half years on, Gus doesn’t remember her, not even her voice. But Rose has memories and says she misses her mum, especially when she’s upset.

‘Gus has always been cuddly but I feel he needs me more. Rose was scared that I was going to die too and would ask, “Are you going away? When are you coming back?” Early on, we met some ladies and Rose asked if they would be her new mum. But now she understands that it’s a fact, it’s only daddy and that’s it.

‘Being parents was a split business. Now I have to do everything myself. Sometimes I felt like a failure, that I’d let everyone down. Those black moments are far less frequent now.

‘It was painful for me, bringing up memories and talking about the special person we’ve lost, but school helped Rose a lot. I wanted to spend time with people and let our children play together, rather than sinking in sadness, but some of the school mums said their husbands were jealous and stopped calling me. I attended Child Bereavement UK’s support groups to meet new people and see how they cope.

‘I’m very grateful that I’ve got young children. If I didn’t I don’t think I would be here. Family is the number-one important thing.’

Tahlia and Cameron

Tahlia recalls her brother, Cameron, dying from neuroblastoma when she was six years old

‘I’ve had nearly 30 years to come to terms with my brother’s death, but raw emotion lingers. As a five-year-old, I was very aware that he was ill, yet at the same time was confused by what was going on. When Cameron needed my parents by his side, as he often did, I was taken in by friends and family. I was often jealous that he was getting our parents to himself. I was jealous that he got a new train set to play with in hospital and that people were always asking about him, not me.

‘After he died, people assumed that I wouldn’t remember him and it wouldn’t affect me. Not only do I remember our time together vividly, but the acute changes which happened within our family because of his death last forever. I felt very lonely. My big brother had died, and my parents had changed. Over the years different things have affected me – hearing a song that we listened to together, seeing friends with their older brothers, feeling that I needed to achieve enough for two people, guilt at being left behind.

‘A primary teacher found me crying and gave me the best piece of advice: “You will always feel a knot inside, but over time that knot will start to unravel, and little by little it will feel easier.” Bereavement doesn’t go away but it becomes a part of you.’

RAISING MONEY

The UK’s largest nursery group, Busy Bees, has chosen childhood bereavement charity Winston’s Wish as its charity of the year. Children and staff across 250 nurseries will be raising money through fun days, bake sales, competitions and dress-up days to fund a number of projects. These include publishing a book to support children to cope with grief, and a bereavement service for children aged five and under.

‘It is extremely important to us that we work with a national charity that supports children and families, and Winston’s Wish is a fantastic fit,’ says managing director Marg Randles. ‘The death of someone close to us is one of the most fundamental losses anyone will ever face, and something no child should have to go through alone or unsupported. It is vital there are specialist individuals on hand to guide young people through the grieving process. We want to make sure children and families across the country that have been affected by a bereavement have somewhere and someone to turn to.’

FACTS AND FIGURES

There is an absence of official data on the number of children who are bereaved each year. Using sources including mortality statistics and census data, the Child Bereavement Network has estimated:

In 2014, 23,200 parents died in the UK, leaving behind around 40,000 dependent children aged 0 to17– 110 newly bereaved childrena day.

Mortality rates vary by social class and geography. Children living in disadvantaged areas are more likely to be bereaved.

MORE INFORMATION

Books for children

• A Place in My Heart by Annette Aubrey – Andrew is confused about his granddad dying
• Badger’s Parting Gifts by Susan Varley – Old Badger tries to prepare his friends for his death
• I Miss You: A first look at death by Pat Thomas – addresses children’s feelings and questions about death
• Sad Book by Michael Rosen – chronicles Rosen’s response to the death of his son
• Goodbye Grandma by Melanie Walsh – a boy asks his mum questions about the loss of his grandmother
• Always and Forever by Alan Durant – Fox’s friends find solace in their memories of him

Books for carers

• Supporting Children’s Experiences of Loss and Separation by Pre-school Learning Alliance
• Is Daddy Coming Back In A Minute? by Elke and Alex Barber – explains sudden death to pre-school children in words that they can understand
• Helping Children Cope with Grief by Rosemary Wells
• Grief in Children:A handbook for adults by Atle Dyregrov
• Beyond the Rough Rock: Supporting a child who has been bereaved through suicide by Di Stubbs and Julie Stokes

Useful websites

• www.childbereavementuk.org
• www.childhoodbereavementnetwork.org.uk
• www.childdeathhelpline.org.uk
• www.cruse.org.uk
• www.griefencounter.org.uk
• www.hopeagain.org.uk
• www.seesaw.org.uk
• Survivors of Bereavement by Suicide, www.uk-sobs.org.uk
• www.widowedandyoung.org.uk
• www.winstonswish.org.uk

Financial advice

• www.citizensadvice.org.uk
• www.turn2us.org.uk

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