How to Talk to Children about Death During the COVID-19 Pandemic:
David Schonfeld, MD, directs the National Center for School Crisis and Bereavement at Children's Hospital Los Angeles
Newswise — As the COVID-19 death toll in the United
States climbs dramtically, parents and caregivers need to shy away from
their protective instincts and prepare themselves for some open and
candid conversations with grieving children about death. “For children
to cope, adults need to help them understand that death is permanent and
irreversible,” says David Schonfeld, MD, Director of the National
Center for School Crisis and Bereavement at Children’s Hospital Los
Angeles. “Kids need simple and straightforward answers, and an
opportunity to share their feelings.”
At some point in their lives, all kids are going to experience the loss of a grandparent, a loved one, a friend, or hear about the death of a famous athlete or celebrity in the news media. “When that happens, kids generally want to talk about it; they want to engage parents in conversation. They want to understand it,” Schonfeld says. He adds that even very young children can understand death. “Research suggests that most children come to understand the concepts of death by 5 to 7 years of age; children at even younger ages can also understand death, especially after experiencing a personal loss.”
The pandemic raises its own set unique challenges for parents, given that families are self-quarantining, subject to safer at home orders, and normal routines, like school and work, have been disrupted.
“Social distancing measures, including lengthy school closures, increases the social isolation of grieving children, and makes it difficult to get support for your children,” says Schonfeld. “During the pandemic, families may find it very difficult to meet basic needs such as obtaining food, preparing meals, or providing supervision after the death of a parent or other caregiver, especially when the surviving adults are grieving and feeling overwhelmed by the pandemic.”
The usual outpouring of assistance, support, and companionship that would normally be provided by extended family, friends, neighbors, and members of the school community in the immediate aftermath of a death may not occur – funerals may need to be postponed and family and friends unable to visit, Schonfeld says.
Critical to the healing process will be helping children understand more about the current pandemic. “After the death of someone close, children often become more concerned about their health and that of others they care about,” he says. “The ability to reassure children that others close to them are healthy and not at risk of dying becomes challenging, even if the initial death was unrelated to the pandemic or any infectious disease. It becomes important to help children deal with their fears and concerns about the pandemic, in addition to any grief they may be experiencing after a personal loss.”
Schonfeld identifies four important concepts about death that are vital to understand for any child of any age.
1. Death is irreversible.
Children need to know that when people die, they don’t come back to life. It’s important to speak in clear, simple terms when explaining that death is permanent.
“We tend to make comments like, the person has ‘gone far away’ or is ‘up on the clouds,” which suggests the person will return,” says Dr. Schonfeld. “So, children may wait for the person to return or resent it when the person doesn’t return. They need to understand it’s irreversible so they can begin the mourning process.”
Schonfeld says that for very young kids using the phrase “all gone,” can help them understand that the person will not come back.
2. After death, all life functions end completely.
Make sure children understand that after death, all life functions stop working completely; the person’s body is not working any longer and the person doesn’t think or feel. Otherwise, children may worry that the person who died is still in pain or sad.
Schonfeld suggests explaining to children, “’When a person dies, his or her body stops working and it doesn’t start working again. So, the person doesn’t feel pain, is not hungry, is not scared.’ You can state it very simply.”
3. Death is inevitable.
Children need to understand that all living things eventually die.
When talking to children about death, Dr. Schonfeld says it’s tempting for a parent to say “Oh, I’ll never die” or “I’ll always be there,” but that can lead to confusion for kids. “If kids think that some people are immortal, it may mean that people who do die were chosen to die perhaps because they did something wrong.”
Teaching kids that all living creatures die is something that can be broached easily in nature. “Kids see examples [of death] all the time, like if you find a dead bird or there’s a spider that dies,” says Schonfeld. These are opportunities in everyday life to discuss the basic concepts of death with kids in a way that shows it’s a part of the lifecycle, and it can be done before they experience any personal loss.
3. Explain the cause of death.
While it’s not necessary to share too many details of a person’s death, providing children with an explanation of how or why a person died will make it less likely for kids to feel scared or guilty.
“Kids need an understanding of the physical reason why someone died,” says Schonfeld. “Guilt is also an extremely common reaction to loss. Kids may think, ‘I did something wrong and that’s why someone I loved died. Then that means I can just never do that again, and it shouldn’t happen again.’”
Although children may not say they feel guilty, Dr. Schonfeld advises that it’s a good idea to address that feeling when talking about death. “I always presume the guilt may be there, so I reassure children that there wasn’t anything that they should have done or could have done that would have changed the outcome.”
General Tips:
--The National Center for School Crisis and Bereavement has a COVID-19 Pandemic Resources webpage that includes a 15-minute presentation for parents on how to talk to and support children during a pandemic.
--Many children’s bereavement programs across the country are quickly adapting to the pandemic by providing virtual groups and/or individual support. Contact the organizations in your area to see how they can assist. Check the National Bereavement Resource Guide: State by State Bereavement Listing complied by New York Life and eluna for a list of bereavement organizations in your state to identify local support for bereaved children and their families.
--Reach out to your pediatrician or mental health professionals by email or phone to obtain additional support. Ask your children’s teacher to connect you with school mental health professionals who can talk with you by phone while schools are closed.
--For further information on how to provide support to grieving children during the pandemic, visit the COVID-19 Pandemic Resources webpage of the National Center for School Crisis and Bereavement. You can also download a free booklet: After a Loved One Dies – How children grieve and how parents and other adults can support them developed by the Coalition to Support Grieving Students.
At some point in their lives, all kids are going to experience the loss of a grandparent, a loved one, a friend, or hear about the death of a famous athlete or celebrity in the news media. “When that happens, kids generally want to talk about it; they want to engage parents in conversation. They want to understand it,” Schonfeld says. He adds that even very young children can understand death. “Research suggests that most children come to understand the concepts of death by 5 to 7 years of age; children at even younger ages can also understand death, especially after experiencing a personal loss.”
The pandemic raises its own set unique challenges for parents, given that families are self-quarantining, subject to safer at home orders, and normal routines, like school and work, have been disrupted.
“Social distancing measures, including lengthy school closures, increases the social isolation of grieving children, and makes it difficult to get support for your children,” says Schonfeld. “During the pandemic, families may find it very difficult to meet basic needs such as obtaining food, preparing meals, or providing supervision after the death of a parent or other caregiver, especially when the surviving adults are grieving and feeling overwhelmed by the pandemic.”
The usual outpouring of assistance, support, and companionship that would normally be provided by extended family, friends, neighbors, and members of the school community in the immediate aftermath of a death may not occur – funerals may need to be postponed and family and friends unable to visit, Schonfeld says.
Critical to the healing process will be helping children understand more about the current pandemic. “After the death of someone close, children often become more concerned about their health and that of others they care about,” he says. “The ability to reassure children that others close to them are healthy and not at risk of dying becomes challenging, even if the initial death was unrelated to the pandemic or any infectious disease. It becomes important to help children deal with their fears and concerns about the pandemic, in addition to any grief they may be experiencing after a personal loss.”
Schonfeld identifies four important concepts about death that are vital to understand for any child of any age.
1. Death is irreversible.
Children need to know that when people die, they don’t come back to life. It’s important to speak in clear, simple terms when explaining that death is permanent.
“We tend to make comments like, the person has ‘gone far away’ or is ‘up on the clouds,” which suggests the person will return,” says Dr. Schonfeld. “So, children may wait for the person to return or resent it when the person doesn’t return. They need to understand it’s irreversible so they can begin the mourning process.”
Schonfeld says that for very young kids using the phrase “all gone,” can help them understand that the person will not come back.
2. After death, all life functions end completely.
Make sure children understand that after death, all life functions stop working completely; the person’s body is not working any longer and the person doesn’t think or feel. Otherwise, children may worry that the person who died is still in pain or sad.
Schonfeld suggests explaining to children, “’When a person dies, his or her body stops working and it doesn’t start working again. So, the person doesn’t feel pain, is not hungry, is not scared.’ You can state it very simply.”
3. Death is inevitable.
Children need to understand that all living things eventually die.
When talking to children about death, Dr. Schonfeld says it’s tempting for a parent to say “Oh, I’ll never die” or “I’ll always be there,” but that can lead to confusion for kids. “If kids think that some people are immortal, it may mean that people who do die were chosen to die perhaps because they did something wrong.”
Teaching kids that all living creatures die is something that can be broached easily in nature. “Kids see examples [of death] all the time, like if you find a dead bird or there’s a spider that dies,” says Schonfeld. These are opportunities in everyday life to discuss the basic concepts of death with kids in a way that shows it’s a part of the lifecycle, and it can be done before they experience any personal loss.
3. Explain the cause of death.
While it’s not necessary to share too many details of a person’s death, providing children with an explanation of how or why a person died will make it less likely for kids to feel scared or guilty.
“Kids need an understanding of the physical reason why someone died,” says Schonfeld. “Guilt is also an extremely common reaction to loss. Kids may think, ‘I did something wrong and that’s why someone I loved died. Then that means I can just never do that again, and it shouldn’t happen again.’”
Although children may not say they feel guilty, Dr. Schonfeld advises that it’s a good idea to address that feeling when talking about death. “I always presume the guilt may be there, so I reassure children that there wasn’t anything that they should have done or could have done that would have changed the outcome.”
General Tips:
- Speak clearly and plainly to kids. Don’t use euphemisms.
- “It’s important that we use simple terminology and avoid jargon,” says Schonfeld. “The only reason that some expressions are felt to be comforting is they don’t really address what’s happened. But that’s just confusing for kids.”
- Check back in with children to see if you’ve been clear; ask the child what he or she has understood about what you’ve said.
- Ask children how they feel.
- Allow children to have their feelings.
- “There is a tendency to try to cheer people up when they are grieving,” says Schonfeld. “When people witness grief, it makes them uncomfortable, so they want the person to stop demonstrating their distress. But we can’t really help kids cope if we don’t give them permission to express those feelings.”
- Model ways to cope with grief.
- “Allow your child to own their feelings, and then share a little bit about your feelings and how you have coped with loss,” advises Schonfeld. “You can say, ‘I remember hearing about this [death or tragedy] and I felt very [sad]. What I did was I talked to your mom about it and that made me feel better.’
- Understand that every child grieves differently.
- Young children don’t sustain intense feelings of grief for long periods, so they may cry or yell, then go play. This is typical for grieving children.
- Teenagers may express grief as sadness or anger. This is also quite common
- Teens still need to be parented.
- Teens tend to turn to their peers to talk about important topics—but during challenging times like grieving a death, teens really do need parent presence and discussion. “They may be reluctant to talk about it because it’s uncomfortable, or they may not want to burden their parents by upsetting them and raising the topic,” says Schonfeld. “But they still need an explanation of what happened, and support.”
- Schonfeld also advises parents not to forget that teenagers are still children; although they are more mature and responsible than younger kids, adolescents should not be the primary support system for grieving parents. “Adults need to look for outside support for themselves,” says Dr. Schonfeld.
- Grief changes over time.
- “When someone dies, you lose that person and that is the primary loss. But you also lose everything the person could have done or might have done for you in the future; those are all the secondary losses,” says Schonfeld. “Young kids who lose someone significant don’t appreciate the secondary losses right away. As they get older, kids grow into realizing all that they have lost. That’s relevant because it doesn’t matter how well you explain [a death] to a child at age 5 or 10, there will be more questions when they are older, 15, 20 or 25.
--The National Center for School Crisis and Bereavement has a COVID-19 Pandemic Resources webpage that includes a 15-minute presentation for parents on how to talk to and support children during a pandemic.
--Many children’s bereavement programs across the country are quickly adapting to the pandemic by providing virtual groups and/or individual support. Contact the organizations in your area to see how they can assist. Check the National Bereavement Resource Guide: State by State Bereavement Listing complied by New York Life and eluna for a list of bereavement organizations in your state to identify local support for bereaved children and their families.
--Reach out to your pediatrician or mental health professionals by email or phone to obtain additional support. Ask your children’s teacher to connect you with school mental health professionals who can talk with you by phone while schools are closed.
--For further information on how to provide support to grieving children during the pandemic, visit the COVID-19 Pandemic Resources webpage of the National Center for School Crisis and Bereavement. You can also download a free booklet: After a Loved One Dies – How children grieve and how parents and other adults can support them developed by the Coalition to Support Grieving Students.
