Eluna Custom Resource

Grief by Age: Developmental Stages and Ways to Help

By: Sarah Behm, PPS, MBA

Developmental Stages

an Eluna Camp Erin camper preparing to participate in an activity.

Ages 0-3 Infants/Toddlers

Developmental Stage: During these first two years, children’s development is focused on creating an attachment bond with primary caregiver/s. These bonds are the foundation of trust and healthy relationships. Infants are also rapidly building their social, emotional, and cognitive skills. Personality and self-awareness are starting to form.

Concept of Life & Death: Up to age 3, all objects are alive. Infants and toddlers have very little understanding of death, but they may notice that something is missing or different.

Symptoms of Grief: All children, regardless of their experience with grief, may exhibit the following traits at various ages and stages of their life. However, research has found that after the death of loved one, children may have prolonged or noticeable experiences with one or more of the following symptoms:

  • Behavioral:
    • reduced affection towards caregivers
    • rejecting their environment
    • slow movement or hyperactive movement
    • staring off with a dazed expression
  • Emotional:
    • prolonged sadness/weepiness
    • anxiousness and inability to self-sooth or be soothed
  • Physical:
    • loss of appetite
    • more colds/sickness than usual
    • sleep disturbances (waking up frequently/nightmares/night terrors)
  • Cognitive:
    • fragmented memory (feeling like something is missing and only remembering some details)

How to Help – the 6 Rs:

Reassure:

  • Gaze into their eyes and mirror expressions (smiling or frowning when they are) to strengthen your bond.
  • Identify special ways that the deceased person would soothe the child and incorporate these into routines (cooking a comfort food, using a specific rocking chair or technique, wrapping infant in a special blanket).
  • Be present during self-regulation (take deep breaths together while embracing). Try infant massage as a soothing technique.
  • Avoid overstimulation and teach self-soothing through play (using stuffed animals or puppets).
  • Model appropriate ways to express grief.

Routine:

  • Create a comfortable, safe, and predictable environment to the best of your ability.
  • Create consistent schedules for sleeping and eating routines.
  • If you are one of the primary caregivers, avoid being away for several days at a time.

Release:

  • Make time for creative outlets, such as playing, music, rhythm, art, dancing, movement, and repetitive nursery rhymes.
  • Read a picture book together about grief.

Remember:

Reflect & Connect:

“Daddy’s heart stopped working. He died and won’t be coming home from the hospital.”

“Your mom had an accident and died. We will not be seeing her again.”

Reach Out:

Ages 3-5 Preschool

Developmental Stage: During this preschool age, children develop social/emotional/moral reasoning, engage in imaginative and fantasy play, understand cause and effect, can experience two emotions at once, begin to self-sooth, and experience feelings of shame and guilt.

Concept of Life & Death: Young children will transition from believing all objects are alive to seeing anything that moves as alive. This age group does not understand permanence of death: they may believe the person in asleep and will wake up.

Symptoms of Grief: All children, regardless of their experience with grief, may exhibit the following traits at various ages and stages of their life. However, research has found that after the death of loved one, children may have prolonged or noticeable experiences with one or more of the following symptoms:

  • Behavioral:
    • clingy
    • stubborn
    • impulsive
    • temper tantrums
    • risky behaviors
    • regression (bed wetting/thumb sucking)
    • talking less
  • Emotional:
    • fear of separation
    • extreme sadness/depression
    • unable to be soothed/comforted
    • difficulty with change
  • Physical:
    • frequent headaches or stomachaches
    • more colds than usual
  • Cognitive:
    • magical thinking (that the deceased will return)
    • constant questioning
    • child may believe they caused the death and toxic shame or excessive guilt may develop

How to Help – the 6 Rs:

Reassure:

  • Remind the child that they are safe and loved.
  • When implementing consequences, have child in sight during time-outs (1 min per year of child’s age) and use a repair phase afterwards like: “you and I are okay now”.
  • Identify special ways that the deceased person would soothe the child and incorporate these into daily routines (cooking a comfort food, singing a specific lullaby, comforting child with a special blanket).
  • Be available for their emotional needs and acknowledge feelings “I see that you are…upset/angry/frustrated”.
  • Model appropriate ways to express feelings.
  • Provide choices when possible “would you like to wear the green or red shirt today”.

Routine:

  • Try to stick to a consistent schedule for sleeping, eating, and childcare.
  • Offer healthy comfort foods when child is having a hard day.
  • If you are one of the primary caregivers, avoid being away for several days at a time.

Release:

  • Make time for creative and physical outlets through playing, art, dancing, movement, and music.
  • Read age-appropriate books about grief.

Remember:

Reflect & Connect:

“Daddy’s heart stopped working.”

“Your mom had an accident and died from her injuries.”

“Grandma died today, and we will not be seeing her again.”

“Grandpa died today and won’t be coming home from the hospital.”

Reach out:

Ages 5-11 Elementary School

Developmental Stage: During the elementary school age range, children are developing cognitive, social, emotional, and moral reasoning. Children will begin to socialize and identify friend groups. Competition, eagerness, fairness, and rule-following are common traits of this age group. Anxiety and phobias may also form during this stage (scared of spiders, monsters under the bed, etc.)

Concept of Life & Death: Children will gradually start to understand that death is permanent, and the person will not return. Children may believe that death has scary and mysterious powers. Around age 9, children start to understand that death is both personal (that they will eventually die) and universal (that all living things will die).

Symptoms of Grief: All children, regardless of their experience with grief, may exhibit the following traits at various ages and stages of their life. However, research has found that after the death of loved one, children may have prolonged or more extreme experiences with one or more of the following symptoms:

  • Behavioral:
    • irritability
    • tantrums
    • aggressive outbursts
    • argumentative
    • impulsive
    • hyperactive
    • difficulty with change
    • social challenges or isolation
    • fills emptiness with screentime or eating
  • Emotional:
    • scared about the safety of others
    • fear of disapproval
    • feeling helpless or hopeless
  • Physical:
    • frequent stomachaches, headaches, colds
    • difficulty sleeping (nightmares)
    • loss of appetite or overeating
    • hair may start falling out
  • Cognitive:
    • trouble in school and paying attention
    • identifies with deceased
    • obsessed about details around death and dying

How to Help – the 6 Rs:

Reassure:

  • Stay present and focused on building your relationship with the child.
  • Reassure them with messages of safety and belonging for the child.
  • Identify special ways that the deceased person would soothe the child and incorporate these into daily routines (cooking a favorite dinner/dessert on the weekend, playing a favorite type of music on the way home from school, comforting child with a special item of choice like a sweater of the person who died).
  • Be available for emotional needs and acknowledge feelings.
  • Model appropriate ways to express feelings and fill feelings of emptiness (drawing a body map instead of watching TV or tossing a ball together when feeling sad).
  • Provide choices whenever possible.
  • Set limits for unsafe or unhealthy aggression.

Routine:

  • Stick to a sleep, eating, and an after-school routine if possible.
  • Increase predictability in their environment (set family dinner time, etc.)

Release:

  • Provide time for creative outlets through play, art, dancing, and music.
  • Check out age-appropriate books about grief to read together.
  • Plan regular physical activities (sports, exercise, yoga, dance).

Remember:

Reflect & Connect:

  • Answer all questions about the death of their significant person. Respond to questions with concise and concrete answers. Avoid giving advice unless requested. Ask about excessive daydreaming.
  • Prepare by reading 10 Things Grieving Children Want You To Know or Seven Suggestions for Explaining Death to Children.
  • When explaining the death, using simple and short sentences. Use the words dead and died. Avoid euphemisms such as “gone”, “passed on”, “lost”. Here are some sample scripts to consider:

“Daddy’s heart stopped working.”

“Your mom had an accident and died from her injuries.”

“Grandma died today, and we will not be seeing her again.”

“Grandpa died today and won’t be coming back home from the hospital.”

  • Help children find a support network of trusted peers and adults.
  • For toxic shame or survivor guilt allow child to spend time with a person who had a similar experience.

Reach out:

Ages 11-13 Middle School

Developmental Stage: During the middle school years, pre-teens may experiment with different roles/identities and try to separate that identity from the family. They may show less affection towards caregivers and/or come across as rude. Pre-teens have trouble calculating the level of risk in situations and will experience a rollercoaster of emotions (moodiness). Pre-teens often look to fit in, which can lead to social anxiety.

Concept of Death: Middle schoolers understand that death is permanent, however they may also experience magical thinking (that the person went away on a trip and will return). They also realize that death is both personal (they will die and experience the death of a close person) and universal (that everyone will die).

Symptoms of Grief: All children, regardless of their experience with grief, may exhibit the following traits at various ages and stages of their life. However, research has found that after the death of loved one, children may have prolonged or noticeable experiences with one or more of the following symptoms:

  • Behavioral:
    • risk-taking
    • acting out
    • experimentation with unsafe substances and behaviors
    • may try to take on a caregiving role
    • may isolate from their friends
  • Emotional:
    • difficulty managing big emotions (anger, revenge, sadness, relief, worry)
    • survivors guilt
    • depression or anxiety
    • suicidal ideation
    • fear for safety of self and others (the world is no longer safe)
    • hypervigilance (sensitive to noises/light/movement)
  • Physical:
    • headaches, stomach aches, body pain
    • trouble sleeping (nightmares)
    • changes in eating habits (eating too much or too little)
    • possibility of self-harm
  • Cognitive:
    • unable to stay focused and pay attention
    • trouble in school
    • constant thoughts or questions about the death

How to Help – the 6 Rs:

Reassure:

  • Reinforce safety and love within your relationship and family.
  • Look for subtle signs of grief as this age group is better about masking or hiding their feelings.
  • Be available for emotional needs and acknowledge feelings.
  • Model appropriate ways to express feelings and fill feelings of emptiness (writing/drawing in a diary instead of watching TV or this shake & ground technique).
  • Provide choices whenever possible.

Routine:

  • Identify clear and consistent roles, rules, and responsibilities within the family.
  • Monitor high-risk behavior and set limits with practical consequences.
  • Encourage healthy eating, sleeping, and exercise habits.
  • Increase predictability in their environment (set family dinner time, etc.)

Release:

  • Provide and support creative outlets through art, music, theater, journaling, etc.
  • Offer fiction and nonfiction books to provide a variety of perspectives into grief.
  • Encourage physical outlets (sports, exercise, yoga, dancing) and appropriate options for aggression/anger (boxing/martial arts)
  • Set limits for unsafe or unhealthy aggression.

Remember:

Reflect & Connect:

  • Initiate conversations about the death of your loved one.
  • Engage in active listening by asking open-ended questions and listening without judgement or interpretation.
  • Allow for a wide range of emotional expression (child may want to throw or hit something – support them with safe ways to throw a baseball or hit a punching bag).
  • Answer all questions clearly and accurately. Have patience and prepare by reading 10 Things Grieving Children Want You To Know or Seven Suggestions for Explaining Death to Children.
  • Provide opportunities to talk with nonfamily members for support.
  • For toxic shame or survivor guilt allow child to spend time with a person who had a similar experience.

Reach out:

Ages 13-18 High School

Developmental Stage: During their high school years, teenagers will experiment with different roles and priorities, develop a distinct identity, and may seek to separate that identity from the family. They have trouble calculating risk and their emotions will fluctuate (moodiness). They turn more toward peers for a sense of belonging, which can lead to social anxiety as they seek to fit in. Intimate relationships form (boyfriends/girlfriends), which may lead to a sense of vulnerability. Teenagers begin to be more resourceful, reasonable, and reliable as they age towards adulthood.

Concept of Death: Teenagers understand that death is permanent, however they can experience magical thinking (that the person went away on a trip and will return). Teens often question the meaning of life.

Symptoms of grief: All children, regardless of their experience with grief, may exhibit the following traits at various ages and stages of their life. However, research has found that after the death of loved one, children may have prolonged or noticeable experiences with one or more of the following symptoms:

  • Behavioral:
    • higher risk-taking than normal (substance abuse/unsafe behaviors/reckless driving)
    • taking on caregiving roles or pushing towards independence from the family
    • avoidance
    • social challenges
  • Emotional:
    • difficulty managing big emotions (sadness/anger/relief)
    • survivors guilt
    • depression or anxiety
    • suicidal ideation
    • fear for safety of self and others
    • hypervigilance (sensitive to noises/light/movement)
  • Physical:
    • challenges with sleeping (nightmares)
    • changes in eating habits (eating too much or too little)
    • possibility of self-harm
  • Cognitive:
    • memory flashbacks
    • low attention span
    • struggling with academics and school attendance
    • extreme perfectionism

How to Help – the 6 Rs:

Reassure:

  • Reinforce safety and love within your relationship and family.
  • Look for subtle signs of grief as this age group is better about masking or hiding their feelings.
  • Model appropriate ways of grieving and processing, such as guided mindfulness.

Routine:

  • Identify clear and consistent roles, rules, and responsibilities.
  • Monitor high-risk behavior and set limits with practical consequences.
  • Provide opportunities for extending sleep within reason and encourage healthy eating and exercise habits.
  • Increase predictability in their environment (family dinner times).

Release:

  • Provide and support creative outlets through art, music, theater, journaling, etc.
  • Offer fiction and nonfiction books to provide a variety of perspectives into grief.
  • Encourage physical outlets (sports, exercise, yoga, dancing) and appropriate options for aggression/anger (boxing/martial arts)
  • Set limits for unsafe or unhealthy aggression

Remember:

Reflect & Connect:

  • Initiate conversations about the death of the significant person. Engage in active listening by asking open-ended questions and listening without judgement or interpretation. Try sharing your own emotions to start the conversation.
  • Allow for a wide range of emotional expression (child may want to throw or hit something – support them with safe ways to throw a baseball or hit a punching bag). Answer all questions clearly and accurately.
  • Have patience and prepare by reading 10 Things Grieving Children Want You To Know or Seven Suggestions for Explaining Death to Children.
  • Provide opportunities to talk with nonfamily members for support.
  • For toxic shame/survivor guilt allow child to spend time with a person who had a similar experience

Reach out:

Ages 18 – Mid 20’s Young Adults

Developmental Stage: Young adults start to consider plans for independence, post-secondary education, and career goals. Social maturity and intimate relationships may evolve and develop. Personality and identity strengthen during this time.

Concept of Death: Young adults understand that death is permanent. The death of a significant person can have a profound, permanent effect on young adults. Young adults continue to be vulnerable when processing grief as they are still developing their social, emotional, and coping skills.

Symptoms of grief: All people, regardless of their experience with grief, may exhibit the following traits at various ages and stages of their life. However, research has found that after the death of loved one, young adults may have prolonged or noticeable experiences with one or more of the following symptoms:

  • Behavioral:
    • avoidance
    • isolation
    • risk-taking
  • Emotional:
    • depression or anxiety
    • stress
    • unexpected sadness (crying)
    • range of feelings that may include frustration, shock, relief, guilt, and/or anger
  • Physical:
    • aches and pains
    • tight chest
    • loss of appetite
    • exhaustion
  • Cognitive:
    • disruption in academic or professional functioning
    • fracturing in personal identity development

How to Help – the 6 Rs:

Reassure:

  • Reinforce safety and love within your relationship and family.
  • Examine roles and responsibility within the restructured family system.
  • Adjust boundaries and expectations as needed.
  • Talk openly about how your relationship will continue to evolve through adulthood. Look for subtle signs of grief as this age group is better about masking or hiding their feelings.
  • Model appropriate ways of grieving, such as this grief body scan.
  • Monitor high-risk behavior and reset expectations as needed.

Routine:

  • Provide opportunities for extended sleep within reason and encourage healthy eating habits.
  • If the young adult has moved away, discuss opportunities for communication and visits.

Release:

  • Support creative outlets in art, music, theater, journaling, sports, yoga, exercise, outdoors, hobbies, clubs, etc.
  • Offer fiction and nonfiction books to provide a variety of perspectives on grief.
  • Plan physical outings together (walking, hiking, biking, etc.).

Remember:

Reflect & Connect:

  • Engage in open conversations and active listening.
  • Answer all questions clearly and accurately.
  • Try sharing your own emotions to start the conversation.
  • Have patience and prepare by reading 10 Things Grieving Children Want You To Know or Seven Suggestions for Explaining Death to Children.
  • Provide opportunities to talk with nonfamily members for support.
  • For toxic shame or survivor guilt encourage the young adult to spend time with a person who had a similar experience.

Reach out:

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