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Grief and Bereavement

Everyone grieves in his/her own unique way. The process of grieving is often long and painful for all who knew the child. This can include parents, siblings, relatives, friends, peers, teachers, nurses, neighbors, and anyone that understands the loss of a child.

What are the physical and emotional signs and symptoms of grief?

The emotional and physical expressions of grief are often the most obvious part of mourning. Everyone expresses sadness and loss in different ways. There are some common characteristics, however, that occur when one is experiencing great loss and sadness.

Crying, sorrow, and anger are common emotions when dealing with death. Often anger is misdirected causing conflicts with family members and marital relationships. Feelings of loneliness and desolation can be dangerous to some extent. If the living feel there is no point going on without their loved one, feelings of suicide can pre-occupy their thoughts. These desperate feelings need immediate intervention. It may be normal to think about death and feel left behind when someone close dies, but it can overcome all other emotions and lead to suicide.

Appetite changes, eating more or much less, may occur. Sleep may increase or decrease to the point of exhaustion. Survivors may detach from all those around them, including surviving siblings and spouses. However, attachment to surviving siblings may become overbearing and unhealthy to both parent and sibling.

These strong emotional and physical symptoms of grief may not occur for all people who experience a loss. These symptoms may last as short as a week after the death or may last months or years.

What are the stages of grief?

The grieving process varies from person to person in terms of the order in which one experiences the stages of grief, as well as the time it takes to go through the stages of grief. Persons who are grieving do not necessarily progress in order. Some people may start with anger, while others may start with denial. The stages of grieving are not necessarily a one time experience. However, each step helps with the healing process. Grief is usually divided into five stages:

Sibling and peer bereavement:

The impact of a child's death on their siblings is important to remember and address. Most young children can overcome the trauma of a sibling's death with the necessary support and time. Many children have strong feelings of guilt and blame when their sibling dies. Often the child that has died is idealized after his/her death, leaving feelings of inferiority and neglect for the surviving siblings. These siblings have often been surrounded by death, illness, and great sorrow from all family members, especially parents, during the dying child's experience. More often, the young siblings of a child with a terminal illness have been protected from some of the experiences associated with the death. They may have not been allowed to visit the dying child, prevented from participating in the religious or cultural rituals, and possibly, even prevented from attending the funeral. All of these experiences may help with closure and can make a sibling's survivor-guilt less burdensome.

For peers and classmates, the grief process may be experienced in a variety of ways. Many children may not have had an experience with any one their age dying from an illness or accident. For any age group, review of our own mortality and purpose in life is evaluated. Young children may fear they will die soon also. They may also have feelings of guilt and blame, similar to the siblings expression of grief. The peer of a dying child also needs time and emotional support to grieve over his/her loss of a friend, neighbor, and/or classmate. There are many support groups that include non-family members and peers in helping work through the grieving process.

Help is available:

There are many support groups available that are experienced in helping families cope with a loss and work through their emotions associated with grieving. The phone book, hospitals, churches, and the Internet are all full of sources that are available to help.

It is important to understand that grieving is a normal response. Grieving, however, should be managed so that activities of daily living and relationships among the survivors are able to be maintained. Misdirected anger and feelings of guilt and blame can be very detrimental to a family and marriage. Seeking out support groups and professional help may make the grieving process more manageable and have less long-lasting effects.

No support group will be able to take away the hurt and sorrow, nor will they be able to magically end the grieving. Support groups will, however, help you understand your emotions, the loss, and meet others who have had similar experiences and what helped them through their toughest moments.

Follow-up care is also an important task for support groups. Often there is a lot of attention focused on the family in the first few months following the death, but there may be little support years down the road. Grief can recur years later. It may be triggered by a memory of the deceased, another child in the family, or by an anniversary or birthday associated with the deceased. Follow-up care in the bereavement process is important to be able to detect recurrence of grief and to manage long-lasting effects of grief. Follow-up care may take place over months to years.

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Online Resources of Care of the Terminally Ill Child

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