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    Grief, Bereavement, and Coping With Loss (PDQ®): Supportive care - Patient Information [NCI] - Children and Grief

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    Boys often become more aggressive and destructive (for example, acting out in school), instead of showing their sadness openly.

    When one parent dies, children may feel abandoned by both the deceased parent and the living parent, whose grief may make him or her unable to emotionally support the child.

    Age 9 and older

    Children aged 9 and older know that death cannot be avoided and do not see it as a punishment. By the time a child is 12 years old, death is seen as final and something that happens to everyone.

    Grief and Developmental Stages

    Age Understanding of Death Expressions of Grief
    Infancy to 2 years Is not yet able to understand death. Quietness, crankiness, decreased activity, poor sleep, and weight loss.
    Separation from mother causes changes.
    2-6 years Death is like sleeping. Asks many questions (How does she go to the bathroom? How does she eat?).
    Problems in eating, sleeping, and bladder and bowel control.
    Fear of being abandoned.
    Tantrums.
    Dead person continues to live and function in some ways. "Magical thinking" (Did I think or do something that caused the death? Like when I said I hate you and I wish you would die?).
    Death is not final.
    Dead person can come back to life.
    6-9 years Death is thought of as a person or spirit (skeleton, ghost, bogeyman). Curious about death.
    Asks specific questions.
    May have fears about school.
    Death is final and scary. May have aggressive behavior (especially boys).
    Worries about imaginary illnesses.
    Death happens to others, it won't happen to me. May feel abandoned.
    9 and older Everyone will die. Strong emotions, guilt, anger, shame.
    Increased anxiety over own death.
    Mood swings.
    Death is final. Fear of rejection; not wanting to be different from peers.
    Even I will die. Changes in eating habits.
    Sleeping problems.
    Regressive behavior (loss of interest in outside activities).
    Impulsive behavior.
    Feels guilty about being alive (especially related to death of a brother, sister, or peer).

    Most children who have had a loss have three common worries about death.

    Children coping with a loss often have these three questions:

    1 | 2 | 3 | 4 | 5
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