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Grief in the Extended Family
last updated:
Tue, 11/29/2011 9:30 AM

by Jamie Droke
Child Life Specialist

The loss of a child has a profound impact on many people. Of course, the people closest to the child, particularly those who live in the same house as the child, are often affected the most because of how the loss has changed many details of their everyday life. Extended family members, however, can also face unbearable grief over the loss, even though this grief is often overlooked by others.

Consider, for example, grandparents who lose a grandchild. Their grief is complicated by the grief they experience while watching their child suffer the loss of a child. This can be true for aunts and uncles, cousins, and other extended family, who have suffered the loss of the child and now feel helpless in aiding the parents of the child in their grief.

I think we have talked about the stages of grief before on our blog, but it might have been a while, so here is a refresher, crash course on the stages of grief and particularly how these stages play out or affect extended family members. Just a reminder, someone who is grieving may experience these in any order, may move onto another stage and then return to a previous one, skip a stage all together, or stay in one stage for an extended period of time while hurrying through the others.

  • Denial: This is often, but not always, the first stage of grief. For extended family members, denial often comes in the form of numbness as they attempt to simply get through the first couple of days, supporting the parents and siblings but not paying much attention to their own grief.
  • Anger: This stage is sometimes experienced as guilt, as in a grandparent feeling guilty that the child’s life ended before their own. Sometimes anger is felt towards God, medical staff, or the circumstances surrounding a child’s death.
  • Bargaining:  Extended family members often find themselves bargaining with God, that they should have been “taken” instead of the child that was lost. Some family members will make resolutions to be a better person if only the pain and hurt will go away.
  • Depression: Sadness and depression is a normal part of any grieving process, and in my opinion, evidence of this stage is present throughout the entire grieving process. Sadly, sometimes extended family members do not feel comfortable sharing this stage with others. They may think they need to hold it together for the parents, or that by experiencing their own sadness they are detracting from the parents’ sadness.
  • Acceptance: This final stage of grief is a difficult one to reach. Accepting the loss does not mean forgetting the child or no longer missing him or her. And for extended family members it is also complicated by accepting a change in the legacy they are leaving behind. Part of a person’s legacy is in their children and grandchildren, and to lose a grandchild is like a loss of part of your legacy. Acceptance means that family members are able to remember the happy memories of their lost loved one and regain a new normal.

If you or someone you know has lost a grandchild, niece or nephew, cousin, or other extended family member, give yourself and them time to grieve the loss in any combination of these stages. Listening and providing emotional support by validating their feelings of loss can help family members move towards acceptance over time.

Teens & the Death of a Peer (pt. 2)
last updated:
Wed, 9/29/2010 9:30 AM

by Dana Givens, Child Life Specialist
and Jenny Shelton, Child Life Manager

Yesterday, we discussed the developmental factors and the stages of grief that impact adolescents.  Being a teenager is already a tough process, and the death of a peer makes it that much more difficult.  Today, we’ll cover the reactions of teens and what you can do to help.

Adolescents respond to grief in many different ways.  Some adolescents may be visibly upset, while others may appear to have little to no reaction.  Still others may act out, laugh, or act inappropriate at times.

Adolescents, like adults experience a wide range of feelings when they learn that someone has died.  Unlike adults, they are less able to hide unacceptable feelings.  Adolescents may also display their feelings through physical symptoms such as headaches, stomach aches, fears about their health, difficulty eating/sleeping/concentrating and becoming easily agitated. 

When a peer dies, adolescents can be particularly vulnerable to feelings of fear and guilt.  Adolescents who may have had a fight with the deceased peer may feel a sense of responsibility and guilt about the death.  They may also experience survivor’s guilt; wondering like their peer died and they are alive.  These responses are all normal for adolescents.  It is important to pay close attention to the severity, intensity, and duration of symptoms to determine if professional assistance is needed.

The death of a peer can greatly affect an adolescent, even if they did not know the peer personally.  Therefore it is important to provide opportunities for adolescents to express their feelings of grief and loss.  Rituals (sending sympathy cards or attending the funeral) can provide a source of continuity and support.  Often adolescents need to spend time with their peers.  Parents/Caregivers can encourage adolescents to spend time with their peers and/or open their home to them. 

It is important for caregivers to be attentive and present when their adolescent is grieving.  Be there to answer their questions and reassure them that their feelings are normal.  Caregivers need to remember it is important to provide a sense of structure and stability during a time of disruption/crisis.  Gently enforce limits and monitor their activities to ensure that they are not engaging in risky behaviors.

Dealing with the death of a peer can be difficult on anyone, and it is easy for parents/caregivers to feel like they don’t have the right words.  Remember, it’s not about being able to say the perfect thing, but instead that you are there, being supportive.  Don’t be afraid to laugh and cry with them.  Just know that the most important thing is that you’re there.

Teens and the Death of a Peer
last updated:
Tue, 9/28/2010 10:26 AM

by Dana Givens, Child Life Specialist,
and Jenny Shelton, Child Life Manager

While working at Le Bonheur Children's, you get to interact with some of the most greatest kids you could ever hope to meet.  Since child life specialist work in specific areas, we typically get to know patients with particular type of diagnosis.  Over the past few months, we have had a group of teen patients, that share a similar diagnosis, that has had to deal with several deaths of their peers.  It is for that reason, we wanted to take a moment to talk about teens and the death of a peer.

Being an adolescent in today’s society can be a very stressful task, and dealing with the loss of a loved one at the same time can be overwhelming at times. During the adolescent years, teenagers go through many changes, physically, emotional, socially, and cognitively.

Physically there is a rapid growth change in height. Puberty begins for both males and females, where their bodies are preparing for adulthood. Emotionally adolescents are dealing with the changes of their outward appearance and how others perceive them. They are striving to become independent, and need autonomy from parents.

Adolescents mostly rely on the support of close friends and peers rather than parents. Socially peers are very important at this stage of development. At this time adolescent spend more time with peers/ close friends than family members. Conformity to peers increase at this time, as “fitting in” with others becomes very importance. Dating becomes very important. Often there are numerous relationships that take place during this time and risky behaviors, such as unsafe sex, drinking, and smoking.

Cognitively adolescents are more able to think abstractly than before. Adolescence can think hypothetically rather than being limited to things/event that they can directly observe. Adolescence begins thinking more often about the process of thinking itself, or metacognition., as a result, adolescents may display increased self-consciousness.
Kubler-Ross Stages of Grief

  • Denial- “This can’t be happening.” Refusal to accept facts, information, or reality relating to the situation. Feelings of: shock, fear, and numbness
  • Anger- “How can this happen?” “Who is to blame?” Being upset at themselves or others as way to cope with the situation. Feelings of: frustrations, irritation, shame
  • Bargaining- “I’ll do anything for a few more days with him” Attempting to bargain with whatever God/religion the person believes in to make the situation better. The hope that they can postpone death. Feelings of: reaching out, desire to find meaning
  • Depression- “I’m so sad, why bother doing anything at all.” Preparatory grieving, beginning to understanding the certainty of death. The  person has came to terms with reality of the situation and has emotional attachment. Feelings of: helplessness, lack of energy
  • Acceptance- “ It’s going to be okay.” Emotional detachment and objectivity, comes to terms with death. Feeling of: calmness, acceptance, and new plan in place.

Since everyone grieves in their own way everyone will not go through all of the stages. Some people may go through the stages in a different order than others. Other may go through some stages and regress back to another before coming to acceptance, and that is okay. Just being aware of the process makes you better prepare to help your child through the grieving process.

Reflections on Day 2 of Bravehearts
last updated:
Sat, 6/12/2010 9:30 AM

by Stephanie Martin
Child Life Intern

Camp Bravehearts has been an amazing experience so far. Today, groups were led that continued to teach children that it is ok to feel a wide range of emotions when dealing with the loss of a loved one. Common fears most children expressed were sad, angry, and confused. Other emotions that were expressed were happy, joyful, and jealous.

These emotions are not commonly correlated with death however are feelings expressed by the children when they recall happy memories or perhaps have seen there loved one suffer for an extended period of time. Jealousy was expressed by children who stated that it made them jealous that someone else had a certain loved one in their lives while they did not.

Many activities were led today to help the children continue to cope with their losses. I found it interesting how differently children expressed their emotions, some expressed themselves verbally, some through art, others through writing, and some through outward actions.

Watching the different age groups today showed that children, even as young as five, can understand why their loved one died, what happened, and even ask questions about the events. Some children stated that they knew what happened to their loved ones, while others stated they did not want to know. I liked observing how each child was uniquely different in how they coped with the death of their loved one.

One activity done today that I observed with the five- eight year old group was that the leader had them write down on a rock all the negative feelings they had, or any feeling they had that they wanted to leave at camp and not take home with them. Once all the children had their rocks we went to the lake where the children threw their rocks into the water as they screamed out what they wrote down. All the campers today also got to make memory boxes. They painted the boxes and decorated the boxes however they wanted to, and then inside they put things that would help them remember their loved ones who had passed on.

It was very moving to see how even the simplest of activities could be an outlet for children to be able to express themselves and how they are feeling.


About the author:  Stephanie Martin is from Little Rock, Arkansas and a graduate from the University of Arkansas at Fayetteville. She has her bachelor’s degree in Child Development with an emphasis in Health Sciences.

Reflections on Day 1 of Bravehearts
last updated:
Fri, 6/11/2010 9:30 AM

by Anne Hamilton
Child Life Intern

My name is Anne Hamilton, and I’m one of two Child Life interns at Le Bonheur Children’s this summer. Yesterday I had the opportunity to volunteer on the first day for Camp Bravehearts. It is a three day grief camp for children in the Memphis area who have lost a family member or loved one.

This was my first experience working at a bereavement camp, so I was excited to meet these children and their families. After an hour spent together on the first day, the kids began to understand that they indeed have different stories, but they also have something in common. Each person at this camp lost someone very special to them. They realized for the next three days, they didn’t have to act like everything was okay, but they could finally be honest with other children like themselves and together they could begin to let go.

The day was busy. Of course we climbed the rock wall, ran under the parachute, soaked ourselves in the water games, and took part in all kinds of camp fun, but our main focus was to work through the reason we were there - grief. I spent most of my day with the six, seven, and eight year olds, and we used our time to talk about emotions. We learned that it’s okay to be sad, mad, angry, jealous, and confused all at the same time. We learned that we don’t always have to have it all together, and some days will be harder than others. We learned that it’s okay to cry and let those feelings out. We came up with ideas to express our emotions in ways that don’t hurt us or those around us. We used art and drawing as an avenue to explain those feelings to our new friends.

I know it can be hard to open up and talk about someone we love that has died, so I was honored that these kids would allow me to listen. I came to give but so much was given to me. These kids were a blessing to be around, and I personally was so encouraged. It is not easy to face grief, and it does require courage. I am so proud of these kids for their bravery, and I am grateful for the opportunity to share in their lives.

About the author:  Anne Hamilton is a Child Life intern at Le Bonheur Children’s Hospital. She is from Florence, Alabama and will graduate from The University of Alabama in August. She plans to pursue a career as a Child Life Specialist.

Talking with Children About Death
last updated:
Thu, 6/10/2010 9:30 AM

by Jenny Shelton
Child Life Manager

As Thomas, our summer interns, and myself head off to provide therapeutic interventions at Camp Bravehearts (Methodist Hospice's grief camp for children ages 6-16 and their families) this week, I though it would be a good time to tack the difficult subject of death in relation to talking with children.  I must quote my three year-old nephew (Thomas), who randomly brought up death in our last phone conversation about people we love: “Aunt Jen Jen, one day we will all die, right???   But, not right now…maybe in a little while.”

As much as we would like to ignore the subject, we know that every living thing as a lifetime.  I think that one of the hardest conversations that parents have to engage their children in is telling them that someone special has died.  As a Certified Child Life Specialist in the pediatric intensive care unit (PICU), my role is to help parents find the appropriate words when talking to their child(ren) when someone has died.  The first thing that I educate parents on is how children understand death at different ages.  Children under the age of five have difficulty understanding that death is irreversible and need to hear concrete statements using the words “died” or “dead” to start to master this concept.  Children do not fully understand the concept of death until about the age of nine or ten.

I also, in my conversations, encourage parents to be honest and provided simplistic explanations about how the person died.  By having explanations children are able to better understand the situation surrounding the death versus using their imaginations to fill in the blanks.  When someone special has died this is a great time to talk with children about feelings and how to express those feelings in a positive way.  Allow your child(ren) to see you become emotional, because we learn to express our emotions through modeling those around us. 

I always encourage parents to be available for children as they grieve the death of someone special by providing support and answering questions that come up in the process.  Children are very intuitive and come up with some of the most inquisitive questions about death, so be prepared and know that you will not have all of the answers.  Finally, grief is not something that you get over it is something that you journey through…this is true even for children.

Things to Remember:

  • Your child’s understanding of death
  • Give honest and simplistic explanations
  • Talk about feelings
  • Model positive ways to express grief
  • Be available for support and questions
Talking with Children about Death
last updated:
Fri, 4/16/2010 9:10 AM



by Thomas Hobson
Child Life Director


There are times that death seems like one of the most taboo topics in our society. It is one of the most difficult experiences a family can go through.  To make the situation harder, the thought of talking to children about death can be hard for parents.  Death is a topic that many feel like the have no idea what to say or which words to use.  Having children ask questions about death can be even harder when, especially if you are still processing your own feelings. 


This past Wednesday (April 14, 2010), PBS aired a Sesame Street special dealing with children and grief.  It centers on the character Elmo and the death of his uncle, and is hosted by Katie Couric.  Much like every thing else done by the Children’s Television Workshop, it is extremely well done and is a wonderful resource for parents.


I’ve included a clip from an interview done earlier this week on the special:

If you would like to see the entire episode of PBS’ When Families Grieve, the Sesame Street special click here.


There are situations in the hospital when families have to talk to their child about the death of a loved one.  Here at Le Bonheur Children’s, Child Life Services has served as a resource for families in these situations.  We work together with the rest of the interdisciplinary team to help equip families with the right tools to communicate.


Additionally, there are some wonderful resources in the community that can provide support to you and your child.  If you have a child that has been struggling to cope with a recent death, I would recommend looking into Camp BraveHearts. It is a family grief camp that is hosted by Methodist Hospice and has several of us in Child Life Services working directly with the camp.


Talking with children about death and grief can be one of the hardest conversations that you can have.  Just know that there are wonderful resources in the community to help with preparing for the discussion and providing support during the grief process.  It may not be something that you’re comfortable talking about, but it will be a strengthen experience for both you and your child.


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Le Bonheur Children's Medical Center is a leading children's hospital in the Mid South, providing pediatric care to children from 95 counties in six states.
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