Helping Children and Adolescents Think About Death, Dying and Bereavement PDF

How can children and adolescents begin to understand death
and cope with bereavement? And how can we, as adults,

support and engage with young people as they face the death
of someone close to them, or think about their own dying?
Marian Carter
Marian Carter
Exploring how children and adolescents can engage with all
aspects of death, dying and bereavement, this complete guide
looks at how children comprehend the death of a pet or, for
Helping Children and
example, a grandparent, their own death, bereavement and
grieving. It combines reflections on experience, sociological,
Adolescents Think about
psychological and historical insights and perspectives from
different world faiths to offer guidance on how to discuss
Death, Dying and
death with children. It places a particular emphasis on the
importance of listening to the child or adolescent and adapting Bereavement
your approach based on their responses. The book also
explains how personal experiences of loss can provide you
with models for interacting with young people on the
subject of death.
about Death, Dying and Bereavement

Helping Children and Adolescents Think
‘Helping Children and Adolescents Think about Death, Dying
and Bereavement is a comprehensive resource that addresses
how young people feel and think about death and includes
practical suggestions on how to include them when a pet or
person dies in their life. Marian Carter has shared excellent
examples about children and has created a useful “spiral
curriculum” to aid the reader in understanding a situation
more deeply. She also includes interventions that schools
can use to help kids cope with bereavement. I would highly
recommend this book to parents and professionals working
with grieving children.’
— Linda Goldman, author of Great Answers to Difficult
Questions About Death: What Children Need to Know
Marian Carter is an experienced chaplain and educator

who has worked in hospital and hospice settings
and in theological education.
Jessica Kingsley Publishers
www.jkp.com
Cover design: www.ianrossdesigner.com
Carter_HelpingChildren_UKPB_AW.indd 1 09/06/2016 17:49

Helping Children and Adolescents Think
about Death, Dying and Bereavement
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Talking About Death and Bereavement in School

How to Help Children Aged 4 to 11 to Feel Supported and Understood
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What Does Dead Mean?

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Helping Children and
Adolescents Think about
Death, Dying and
Bereavement
Marian Carter
Jessica Kingsley Publishers

London and Philadelphia
All Bible quotations are taken from the New Revised Standard Version Bible: Anglicized
Edition, copyright 1989, 1995, Division of Christian Education of the National
Council of the Churches of Christ in the United States of America. Used by permission.
All rights reserved.
First published in 2016
by Jessica Kingsley Publishers
73 Collier Street
London N1 9BE, UK
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA
www.jkp.com
Copyright © Marian Carter 2016
Front cover image source: iStockphoto®. The cover image is for illustrative purposes
only, and any person featuring is a model.
All rights reserved. No part of this publication may be reproduced in any material form
(including photocopying, storing in any medium by electronic means or transmitting)
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Warning: The doing of an unauthorised act in relation to a copyright work may result in
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Library of Congress Cataloging in Publication Data
Names: Carter, Marian, author. Title: Helping children and adolescents think about
death, dying, and
bereavement / Marian Carter. Description: Philadelphia : Jessica Kingsley Publishers,
2016. | Includes
bibliographical references and index. Identifiers: LCCN 2016004457 | ISBN
9781785920110 (alk. paper) Subjects: LCSH: Children and death. | Death--
Psychological aspects. Classification: LCC BF723.D3 C37 2016 | DDC 155.9/37083-
-dc23 LC record available at https://lccn.loc.gov/2016004457
British Library Cataloguing in Publication Data
A CIP catalogue record for this book is available from the British Library
ISBN 978 1 78592 011 0
eISBN 978 1 78450 255 3
To all the children who have challenged
me and from whom I have learnt.
To Jo Roberts, a friend and encourager.
To editors Natalie Watson, Jane Evans and

Kerrie Morton for their wise and helpful comments.
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
1. What is Death? . . . . . . . . . . . . . . . . . . . . . . . . . . 15
2. Grief and Bereavement . . . . . . . . . . . . . . . . . . . . . 39
3. Challenging Factors Influencing Grief . . . . . . . . . . . . . 63
4. What Should We Tell Children and Adolescents? . . . . . . . 89
5. Schools Coping with Bereavement and Death . . . . . . . . 109
6. Funerals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
7. Continuing Care of Children and Adolescents . . . . . . . . 155
8. Care of the Carers Including Ourselves . . . . . . . . . . . . 171
9. Weaving the Threads Together . . . . . . . . . . . . . . . . . 188
Appendix 1: Creating a School Policy for the Pastoral Care

of Bereaved Pupils . . . . . . . . . . . . . . . . . . . . . 192
Appendix 2: Creating a School Policy: Exploring Loss through

the Curriculum . . . . . . . . . . . . . . . . . . . . . . 196
Appendix 3: The Nature of Childhood . . . . . . . . . . . . . . . . . 200
Appendix 4: Babies and Infants Dying . . . . . . . . . . . . . . . . . . 201
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Useful Websites and Organisations . . . . . . . . . . . . . . . . . . 214
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224

Introduction
Working in schools, hospitals, hospices and a parish I have been

challenged and inspired by the insights from and conversations
with children and young people. It is an amazing privilege. I have
always been a teacher in primary and secondary schools and trained
teachers and clergy while working throughout in a voluntary capacity
with children and adolescents. Bereavement has been a significant
area of conversations. For nine months, I lived with a family whose
young mother had died leaving three children and learnt rapidly the
understandings and needs of each of them. More recently, I have
been alongside my teenage niece, an only child, in the terminal illness
and death of my sister, her mother. I have worked in a hospital with
responsibility as a chaplain for the Special Care Baby Unit; then as
a full-time hospice chaplain I was involved with the children and
grandchildren of patients, leading funerals with children present and
running courses for teachers and social workers on bereavement care.
The book is concerned with how children and adolescents
understand death, their own mortality and the death of someone they
love, including pets; how children deal with bereavement and funerals;
and how they can be supported in continuing care. It is intended to
be used by parents and professionals, children and youth workers,
health professionals, social workers, funeral directors, teachers and
ministers of religion – both those in training and qualified in all these
professions – who face children’s grief and their questions about death.
This is a theoretical and practical resource, since there is no
comprehensive book available, and this is a growing concern with
the recognition that learning about death is part of a child’s ‘primary
socialisation’ without which the child is likely, subsequently through
adult life, to suffer psychological problems such as depression when
faced with mortality. I have experienced that children have a freshness
and openness in attitudes to death and can be a model from which adults
9
10 Helping Children and Adolescents Think about Death, Dying and Bereavement
can learn; adolescents are more thought-provoking! The examples in

this book are from my own experience (the names have been changed
to honour confidentiality). Although most of my experience is from
a UK perspective, research indicates and includes North American
perspectives.
Since this book is significant as a resource for those who do not
have faith, the material on faiths will be with a light touch. Children
do ask questions about death such as, ‘Where is granny now?’ We
need to be open in exploring these with children. These are questions
common to those of different religious faiths, and those with none.
Each chapter has a pattern beginning with an illustrative diagram
– the hermeneutical circle (see below) – since it begins with experience
and leads finally to practical responses. At times, I refer back to the
original experience: this is an example of the ‘spiral curriculum’, since
when we return we will have a deeper understanding of a situation.
The experience A child’s

of readers experience
Resources for An adolescent’s

readers experience
Reflection
Drawing together
experience and Cultural context –
cultural context Material from the
leading to practical human sciences
implications
Believers’
experiences –
world faiths
Each chapter also includes activities to elicit the reader’s experience.
Chapter overview
Chapter 1: What is Death?
Children suffer losses, and death is the ultimate loss. Death is
experienced in many ways – on the TV news, children playing
‘dead’ in the playground or the death of someone close, for example
Introduction 11
a parent, grandparent, favourite teacher or sibling. The development

of the stages of understanding in children come from insights in the
psychological and social sciences and listening to the experience of
children’s voices and questions. Both those of faith and those with
none wrestle with the meaning and significance of death.
Chapter 2: Grief and Bereavement

Children experience a range of emotions and express their grief in
related behaviour. Grief may seem like jumping in and out of puddles,
one minute sobbing the next asking what is for tea. Adolescent grief
is more hidden. The grief of an adult is more consistent and is often
hidden, a taboo in UK culture. World faiths have rituals and customs
of grieving which are distinctive to each faith.
Chapter 3: Challenging Factors Influencing Grief

Grief and the behaviours associated with it depend on the nature of the
relationship. Each person responds in their own way. Grief is unique.
Different types of death are explored – a miscarriage, terminal illness
of a child and parent, a sudden death and a suicide. Each bereavement
is unique.
Chapter 4: What Should We Tell

Children and Adolescents?
As adults we need to listen to the child; children are very realistic and
‘down to earth’. This listening will give us clues to the approach to use
to comfort and reassure children. Euphemisms such as ‘Gran has gone
away for a holiday’ and ‘Grandad is a star in the sky’ are examined.
Anticipatory grief and actual grief raise questions about how much
a child should be told about a situation. Adolescents need listening
to rather than telling. World faiths explore understandings of a life
beyond death. How is this handled with children? Is it possible to live
on beyond death?
Chapter 5: Schools Coping with

Bereavement and Death
Bereaved and grieving children and young people attend school.
Should schools respond? An exploration of response is through the
significance and practice of pastoral care and through the curriculum.
Models of these two responses are suggested. A large proportion of

schools are faith schools and reflect each of the different world faiths.
Their contribution and the criticism of them are examined.
Chapter 6: Funerals: The Attendance and

Participation of Children and Adolescents
Should children be encouraged to attend a funeral? We look at
preparing a child for what will happen at a funeral. Can a funeral be
child friendly? What arrangements need to be made for a child or
adolescent to attend a funeral? Can a child play a role in the funeral?
What are the alternatives, if we are taking grief in a child or adolescent
seriously? The rituals of each of the world faiths are examined.
Chapter 7: Continuing Care of

Children and Adolescents
What form might this take and who might be responsible? As adults
we sometimes forget that a child or adolescent needs to revisit a
significant loss. However, the continuing remembrance of a loss may
become pathological and need professional help. There are public
occasions when those who have died are remembered, such as at
the Cenotaph. Practical suggestions are given in the chapter to help
children and adolescents positively to grieve.
Chapter 8: Care of the Carers Including Ourselves

Parents and professionals are asked to recognise their own losses and
remember how they coped; these losses might well be ignited again in
working with bereaved children and adolescents. Resources for ‘stress
busting’ are examined and spiritual resources are also looked at.
Chapter 9: Weaving the Threads Together

This chapter is a summary of the important points in regard to the care
of bereaved children and adolescents including how, as adults, we can
learn from them as well as responding to their grief and distress.
The methodology used in this book

I have attempted to use the methods of Paulo Freire (1921–1997),
so that as a reader you may make links with your own professional
Introduction 13
experience and relate new insights to your existing life experience and
knowledge. Paulo Freire challenged traditional education methods
in his book Pedagogy of the Oppressed. His emphasis was on dialogue
signifying respect in the pupil–teacher relationship, in contrast to what
he describes as the ‘banking’ type of education, where the educator
‘deposits’ knowledge into the mind of the listener or reader. Freire
believed that the educator had to forget himself, to die in order to be
born again and to educate alongside, to teach and learn from the person
being taught. Education was about praxis; it deepened understanding
and made a difference to building community, leading to actions for
justice and human flourishing. His is a pedagogy of hope. He wrote
of conscientisation, of developing a consciousness in people that has
the power to transform their thinking and attitudes. Freire’s learning
used personal experience, narrative, the senses, the imagination, life
stories, experience and exploring together. I have attempted to follow
his example.
The method to be used in this book is one of lifelong learning. In
current adult education individuals are encouraged to have a ‘buddy’
or a ‘mentor’. The invitation is for the reader to find someone with
whom to share. You will be invited to engage with this book through
activities, questions and reflection in the section of each chapter headed
‘Activities to elicit the reader’s experience’. My hope is that you and
your ‘work’ in supporting bereaved children and adolescents will be
enriched. If you would like to enter into a more personal dialogue,
then that is possible. I have set up a website (dyingtolive.org.uk) for
conversations and comments.
1
What is Death?
If you never get born you never have to die, but you miss a lot.
(Alison in Marshall 2003, p.86)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
A child’s experience
Stephanie, a three-year-old, lived in a rural village. She and her mother
came across a dead pheasant while walking across a field. Stephanie
was rather surprised that it did not seem to move. Her mother explained
that it was dead. ‘If I breathe on it, will it come alive?’ she asked. Later
Stephanie asked her mother, ‘Will you die, Mummy?’ ‘One day,’ her
mother replied, ‘but when you are much older.’
15
Reflection on experience
We each have a need to make meaning from our experiences of life.
Children have a drive to make sense of the world in which they live
and Stephanie was doing just that. She knew that living things like
pheasants move and breathe; if she breathed on the pheasant, it might
live. Early humans noted the importance of the breath. The breath was
the life, the spirit of a person. When the breath ceased, so did life and
death resulted. Children need their questions answered honestly. Her
question, ‘Will you die, mummy?’ needed the truthful answer, ‘One
day’ and the reassuring words, ‘but when you are much older’ that her
mother would be present for her now and for years to come.
An adolescent’s experience
The major event of 11 September 2001 shook the world. Many people
can recall where they were when the attack on the twin towers of the
World Trade Center in New York City happened. Regular television
and radio programmes were suddenly interrupted, and American TV
took over. We watched in horror. Was this a film or reality? On a clear
Tuesday morning an American Airlines Boeing 767 with passengers
on board was hijacked and crashed in the North Tower leaving a
gaping, burning hole near the 89th floor of the 110-storey skyscraper,
instantly killing hundreds and trapping hundreds more in upper floors.
Eighteen minutes later a second Boeing 767 United Airlines Flight
175 turned sharply and sliced into the south tower near the 60th floor.
Debris was showered over surrounding buildings. Fifteen minutes later
the South Tower collapsed, followed later by the North Tower. Three
thousand died in the World Trade Center and its vicinity, including
343 firefighters and paramedics, 23 police and 37 Port Authority
police. The event dominated the news for several days. A year later a
group of secondary school pupils in the UK were asked to recall the
event. Natalie, aged 15, said:
It was like something you saw in a film, but this was real, and that
shook me up inside…I kept asking myself, how can any human
being treat another with no care at all? No care about whether they
live or die, no care about how many families they destroy. (Natalie,
quoted in Duffy 2008, p.46)
What is Death? 17
We live in a world where communication can be almost instantaneous.
Acts of terrorism continue, fear of further threats of death lie at the
door. We are all involved. It may seem as Natalie said, at first like ‘a
film’, but death is a reality, its presence and immanence unknown to us.
Linking adult, child and adolescent experience

In the UK, there is a taboo among adults about talking of death, but
this is beginning to change. Groups like the Dying Matters Coalition
are beginning to develop, and there are ‘Death Cafes’: the first in
Britain took place in September 2011, organised by Jon Underwood,
‘to create an environment where talking about death is natural and
comfortable…death is a catalyst to think about important things
in life’ (Battersby 2012). Underwood mentions that we ‘out-source’
death to hospitals, behind closed doors, but gradually death is being
brought out of the shadows (Battersby 2012). There are websites to
be found on the internet through which you can find death cafes near
you. Funeral festivals are advertised in national newspapers. They are
organised by funeral directors concerned that people should know the
choices of prepayment funeral plans, wills and advanced directives.
In the USA, ‘Death over Dinner’ is encouraged as a way to talk in an
informal way over a meal with friends and strangers about personal
experiences with life and death. One hostess, a former hospice
volunteer, said:
We want to talk in an informal way about personal experiences with
death. How do people want to die? Have you shared that with anyone?
What deaths have you experienced? We don’t want to be distasteful,
or uncomfortable, but an uplifting atmosphere. (Hafiz 2013)
There are published accounts of dying such as those of The Guardian
columnist John Diamond (Diamond 1998), Philip Gould (Gould
2012) and Christopher Hitchens (Hitchens 2012). There are guides
to dying well, for example that by Rabbi Julia Neuberger (Neuberger
1999) and other factual and fiction books about death (Albom 2003;
De Hennezel 1997; Levine 1986; Reoch 1997; Schwartz 1998). An
online search will find ‘training and life coaching classes’ and one of
the tasks on such a course is to write your obituary. This is a reality
check to ask the questions ‘why am I here?’ and ‘what do I want to be
able to say about my life at the end?’ In the USA, Legacy.com publishes
self-written obituaries each month; the UK equivalent is ObitKit.com.
There have been reality type films such as the documentary Life
Before Death (2002) about pain relief for dying patients, Shadowlands
(1993) the story of C.S. Lewis’s wife’s dying, Dying Young (1991) about
a nurse working with a dying young man, I Didn’t Want That (2012),
The Bucket List – Time to Start Living (2007) where two terminally ill
men fulfil dreams before death and The Fault in Our Stars (2014), which
tells the story of two teenage cancer patients beginning a life affirming
journey. There have also been fantasy films such as Death Becomes Her
(1992) where an immortality treatment replaces death, Sixth Sense
(1999) in which a young man communes with spirits of the dead and
Lonely Bones (2009), in which a murdered girl comes to visit her family.
In the UK, the Wellcome Institute had a display from autumn 2012 to
spring 2013: ‘Death: A Self-Portrait, the Richard Harris Collection’.
A newspaper stated:
Death in a secular and medicalized world has been made into
something to be put off. All credit to the Wellcome Foundation for
holding a show that reminds us that death has been an intrinsic part
of life through most of human history. (Hamilton 2012)
In contrast to an adult obsession, young children in particular are
fascinated by death and talk about it naturally, though their concept
development is different from that of adults. The American psychologist
J.A. Graham believes that children’s comprehension of death depends
on both experience and developmental level:
Children’s experiences with death (i.e. actual experience and what they
have been told about death) are critical to their understanding,
they also do not have enough life experience to realize that death is
inevitable for all living things. Children may not understand that death
is permanent and that it cannot be ‘fixed’ or reversed. (Graham 2013)
Death is a loss – the ultimate loss – and is experienced by children and
adolescents. In 2012 in the UK over 3000 babies died before their
first birthday – for reasons ranging from preterm underweight birth,
poor prenatal care, poverty, social inequality and abuse – and over
2000 children and young people died between the ages of one and
nineteen. One in five deaths is of those between 15 and 19 years as a
What is Death? 19
result of road accidents, risk-taking behaviour, poisoning and cancer

(Wolfe et al. 2014).
Every day more than a hundred children in the UK are bereaved of
a parent, 24,000 every year; 6 per cent of 5–16-year-olds – 537,450
in the UK – have experienced the death of a close friend of the family;
and the incidence of memories of childhood bereavement undealt
with in youth offenders can be up to ten times higher – 41 per cent –
than the national average of 4 per cent. These facts and figures come
from the charity Winston’s Wish which is the major provider of care
for the bereaved child in the UK.
Children and adolescents, in common with everyone, experience
loss across a wide range of experience. Physical losses may be the
security of the womb at birth, health through infections, a tooth,
the hormonal change of puberty or an illness resulting in a loss of
freedom which may be temporary or permanent. The ultimate loss is
the death of a person – a grandparent, parent, sibling or peer-group
friend – or a terminal illness of the child or adolescent himself. Social
loss might include moving house and school through changed family
circumstances with the ensuing break of friendship groups. Emotional
loss is felt with the separation or divorce of parents, parents changing
partners, the ending of a peer friendship and the breaking down of
a relationship. A loss of self-esteem may result from poor marks in
school, failing an important exam or parents’ divorce. Loss can be
spiritual loss, a feeling of being alone; a lack of self-worth; feeling
unloved; or feeling life has no purpose. Loss can be vicarious through
television dramas, ‘soaps’ and from adverts and computer games.
Sociological, psychological
and historical insights
What is death? How is death historically defined? In 77–79 ce, the
Roman author Pliny the Elder wrote in his Historia Naturalis, ‘so
uncertain is men’s judgment that they cannot determine even death
itself ’. In 1768, the first edition of the Encyclopaedia Britannica defined
death as, ‘the separation of the soul and the body’, reflecting the
context of a predominantly religious society. In 1974, in the fifteenth
edition of the Encyclopaedia, the definition was 30 times longer and
solely from a biological standpoint. One reason for this is that medical
advances make it more difficult to determine if a person is dead. The
nearest definition is, ‘the final cessation of activity in the central

nervous system noted especially by a flat electroencephalogram for
a predetermined length of time’. But is this satisfactory? Death can
be ‘reversed’ with an electric shock, cardiopulmonary resuscitation
(CPR). Breathing and heartbeat can sometimes be restarted. Without a
functioning heart or lungs, life can be sustained with a combination of
life support devices, organ transplants and artificial pacemakers.
The social historian Philippe Ariès notes changes in perceptions
of death (Ariès 1974, p.28). He begins with ‘tamed death’, anticipated
through natural signs and a dying person’s premonition, typical of the
Early Middle Ages. It needed preparation by the dying person: being
at peace within one’s self, making peace with others and God, so that
the dying person could rest, knowing their immortality was assured.
The Middle Ages emphasised humanity’s collective judgement at the
end of time, but by the fifteenth century the focus was on individual
judgement after death, which called for preparation during life, and
a manual emerged, Ars Moriendi (Art of Dying), to educate priests in
ministry to the dying.
Today attitudes are very different. Ariès states that society denies
death. It has become ‘excluded, invisible, wild, untamed by ritual or
community’ (1981, p.585). Ariès believes this is related to the dominant
model of western health care – the medical model – a sociological
term which indicates that, from the mid-twentieth century, illnesses
of body and mind have an underlying cause which can usually be
diagnosed, removed, reversed or replaced in treatment. The patient
is cured and can return to the status quo existing before the illness,
thus death is denied. The success of medicine and public health can
be seen in the figures of life expectancy in the UK, which rose from
44 years for males and 47 years for females in 1990 to 78.2 years for
males and 82.3 years for females in 2012. However, if adults recognise
and admit their mortality the prospect would become less fearful and
adults might learn to enjoy the present moment.
A child or adolescent’s knowledge of death

Knowledge of death today is extensive from seeing a dead bird or
hedgehog in the road or garden, the death of a pet, a family member
with a terminal illness (this might include the child or adolescent him
or herself ), witnessing a road accident, death reported in the media,
films and game-stations. These death-related experiences in children
What is Death? 21
are more common than adults realise. Understanding death is an

important issue for children and begins at an early age.
The systematic study of children’s understanding of death began
in 1934 (Schilder and Wechsler 1934), and by 1995 there were over
a hundred such studies in the English language. However, progress
is slow and the results considered confusing (Speece 1995). Speece
and Brent list reasons for the lack of progress and confusion; two
of the most important appear to be first confusion over the names
for, definitions of and operationalisations of the various aspects
of the concept of death, and second, the lack of reliable and valid
standardised measures for these aspects (Speece and Brent 1996). To
help children we need to know how they think and how they process
information; this is clarified by the research.
The categories below are guidelines only and should not be
considered prescriptive for the child being helped. Children and
adolescents mature at different rates and their understanding will
depend on their life experience as much as their chronological age.
It is important to remember that parents know their own child best.
Children’s and adolescents’ concepts develop in stages from literal and
concrete to abstract; this includes their concept of death which, since
the 1970s, has been considered to be composed of several relatively
distinct sub-concepts, referred to in the literature as ‘components’.
For most research four are cited: universality, irreversibility, non-
functionality and causality.
Universality
This refers to the understanding that all living things must inevitably
die. The younger the child, the more likely they are to say that death
is not universal; some studies suggest children think that if you are
clever, or lucky, death is avoidable; also that it happens to others, such
as the old or the handicapped, but not to them (e.g. Speece 1995). It
takes time before a young child extends death to himself.
Irreversibility
Once the physical body dies, it cannot be made alive again. Younger
children are more likely to view death as temporary and reversible,
similar to sleep from which a person wakes or a holiday from which
there is a return. They may think reversal is possible as a result of
wishful thinking, praying or medical intervention. The latter reflects
advances in medical technology, but the success of cardiopulmonary

resuscitation will depend on the availability of appropriate resources
and the time factor of the nearness of medical help underlined
by the changing definition of what constitutes ‘alive’ and ‘dead’. In
the research children also respond with non-corporeal responses.
Common in young children is reference to ‘heaven’ although the
issue of irreversibility is in reference to the physical body. Children, in
common with many adults, often understand some form of personal
continuation after the death of the physical body, a continuing of
the soul or spirit without the body, or for others reincarnation in a
new body.
Non-functionality
This refers to the understanding that at death all the life-determining
capabilities of the physical – walking, eating, breathing, sensing –
cease to function. Younger children are likely to think that the dead
continue to be able to perform certain functions but not others. One
researcher found that children are more likely to realise that concrete,
observable functions such as eating and speaking cease with death,
than recognise that internal functions such as thinking, dreaming and
knowing cease.
Causality
There is no consensus on the definition of causality. Much research
agrees that it involves an abstract and realistic understanding of the
external and internal events that might possibly cause an individual’s
death, for example Speece (1995). ‘Abstract’ means that the given causes
are not restricted to particular individuals or events but are classes of
causes applicable to living things in general. ‘Realistic’ refers to the
fact that the causes stated are generally accepted by mature adults as
valid causes of death. Younger children may provide unrealistic causes
related to themselves, such as bad behaviour, or specific concrete
causes such as guns or accidents rather than more ‘abstract’ causes
such as illness or old age. Young children lack understanding that
death is finally a failure of internal body organs or functions.
What is Death? 23
Developmental stages and understanding of death

Younger children are likely to be more concrete in their thinking
and understanding of death while the older child and adolescent are
more realistic and abstract. The age at which children achieve an adult
understanding of the four key components varies between four and
twelve years. The majority of research suggests that at about seven
years old most children have understood each of the four key bio-
scientific components introduced above. Children are likely to ‘revisit’
any experience of death as they move through their developmental
stages. I will return to how the conceptual stages influence behaviour
and the care that needs to be taken with grieving children and bereaved
adolescents in Chapter 2.
Babies do not understand that a parent, sibling or a close relative
has died but sense the disappearance, particularly of someone who
daily responded to their physical and emotional needs, and the feeling
of sadness and the atmosphere of the home.
A toddler might show a basic understanding of death when
he sees a dead bird or insect in the garden but does not usually
understand the implications of this, for instance that the dead bird
cannot feel anything or won’t ever get up again. Toddlers continue to
sense the emotional feelings of sadness or anxiety in the home when a
significant person is missing and other relatives new to the child come
into the house. Games like ‘peek-a-boo’ are loved by toddlers; in such
games significant adults can disappear and reappear again and it is
through these games that the child may slowly begin to understand
the concept of ‘gone for good’.
Three- to five-year-old preschool children are egocentric. Many
consider that children of this age do not understand that death is final.
Some psychologists disagree, believing that children can comprehend
the permanence of death and can acquire a concept of heaven, albeit
concrete, since they are literal thinkers – heaven is therefore somewhere
with green fields, flowers, sunshine – whereas abstract concepts like
‘forever’ and the fact that death is permanent are difficult to grasp. They
do not grasp that the functions of life have ceased – their questions
reflect their concern about the physical wellbeing of the dead person.
Children tend to think of death as like sleep or a journey: people wake
up and Gran returns from holiday. Adults should not use the word
‘sleep’ or other euphemisms but the word death itself (see Chapter 4,
‘What Should We Tell Children and Adolescents?’). A child may well
ask about a dead mother, ‘When will Mum be home?’ Children use the
word ‘dead’ without understanding its full meaning – Susie, a three-
year-old, whose mother had died at home, was doing her jigsaw, but
there was a piece missing. Susie said the piece was ‘dead’. This age
group is very matter of fact and ask questions which the adults may
find difficult. They repeatedly want to know and be told the ‘story’
again. They are prone to magical thinking, experiencing themselves as
the centre of life; they may believe that their thoughts or actions can
cause things to happen to themselves and to others. The far-reaching
consequences of a death are not yet apparent to them. Children of this
age certainly express sadness and vividly describe their feelings, many
describing this as physical pain.
Five- to nine-year-old children are concrete thinkers. At this stage
children begin to develop an understanding that death is permanent
and irreversible, with all life functions ended and final. They may be
fascinated with the physical aspects of death or the rituals surrounding
it. This derives from a developing imagination and ‘magical thinking’
and assumes a dead person can see and hear the living. It is an age
of fear and fantasy. Children may personalise death as a skeleton,
a monster or a ghost and may become curious about the rituals of
death and functions of dead bodies, often asking if dead people need
food or clothing, which reinforces the belief that their thoughts or
actions caused the death and can lead them to fill in the gaps in their
knowledge. A child may see death as a person who might ‘come to
get you’ or ‘catch you’ if you are unlucky. This growing understanding
can lead to a fear of going to sleep or of the dark. Children will need
reassurance and comfort as they begin to realise their own mortality;
something like a night light may be helpful.
By the age of seven, children seem to be able to appreciate that
death is unavoidable and will happen to everyone, and that there is
a concrete cause of death, such as old age or accident. At this age,
generally, death means no longer being able to eat, sleep, laugh, cry
or feel pain. All life functions have ended. They are reluctant to see
death for themselves. Seven-year-old Amy’s terminally ill mother
died at home. Amy believed her mum died because the nurse was
late in coming to care for her mum, not realising the death was due
to the spread of her cancer. As they get older, children begin to have
a more mature understanding of death, realising its ‘external’ causes
– accidents – and ‘internal, natural’ causes such as disease and old
What is Death? 25
age and that it is final, permanent, universal and an unavoidable part

of life. Children can become fearful as a result of their deepening
realisation of the possibility of their own future death.
Nine- to eleven-year-old children are generally very matter of fact,
and the acceptance of death as a fact of life is evident. Death is accepted
as finality for all living things. It is inevitable and irreversible. Their
understanding of death is influenced by their own past experiences
of death and dying and the explanations that were given to them at
that time. There is a greater ability to think abstractly, with thinking
about fairness and fate, justice and injustice in relation to life and
death. These young people are aware that death will happen to them
but do not wish to dwell on it, but get on with living. Some might
continue to struggle with the finality of death possibly because of
certain religious beliefs, states Graham (2013), a clinical psychologist
in the USA. However, this may suggest a more mature understanding
of death rather than a less mature one. Children with immature,
binary concepts of death see people as either alive or dead, and do
not consider the idea that there may be any other options based on
religious values and ideas about an afterlife.
Adolescent understanding is influenced by the hormonal changes
of the age group. This is a period when there is a search for identity
and meaning in life and maturing cognitive ability. There is a gradual
ability to comprehend the finality and enduring consequences of a loss
coupled with the capacity to use abstract ideas and project the impact
of a death of someone known to them, family or friend, to the future.
Adolescents increasingly develop their own beliefs and strongly held
views, and may challenge the beliefs and explanations offered by
others. They sometimes find it hard to ask for support at a significant
loss, trying to show the world they are independent. Adolescents
may talk at length about the death, but seldom to those closest to
them in the family. Their peer group are very significant at this time
as a ‘sounding board’ distinct from the emotions of the family. The
awareness of their own mortality may however show itself through
risk-taking behaviour – ‘dicing with death’– such as drug taking or
racing at speed on a motorbike or in cars. Other characteristics are
mood swings and a refusal to cooperate at home. There is interesting
evidence relating to risk taking in adolescence. In some ways, this
can be thought of as natural for adolescents who are kicking over
the traces and establishing their own identities as distinct from that
of their family and upbringing. Nevertheless, each activity involves

high risks and may lead to death. However, the youngsters who had
encountered the death of a close relative at a young age were less
likely to ‘play’ with life through their teenage years. This suggests
that the sooner children learn about death in a natural way, as part of
life, the better.
Terminally ill children and adolescents

Interesting material is produced by the University of Rochester
Online Medical Encyclopedia on the concept of death in terminally ill
children. It indicates that that for a terminally ill child, past experience
of death of a family member or pet, as well as age and emotional
development, are what most influence a child’s own concept of death.
Interestingly, the article also notes that an adult’s misconception and
fears of death are often transferred to his children. A terminally ill
infant has no real concept of death but will react to separation from
known care-givers, painful procedures and an alteration in routine.
Similarly, for a toddler the concept of death has little meaning, but
he may pick up the emotions of the adults, of sadness, depression or
anger, and then become upset or fearful.
The preschool child may begin to understand that death is feared
by adults. The child may ask questions such as: why? and how? about
their own condition, and feel guilt and shame that he has caused the
adults’ sadness. School-age children are developing a more realistic
understanding, that death is permanent, universal and inevitable. Death
may be personified as an angel, skeleton or ghost but the child fears
because of uncertainty of what happens at death. Death is unknown,
control is feared. There is separation from family and friends. The
result for the terminally ill child is anxiety. An adolescent is beginning
to establish his identity, independence from family and significance of
the peer group. Adolescents may want their religious or cultural rituals
observed. A characteristic of adolescence is feelings of immortality or
being exempt from death. A terminally ill adolescent feels threatened
facing death and changes in appearance brought about by treatment
often result in feelings of aloneness or anger. It is important for parents
and care-givers to realise that each child or adolescent is unique and
needs a listener.
What is Death? 27
Believers’ experiences – world faiths

Traditionally, for centuries religions have given meaning to life and
death and hope of a life beyond death, but this has changed with the
decline in the adherence to institutional Christianity and the increasing
interest in spiritualities outside established and organised religion. The
statistics of the 2011 Census of the population of England and Wales
showed that within a population of 56.1 million, Christianity was the
largest religious group at 33.2 million, a decline of more than four
million since the census of 2001, contrasting with a rise of 1.2 million
in Islam. Around one in four stated that they had no faith. The British
Humanist Association said that the statistics on Christianity showed a
significant cultural shift in a society where ‘religious practice, identity,
belonging and belief are all in decline…and non-religious identities
are on the rise’ (Battersby 2012). The UK is multicultural and its values
diverse. It is also considered secular; that is, religious thinking, practice
and institutions have lost their social significance.
In 2013, an independent Commission on Religion and Belief in
British Public Life, convened by the Woolf Institute in Cambridge
with the Rt. Hon. Baroness Elizabeth Butler-Sloss as its chair, was
set up. It had 20 commissioners representing the major world faiths,
academics, industrialists and politicians from across Great Britain and
Northern Ireland and during its two-year project had local public
hearings in Belfast, Birmingham, Cardiff, Glasgow, Leeds, Leicester
and London. The final report was published on 7 December 2015
(Commission on Religion and Belief in British Public Life 2015). The
Commission’s purpose was ‘to consider the place of religion and belief
in contemporary Britain; to consider emerging trends and identities
and to make recommendations for public life and policy’. The report
noted dramatic changes in Britain’s landscape in terms of religion and
belief in the last half a century (p.9):
• The first is the increase in the number of people with non-
religious beliefs and identities. Almost a half of the population
today describes itself as non-religious, as compared with an
eighth in England and a third in Scotland in 2001.
• The second is the general decline in Christian affiliation, belief
and practice. Thirty years ago, two-thirds of the population
would have identified as Christians. Today, that figure is four
in ten, and at the same time there has been a shift away from
mainstream denominations and a growth in evangelical and

Pentecostal churches.
• The third is the increased diversity amongst people who have
a religious faith. Fifty years ago Judaism – at one in 150 – was
the largest non-Christian tradition in the UK. Now it is the
fourth largest behind Islam, Hinduism and Sikhism. Although
still comprising less than one in ten of the population, faith
traditions other than Christian have younger age profiles and
are therefore growing faster.
The report suggests that ‘intra- and inter-faith disputes’ linked with
today’s geopolitical crises across the Middle East and in parts of Africa
and Asia reflect back on UK society creating or furthering tensions
between communities. Ethno-religious issues and identities in the UK
and globally are reshaping society in inconceivable ways and ‘how we
respond to such changes will have a profound impact on public life’ (p.6).
In Section 6, ‘Dialogue’, the report recognises constructive
dialogue between ‘people holding different beliefs and worldviews,
and belonging to different traditions and backgrounds’ having ‘vital
roles to play in the tasks of building and maintaining relationships of
mutual understandings and trust, and of strengthening the bonds of
community’ (p.49). The London Society of Jews and Christians was
founded in 1927; the World Congress of Faiths in 1936 and the Council
of Christians and Jews in 1942. ‘Formal interreligious dialogue may be
bilateral, trilateral or multilateral. Multilateral engagement is important
in a shared society but is valuably supplemented by dialogue between
two or three traditions, this can make it possible to go more deeply
into painful shared histories which affect contemporary perceptions
and experiences’ (p.50). The report relates that the number of local
interfaith organisations increased from 30 to over 230 between 1987
and 2015. For historic and numerical reasons these are between
the Abrahamic faiths: ‘there is scope for more bilateral dialogue
between Abrahamic and Dharmic traditions’ (p.52).
Section 4, ‘Education’, has significant reflections on Faith Schools
– organisation, adherence policy, Collective Worship and Religious
Education. It made recommendations concerning these topics. These
will be returned to in Chapter 5, ‘Schools Coping with Bereavement
and Death’, in the section on world faiths.
What is Death? 29
The twenty-first century began with incidents of global terrorism

arising from deeply distorted religious ideologies and political, often
racial, differences with bombings in New York in 2001 and London
in 2005. At the beginning of the chapter reactions of adolescents to
the atrocities were discussed. This century has heard voices expressing
concerns on climate change becoming more strident with the fifth
Intergovernmental Panel on Climate Change – The Physical Science Basis (27
October 2013), stating the threat to the existence of the cosmos.
The sixth panel was in Paris in 2015. There was the fear of nuclear
proliferation. Another concern was the world’s sustainability for fresh
water and food with a rise in world population projected from six
and a half billion to nine billion by 2050. The global community has,
through increased communications, become aware of the injustices
and inequalities of the planet. The economic crisis of the developed
countries resulted in the UK privatising sections of the NHS
and freezing wages for many, leaving a socially divided, aimless and
fragmented society. Yet institutional religion continued to be in the
spotlight, its leaders making statements about political policy and its
economic effects particularly on the poorest, raising media comments
such as ‘keep religion out of politics’.
Faith questions were raised in response to the loss of 3000 lives
in the destruction of the World Trade Center (11 September 2001).
In response, in the US, Sam Harris – author, neuroscientist and
philosopher – blamed Islam, while directly criticising Christianity and
Judaism. In the UK, it was Richard Dawkins’s book The God Delusion
(2006) that had impact. These writers are the new atheists: reductive
materialists, who frequently criticise religion without understanding
it, quoting biblical texts without contexts and confusing folk religion
with reflective theology. In the context of the twenty-first century, a
medicalised approach to death dominates; there is less conventional
religious certainty, which results in doubts relating to a life after death,
while there is a growth in spirituality.
Stephen Cave comments that death:
is the point at which the profane and sacred collide – an event
completely natural and yet surrounded by mystery; steeped in the
physical realities of bodily processes, yet enwreathed with existential
hopes and fears…many in the secular west and beyond, who have
been unmoored from the spiritual certainties of the past, seem to have
concluded that it is best not to think about it at all. (2015, p.6)
The major belief systems of the world have wrestled with the
mystery of death. We live in a multicultural society. Many children
and adolescents attend schools in urban and suburban areas with a
diversity of ethnic groups. Each group will have distinct rites and
practices associated with death, some religious, others not. A useful
resource for understanding death and bereavement across cultures is
Parkes, Laungani and Young (1997).
The Abrahamic faiths of Judaism, Christianity and Islam have a
common origin, but within each faith there are different expressions,
for example Conservative and Liberal, Protestant and Catholic, Shia
and Sunni Muslims. The Eastern faiths of Hinduism, Buddhism and
Sikhism emerged from very different cultures, some of which have been
moderated by Western culture, though each believes in an afterlife.
Judaism
In Judaism, life is valued above all else. Death is not a tragedy, even
when it occurs early in life; it is a natural process. Our deaths, like
our lives, have meaning and are all part of God’s plan. The book of
Genesis reflects life through stories, rather than abstract ideas. Jews
believe that humans are created in the ‘image’ and ‘likeness’ of God
(Genesis 1.27). Hebrew faith is down to earth. The Jews did not begin
by worshipping the one God, the Creator. God in the Exodus delivered
them from slavery and brought them into existence from nothing,
establishing a Covenant relationship. This led them to believe that this
must be the God who created the world. Genesis 1–11 is an ancient
and composite text dealing with the universal themes of our human
experience: good and evil; setting out why we need to be saved, from
what and for what; and why God is doing it the way God is. There
are four different pictures of creation (Genesis 1.1–2.4; 2.4b–3.24;
Psalms 74.12–17 and 89.5–18; Proverbs 8.22–31), each emerging
from a different experience and raising questions about life, faith and
the world. Humanity is a paradox, created in the image and likeness
of God (Genesis 1.26), ‘a little lower than God’ (Psalms 8.5–8), ‘given
dominion over the works of God’s hands’ (Genesis 1.26), yet people
are self-centred, living in broken relationships with others and with
God (Genesis 3).
What is Death? 31
The stories of the Creation, scholars believe, are influenced by

other stories in the Ancient Near East (ANE) and brought back from
the Jewish exile in Babylon. Genesis 1.1–2.4 is a poem in which
order is created from chaos, separating light from dark, ending
with the creation of humans and the Sabbath. The climax is not
humanity but the Sabbath, a day for God’s blessing and worship
of the Creator. It is possibly a hymn explaining the significance of
the Sabbath. Underlying the story are theological insights. God is a
loving Creator and Sustainer. There is delight in the material world.
The personification of ‘Wisdom’, present at creation, ‘rejoices in
the world and delights in the human race’ (Proverbs 8.27–31 and
Psalms 104). Christian history has often not taken the material world
seriously, seeing it as either infected by sin or despising it because it
is inferior to the spiritual, but our bodies are ‘material’; the alienation
of body dividing it from spirit is not Hebraic but the influence of
Greek philosophy. The story witnesses to the interdependence of life,
plant and animal. ‘Then God said, “Let us make humankind in our
image according to our likeness”’ (Genesis 1.26): humans are unique
in their relationship with the Creator. In the ANE, kings were held to
be in ‘the image of God’, that is they were God’s representatives. In
Genesis, humans represent God in caring for creation (1.26), but what
of likeness? Origen (184–253) distinguished between ‘man’, ‘receiving
the honour of God’s image in his first creation, whereas the perfection
of God’s likeness was reserved for him at the consummation’ (the end
of time). Irenaeus explained this as Adam and Eve being like innocent
children who needed to grow in self-consciousness to become morally
aware adults.
The second Creation story (Genesis 2.4b–3.24) is from a human
perspective, here the ‘Lord God formed man from the dust of the
ground, and breathed into his nostrils the breath of life and the man
became a living being’ (Genesis 2.7). The Hebrew word ruach means
‘breath’ and is physical and spiritual. Spirit is embodied in the world;
if God withdraws ruach everything disintegrates into dust (Psalms
104.29) The breath of God’s life, ‘fills the world and holds together
all things’ (Wisdom 1.7). When the breath of a man leaves him, he
expires and dies. The Hebrew word nephesh is translated as ‘life/soul/
spirit/self/flesh’. Humanity is both physical and spiritual, holistic. We
use the expression ‘embodied’. The idea is reinforced by a wordplay
on the name Adam (human/earthling) and the Hebrew word adamah
meaning earth. Central to the Creation stories is the uniqueness of

humans as created to reflect and be in communion with their Creator:
humans may be, as the cosmologists today tell us, ‘the debris of
exploding stars’, but within us is ‘the breath of God’.
Genesis 3 is a story illustrating the difference between the goodness
of God’s creation and humanity’s disobedience and death. It begins in
a garden paradise of harmony between man and woman, humanity and
God. There is one condition: God commands the humans not to eat the
fruit of a particular tree. A serpent questions Eve, casting doubt about
God’s intentions. Eve saw the fruit, ate and gave it to her husband. They
became aware of their nakedness and were ashamed, covering their
genitals and hiding from God. Questioned by God, they blamed each
other, then the serpent. They were punished – expelled from the garden
– since humanity had become like God, for in knowing good and evil,
they might, ‘Take from the Tree of Life and live for ever’. The story
suggests the entry of death into the world as punishment for the sin of
disobedience; immortality is lost and humans become mortal. This is
also suggested in the Wisdom Literature (538 BCE), ‘for God created
us for in-corruption and made us in the image of his own eternity
but through the devil’s envy death entered into the world’ (Wisdom
2.23–24). The serpent becomes the devil. This is an anachronism of
later Persian influence since in the ANE the snake was often associated
with wisdom and the human potential for discernment. In the Rabbinic
tradition, the Torah is identified with Wisdom and is the Tree of Life
through which God, ‘Planted eternal life within us’ (Proverbs 3.13–18;
11.30; 13.12; 15.4).
Judaism considers Genesis 1–3 as a parable of the human condition,
not history. Adam’s responsibility for the sins of humanity, the entry
of death into the world and the doctrine of inherited sin is not found
in mainstream Judaism, which teaches that humans are born sin-free
and later choose to sin and bring suffering on themselves. Inherited
sin is considered a Greek, Pauline Christian interpretation and not a
Hebrew concept (Barr 1992; Berger and Wyschogrod 1996; Magonet
2004). For Jews, Genesis 1–3 is life-affirming; though aware of sin,
blessing dictates the agenda.
Gradually, in Judaism there developed hints of a shadowy life after
death joining the departed in the underworld; ‘Sheol ’ is Hebrew for
‘the land of forgetfulness’, or Hades in the Greek of the Septuagint
(LXX). There are 65 biblical references to the descent to Sheol. For
What is Death? 33
Jews, the idea of existence after death without a body was unthinkable;
a human is embodied. Centuries later the concept of resurrection
developed. Resurrection would involve a body, in a world created and
renewed. It is likely that this belief was due to Jewish apocalyptic
thinking, arising from the experience of the Maccabean Revolt
(168/7–164 bce) against the Greek overlord Antiochus Epiphanes.
Justice was demanded. God was just and must reward the faithful
violated martyrs of the Maccabean family. This crisis of faith led to the
answer of a double, this-worldly, resurrection: to life for those loyal
to God under persecution and condemnation for the disloyal (Daniel
12.1–4). Scholars suggest reasons for the rise of thinking of a soul: the
influence of Zoroastrianism, the religion of the Medes and Persians
conquerors of the Jews (539–333 bce); or the Greek conquest and
Greek philosophy experienced by Jews of the Dispersion (333–160
bce, cf. Wisdom 3 and 5 and 4 Maccabees). From the second century
bce, the rise of mystery religions such as the Mithraism faith of the
Roman soldiers, known to have been brought to the UK from remains
of a temple found in the City of London, helped ideas of a soul and its
afterlife to develop further.
During the years that followed, there was hope for a better life for
God’s people. Yet God’s promises for life, blessing and hope seemed to
end in failure. Disillusioned, the writers concluded that if their belief
was not fulfilled by human activity, it would be in a final Judgement
led by a Messiah. Apocalyptic literature expressed the hope that God
would defeat the powers of sin and death and establish a kingdom in
this world. It is likely that this thinking emerged in the first century
CE, when Jews were persecuted. For some, God’s righting of injustice
would be in a new world, a Garden of Eden. The central belief was
that, ‘at the end of history, God will resurrect the dead and restore them
to full bodily existence’ (Levenson 2006, p.ix). In the Gospels, there
is a clear difference between Jewish groups: the Sadducees who did
not accept resurrection and the Pharisees who did. Some Jews found a
belief in God’s goodness no longer possible; the only immortality was
living on in the mind of God.
In Judaism, there is little development of a theology of an afterlife
since it is unknown; what Jews know is the present, which they live to
the full, in just lives, worshipping and honouring God.
Christianity
Christianity is rooted in Judaism and inherited the Hebrew Scriptures.
It has a great deal to say about eternal life: a gift of God, evidenced
in a quality of life not interrupted by death (John 3.16, 36; 4.14).
The defeat of death was affirmed by the resurrection of Jesus, though
his body is described as different from the one before the crucifixion.
We are embodied and need a body to be human, yet we know that
at death our physical body disintegrates. Paul (in 1 Corinthians
15.50–3) wrestles with this thinking: ‘Flesh and blood cannot inherit
the kingdom of God nor the perishable inherit the imperishable.
Listen I will tell you a mystery. We will not all die but we will all be
changed.’ Paul uses the metaphor of the seed sown which must die to
be transformed into new life (1 Corinthians 15.35–8). There is also
teaching by Jesus of judgement during life and at death based not on
belief but on actions of care for the sick, homeless and dispossessed
(Matthew 25).
Paul, in his letter to the Romans 5.12f., has some of Christianity’s
most challenging, controversial and distinctive doctrine that sin ‘came
into the world through one man, and death came through sin…all
have sinned’. Paul suggests that Adam’s sin and guilt were inherited
by later generations, but ‘so one man’s act of righteousness leads to
justification and life for all’, Christ as a second Adam, righting Adam’s
sin and death and bringing eternal life (Romans 5.21). However, the
idea of inherited sin is not present in Genesis 3 and is denied by the
Hebrew prophets (Jeremiah 31.29–31 and Ezekiel 18.2–4).
The doctrine of Original Sin was developed by Augustine
(354–430 CE), influential in the Western Church’s theology and
interpretation of Genesis 3. He taught that Adam and Eve’s act of
disobedience led to feelings of shame evidenced in an uncontrollable
stirring of the genitals, so that they covered themselves. He used the
word concupiscence (desire) for the act of procreation through which
sin, he believed, was transferred to successive generations. The Greek
fathers such as Irenaeus and the Orthodox Church emphasise the
cosmic dimension of the Fall; because of Adam, humans are born into
a fallen world, but though fallen, are not deprived of free will. It is
not a ‘fall’ but a failure to develop into the fullness of being human.
Today, the Roman Catholic Church teaches that humans are made
in the image of God, and within are urges of good and evil. Because of
the effects of Original Sin humans inherit a fallen nature. Humans do
What is Death? 35
not bear ‘original guilt’ from Adam and Eve’s disobedience, though
‘the devil’ has acquired a certain hold on humans. Anglicanism follows
Luther in teaching that humans inherit Adam’s guilt and are in a state of
sin from their conception. This is reflected in the baptism of children to
cleanse them from the ‘Original Sin’ inherited through birth. Douglas
Davies notes that Christianity may be defined as both positive and
negative in attitudes to death. The positive is that death, the outcome
of sin, is overcome through the love of Christ, the comfort of the
Spirit and God’s ultimate faithfulness; this is Good News. Negative is
that death is ‘the central moral pivot around which God works with
the cross as its symbol’ (Davies 2008, p.8). It is death conquered by
life, but ‘there remains a certain Christian romantic commitment to
death as evil that can be adjudged as less than valuable’ (Davies 2008,
pp.8–9). Western Christianity has tended to emphasise guilt and sin,
which is prominent in the Roman Catholic theology of the Mass. In
the Protestant theology the emphasis is on Christ’s Cross and in a
literalist interpretation of Genesis 3. In the Eastern Orthodox tradition
there is an emphasis on God’s glory and love. This emphasis can be
seen dramatically in the difference in interior architecture between
Orthodox and Catholic churches.
Islam
Islam has roots in both Judaism and Christianity; for Mohammed, this
world was transitory, though Muslims give credence to it because it is
what they experience. The true life is after death, and this belief is an
act of faith: the Qur’an states, ‘Who will give life to bones while they
are disintegrating?… He will give them life who produced them the
first time; and He is, of all creation, Knowing’ (Qur’an 36.78–80). The
Muslim is accountable for the way he lives, because behaviour shapes
future character. Life after death is necessary – a response to God’s
attributes. God’s justice and mercy have no meaning if there is no life
after death. It is characterised by a day of judgement, the fires of hell
or the garden paradise of heaven. In Islam, the word Jahannam derives
from Gehenna; the Qur’an contains 77 references to it.
Hinduism and Buddhism

Within these faiths, this life is the first of many lives. The way of life
now, particularly the believer’s concern for the marginalised, affects
life beyond this one. This belief is expressed in the law of Karma, the
essence of which is that our past determines who we are and will be.
This doctrine is a reincarnation of a life until the final goal of being
one with the ultimate, the Supreme Being, is reached – moksha – or
entering the deathless state of Nirvana. The Hope of Nirvana is the
fusion of the soul with the body but the body is of no importance – it
is the soul that matters.
For Hindus, all created life is sacred. The law of Karma has a
more subtle and complex character. John Hick comments that it is not
the present conscious self that is reborn. Rather, ‘In each incarnation
there is a new empirical self, which comes into existence at conception
and ceases at death’ (Hick 1983, p.491). Underlying the series of
selves is an eternal spiritual reality, the jiva. This is manifest in various
expressions, including the physical body, which perishes at death and
the ‘subtle body’, linga sharira, which lives beyond death and ‘is later
re-embodied by attaching itself to a developing embryo’ (p.491). The
subtle body bears the individual Karma, and selects the appropriate
kind of birth. Memories of previous lives exist only in the jiva. In the
last earthly life, the individual has transcended self-centredness, and is
‘consciously one with the universal atman, or self, which is ultimately
identical with Brahman, the eternal absolute Reality’ (p.491).
Buddhism believes in the brotherhood of all creation. Sickness
and death are accepted as natural to life with a continuous cycle
of birth and rebirth through the diverse forms of animal life until
perfected. It is similar to Hinduism, ‘except that which is successively
reborn is not a continuing entity, the Karma-bearing “subtle body”,
but the stream of karma itself ’ (Hick 1989, p.491). The Advaita Hindu
and the Theravada Buddhist practise meditation and mindfulness and
consciously avoid the domination of human desires and passions in
their spiritual quest of identification with the divine.
Drawing together experience and cultural

context leading to practical implications
As adults, we try to protect our children and shield them from harm.
However, if we try to protect them from the reality of death, or try to
manipulate the reality of death for them by ignoring their questions,
refusing to let them talk of the deceased or using euphemisms of the
dead, we are likely to cause them more harm and distress in the long
run. Depression in adults is often associated with unresolved grief.
What is Death? 37
Young children have a healthier approach to death and dying than

adults. The very young have enquiring minds and ask many questions.
They are fascinated by death in animals, for instance that of wild
birds and pets. It is not morbid to allow children to talk about death
since it is part of their inquisitive nature and desire to make sense of
the world and their own experience of it. This fascination is noted
in the quotation at the heading of each chapter. It may seem macabre,
for example, but Diane loves going to clean her grandfather’s grave
with her grandmother. Diane is ten years old. In contrast, there is still
a taboo in the adult world about talking of death, though in recent
years this has been challenged. Death becomes the butt of jokes:
Woody Allen said, ‘It’s not that I’m afraid of dying. I just don’t want to
be there when it happens.’ In contrast, the German theologian Jürgen
Moltmann stated that ‘to live as if there were no death is to live an
illusion. Death acts as a catalyst to plunge us into more authentic life
modes and it enhances our pleasure in the living of life’ (Moltmann
1996, p.50). An excellent illustration of Moltmann’s words is the life
of Etty Hillesum, a Dutch Jewish woman who died in Auschwitz in
1943. It is described in a book by Patrick Woodhouse (2009).
Michael Morpurgo, at one time Children’s Literature Laureate of
the UK, wrote, ‘My role in life: to teach them (his grandchildren) about
death’ (Morpurgo 2006, p.5). This role emerged from an experience
in his childhood. The news of his grandfather’s death was given to
him at boarding school. It was not grieved so left Morpurgo with
many questions and with fears of death. Years later, his grandmother
died. On this occasion, he saw his grandmother’s body and came to
an understanding of death as simply an end. ‘We need intimations of
mortality – for my grandchildren it may well be the last useful thing I
can do for them’ (p.5).
As adults, we need to engage with our own deaths in order that we
can be alongside, help and learn from children. Children’s concepts of
death, as all their concepts, develop in stages. We need to recognise
these stages and respond in appropriate ways.
The world faiths have responded to questions of death and its
origins through stories called myths: a literary device to explore a
deep insight in a concrete, pictorial way, to explore truth concerning
the significance of death. These stories are universal and are ones that
children can explore. I return to the use of literature with children
in helping them understand death in Chapter 5. Death is a reality
but more importantly a catalyst in order that we might recognise its

finality and enjoy our living.
ACTIVITIES TO ELICIT THE READER’S EXPERIENCE

Thoughts on Death and Dying
Answer these questions quietly and on your own. Notice your emotions as you
do it – jot them down.
1. When as a child, and how, did you first learn about death (e.g. pet/
grandad)?
2. What were your feelings?
3. What thoughts/feelings have you inherited from this childhood

experience about death?
4. How often now do you think about your own death?
Daily Occasionally Never
5. At what age would you like to die?
6. Is there anything you want to resolve/ ask forgiveness for/be thankful

for before you die?
7. Where would you like to die? (Include the sounds/sights/smells

around you.)
8. Who would you like to be with you?
9. What are they saying to you?
10. What would you want to say to them?
11. What concerns you most about dying?
12. Will faith help you when you die?
13. What does ‘death’ mean to you?
14. W
hat do you believe about the afterlife? Where does this belief come
from?
15. H
ave you ever talked about dying and death with any one? Give
examples.
2
Grief and Bereavement
Heaven is not a place. It’s just an idea. But it is a very strong

idea, because if we didn’t have it we wouldn’t have any hope.
(Andy in Marshall 2003, p.25)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
Alex was six. He had a guinea pig, which on the whole he remembered
to feed, though his mother often had to remind him, and some days
it got twice the amount of food it should have and some days none.
One summer day, he went out into the garden to look at the guinea
pig in its hutch. All was silent, and Alex could not understand it. He
opened the door of the hutch and felt inside, calling the guinea pig.
Nothing happened. He found the guinea pig and felt that it was cold
and lifeless. It was dead. Taking it in his hands, he went sobbing to
39
his mother. ‘It’s dead,’ he said through his crying, ‘but where has the
guinea pig man gone to?’
Children need to be taken seriously. Alex’s grief was real and tangible.
His grief is commensurate with that of a six-year-old. The guinea
pig was physically dead – but somehow that was not enough for Alex.
There was something more which he simply called, ‘the guinea pig man’.
Where had ‘the guinea pig man’ gone? What was Alec questioning?
Patricia was twelve; she had leukaemia and was in hospital. Patricia
knew that she was dying. When the consultant, who was a Christian,
tried to talk about death and a next life in order to prepare her, Patricia
told her to ‘piss off’. I was sent for as the chaplain by the consultant to
sort out Patricia. I had met Patricia before, and I knew she loved and
enjoyed jokes, so I went to see her armed with a Spike Milligan joke
book. We chatted and joked. Eventually, I asked her if she had seen the
consultant recently. She simply said that the consultant wanted to talk
about death. ‘But I didn’t,’ she said. ‘I know that I won’t be here much
longer. I don’t need her to tell me about heaven and all that claptrap. I
want to live.’ She stopped talking. ‘What do you enjoy about living?’
I asked. There was no reply. She had fallen asleep laughing at one of
the jokes in my book.
Later that week I heard that Patricia had died. The family asked me
to take her funeral. When I visited the home, a farmworker’s cottage,
Patricia’s body was lying on the settee, the cat curled up on her feet
and her brother and sister playing near her.
Patricia was a lively youngster who was facing death. Her consultant,
with the best will in the world, spoke to her of her death. Perhaps as a
professional her approach could have been more careful. I tried to meet
Patricia where she was. What had she meant when she said that she
wanted to live? Was it that she wanted to live every moment until her
end whenever that was? Or that she wanted to conquer her disease?
I don’t know, but everything in the room where her body was laid at
home seemed so natural; the atmosphere suggested that death was not
Grief and Bereavement 41
to be feared but to be lived. Her siblings, though likely to be missing

her, were getting on with life. Patricia was upfront, wanting quality of
life while she had it. Adults tend to be more aware of the past – regrets
for those things that were not done, opportunities missed – and the
future, wondering what will happen. We forget to live in the present,
the only place we can live.

Grief following bereavement is normal for adults, children and
adolescents but is not easy. In research done by ComRes almost half
of Britons, 47 per cent, say they would feel uncomfortable talking
to someone who has been recently bereaved. Significant numbers of
bereaved people have experienced negative reactions to their grief,
including others avoiding them, crossing the road, ceasing to invite
them to dinner and even the total loss of a friendship (ComRes 2014).
However, the UK sociologist Grace Davie suggested the beginning
of a change of attitude to grief. Davie researched the response to the
death of Diana, Princess of Wales, in a car crash in Paris in 1997.
Following the news of Diana’s death, flowers were laid by the public
outside Kensington Gardens and Buckingham Palace as expressions
of grief by those who had never met the princess. There was a great
outpouring of grief. At St James’s Palace a book of condolence was
opened and others were opened across the country. Grace Davie
commented that expressions of grief at Diana’s death gave people
permission to express the suppressed grief of their own bereavements
(Davie 2000). More recently thousands visited the Tower of London
between July and November 2014 to see an exhibition of ceramic
poppies, which is now on tour in the UK. Each poppy represents a
soldier killed in the past World Wars, but it also evokes in families
memories of their own bereavements.
Emotions as a result of loss are normal, for bereavement is not an
illness, nor is it pathological. Children in particular are frequently not
considered as having feelings and understanding about death, yet they
are great observers of their environment and the grieving of people
around them; their emotions must not be underestimated. Young
children in particular are fascinated by death. However, at a family
death, the adults are so wrapped up in their own grief that they may
forget or ignore children and even refuse to let children talk about the
deceased or attend the funeral. At the death of her husband, grandma

refused to talk about him. A grandson who loved his grandfather spent
more and more time alone in his bedroom refusing to talk. His family,
not understanding the reasons for his silence, were so worried that they
made an appointment for him to see a child psychiatrist. Talking began
the journey to facing the grandson’s bereavement. Adults surrounding
a child need not hide their own grief, since it may help a child to
realise grief is normal, nor should a child be moved to a ‘protected
environment’ away from a dying parent with a terminal illness. It is
not unusual for a bereaved child to develop similar symptoms to that
of the dying or dead person, mirroring the death. Children need to be
respected and informed of what is happening in a situation of terminal
illness and of death itself. It is the sensitivity shown to a child and
adolescent and knowing how to respond to them that is significant.
Children and adolescents experience a range of emotions in
bereavement; they grieve differently from adults since they are still
developing their understanding and coping with life and therefore
with death. For young children, when someone close to them dies it
is a new experience, and they are unprepared for its impact. However,
adults have usually experienced death. Winston’s Wish, a major UK
bereavement charity for children, suggests that while adult grief is
constant and long lived, a child’s grief can seem more like leaping
in and out of puddles: one minute a child may be sobbing, the next
minute asking what is for tea (Crossley 2000). This behaviour may
seem callous to adults in the family, an ‘acting up’. If adults see the
child only during moments like this and not during the moments of
intense sadness and loss, the adult may ignore the fact that children
grieve. The American psychologist Esther Shapiro suggests that
children oscillate, putting their grief down then taking it up again.
The grief of an adult is more consistent and is often hidden, since
grief is frequently taboo in UK culture. A bereaved adult is expected to
return to work immediately after the funeral and behave as if nothing
has happened in her life. But if adults in the family try to protect a
child from their own feelings and grief by remaining silent about the
person who has died, the silence can stall the process of collective
grief in a family which helps positive grief to emerge.
Huw Spanner, writing on children and grief, refers to the changes
in British society in the twenty-first century, which is characterised
by fragmented communities, separated families and a decline in the
practice of religion and other rituals which in the past were markers of
the process of bereavement. Spanner suggests that:
our culture has made childhood into something of a fetish. Children
are supposed to be carefree and innocent, and so the proper thing
seems to be to shield them from anything grim or unpleasant. Even
though (perversely) they are exposed to unreal and inconsequential
forms of death – in films and computer games. (Spanner 2007, p.22)
A result of this has been the reluctance in adults to talk about death
to children. Children have been called ‘the forgotten mourners’ (Smith
1999). If a child is not included in the grief of the family, she may
feel guilty for the death and think that she said or did something that
caused the death. For example, guilt may follow if the child had a row
with Dad before Dad went out and was involved in a fatal car accident.
Guilt might also emerge when a child has forgotten the death in the
family and is having fun, and suddenly realises what she is doing. On
these occasions, the child could be reminded that a deceased parent
would want her to enjoy life.
A child will need to revisit a parental loss since as she gets older
she will miss the deceased in new ways and will need to know more
of the truth of the reasons for the death. For instance, an occasion
of revisiting might be when adolescence is reached and a girl misses
her mum being able to help her with a ‘prom’ graduation outfit.
Spanner states that the consequence of neglect of grief in a child
can be substantial long-term damage, ‘feelings of guilt, inadequacy,
isolation and confusion can erode a child’s natural resilience…lead
to underachievement at school and in the worst cases, exclusion,
anti-social behaviour…mental illness and the inability to maintain
relationships’ (Spanner 2007, p.22). Understanding the unique grief
of children and responding well to it are essential. Grieving is a natural
process: children, as adults, need to know that there is no right way
to grieve. It can include anger, sobbing and silence. Grief varies across
cultures.
Sociological, psychological and

historical insights into grief
Bereavement is the most psychologically distressing experience that
most people encounter. It is useful to have some definitions. Grieving
and mourning are not the same. Alan Billings defines grieving as, ‘our
personal, emotional response to the death of our loved ones’ (Billings
2002, p.74). This may be expressed as:
emotions such as anger, guilt, fear, relief, sadness;
thoughts – processes like understanding, and believing that the
person is gone;
physical responses such as sleeplessness, stomach-aches, headaches or
loss of appetite;
spiritual questioning about the meaning and significance of life and
for some the existence and nature of God.
(The Dougy Center 2008, p.5)
Mourning is ‘the behaviour which particular social groups deem
appropriate in the face of death’ (Billings 2002, p.74). It is public and
intentional such as talking and crying, or often with adolescents, risk-
taking behaviour. All children and adolescents who experience a death
grieve, though they may not mourn. The distinction is critical: it must
not be assumed that an individual is not grieving because there is no
public reaction. It is assumed that grieving is natural, universal and
purely psychological, but mourning is determined by culture. Billings
maintains that both are influenced by culture (Billings 2002, p.74).
The UK sociologist Tony Walter adds a definition of bereavement
as ‘the objective state of having lost someone or something’ (Walter
1999, p.xv). He argues that ‘culture affects grief as well as mourning,
and indeed grief underlies the very constitution of society’ (p.xv).
Models of grieving
Worden’s model
A well-known model is that of Worden who proposed the thinking
that grief is a process and not a fixed ‘state’. People need to work
through their reactions in order to make a complete adjustment. He
drew on Freud’s concept of grief work, Bowlby’s attachment theory,
developmental psychology and Engel’s concept of grief as an illness.
Worden recognised that humans have, and are, narratives or stories
in that we are ‘made up’ of all the people, events and places we have
experienced in our lives. However, change and re-creation are necessary
for each of us as we build on previous memories and incorporate new
experiences such as the death of someone close. Change requires

re-definition of ourselves and our ‘world’ in an ongoing ‘creation
story’. Grief and loss in bereavement are significant parts of our
life story and common to all humans. Worden understood grief as a
process of re-visioning the world, ourselves and our place within the
world. He thought of grief as having four overlapping tasks:
• to accept the reality of the loss
• to experience the pain of grief
• to adjust to an environment in which the deceased is missing
• to let go, that is, to withdraw emotional energy from the
relationship with the deceased and to redirect the energy. The
deceased is not forgotten but rather the influence of the person
on my life is integrated into memory and my life story.
(adapted from Worden 1996, p.45)
The Whirlpool
Richard Wilson, a consultant paediatrician, has suggested a model
of grief called ‘The Whirlpool’. He uses an image of life as a river
running smoothly until it falls over a cliff edge; this is a picture of a
‘waterfall of loss’:
The waterfall of bereavement when the river turns into individual
droplets of water thrown out in all directions, is a state of shock,
numbness, and denial…then the chaotic water hits the pool below
and forms a whirlpool of grief – a state of falling apart, of emotional
chaos. The water can hit the rocks around the pool, producing pain
and physical symptoms in the griever. Or it can wash up on the
opposite bank and stay stuck there. But eventually, the water from
the whirlpool flows on through mourning to an acceptance that loss
is real, but life can carry on. (Ward 1993, pp.65–66)
A helpful diagram of this can be found in image 43 (‘Bereavement,
Loss and Grief, Survival Strategy for Primary Care’) in Ward et al.
(1995).
The Chaplain of Magdalen College School, Oxford, working with
a teenager whose best friend had died, heard how the youngster’s
grief came in huge waves. The Chaplain used the image of ‘waves’ to
suggest that the teenager thought of surfing in Cornwall. Two things

could happen with huge waves: either you tumble them and go with
the flow or ride them. Practice enables you to ride more of them
(Lawton 2014, p.12).
The Grief Wheel

This is a model used by Social Services in the UK, having recognised
and needing to work with the link between juvenile delinquency and
unattended and unresolved loss in their adolescent clients (Grief
Education Institute 1986). The incidence of memories of childhood
bereavement not dealt with in youth offenders can be up to 40 per cent,
ten times higher than the national average of 4 per cent. These losses
were not just about death, though many were, but included the loss
through parental divorce, illness, and injury (YoungMinds 2013). The
Grief Wheel indicates the need for moving through four phases, each
phase merging into the next, but with some movement backwards and
forwards. No time scale is given for the grieving process. The phases
are as follows:
Shock: This is when the reality of the loss has simply not sunk in.
Emotions include numbness of feeling; disbelief; euphoria;
unemotional and suicidal thoughts of wanting to be with the
deceased.
Protest: This occurs when the bereaved protests that the loss cannot
be real, while confronted with evidence that it is real. Emotions
include sadness; guilt – ‘if only’– and fear of his or her own death;
preoccupation with memories; searching for the deceased; physical
distress such as sleep disturbance.
Disorganisation: This happens when the reality of the loss is only too
real. Examples of reaction are confusion, apathy, loss of interest;
anxiety and the loss of any sense of meaning in life.
Reorganisation: This occurs when the bereaved begins to rebuild his or
her life. This is a time of developing balanced and more realistic
memories of the deceased; pleasure in remembering; a return to
previous levels of functioning and new insight and purpose in life.
(Grief Education Institute 1986)
The Grieving Wheel

This model was developed and is used by a hospice in Yukon USA
(Hospice Yukon n.d.). The model recognises that each loss is unique
and yet there is a commonality in grief. The Grieving Wheel helps us
reflect upon these normal responses to loss as recurring cycles in our
lives. Beginning at the top with ‘Life as usual’, we move around the
wheel, often swinging back and forth between the four phases. The
four phases are shown as a circle: Life as usual; Shock; Chaos and New
beginnings, returning to the beginning. Then a major loss occurs and
a new journey begins. The first reaction is a state of ‘Shock’, perhaps
being unable to believe or comprehend what has happened. We long
to return to life as usual, but eventually we come to acknowledge
our loss. The second reaction, moving round the Wheel, is one of
resistance. Reactions are intense pain, anger, sadness, guilt, despair,
loneliness, depression and hopelessness. Emotions feel overwhelming
like ‘Chaos’. This stage is a very significant one in the journey through
grief. Understanding the grieving process can help us realise that
suffering will end and lead towards our healing, and with this we can
find the courage to stay present to the ‘Chaos’. As we adjust, we
come to a new way of thinking about life, a new understanding. The
process turns to ‘New beginnings’ as we are able to begin the process
of ‘Integration’. The Wheel is complete and we are back where we
started with ‘Life as usual’, yet we are different people because of the
experience of bereavement, for this is not a simple circle but a spiral
of growth.
The American psychologist J.A. Graham believes that grieving
after a loss consists of psychological tasks that children work through
progressively:
1. The first phase involves ‘understanding what death is, knowing
its characteristics, and being able to recognize when it has
happened’. For the child it is important to feel ‘self-protected’,
that is they know someone has died but that neither the child
nor the family are in danger.
2. The middle phase involves ‘understanding that death is a
reality and accepting the emotions that come along with that
realization’. This may include reflecting and having memories
about the deceased, not that they will come back, but that
the memories remain. There will be grief, but that of children
and adults is different, since the former have little experience

of death, the latter do. It is children who have to spend
time working out what has happened to the loved parent or
godparent.
3. The last phase of the process involves ‘a reorganisation of a
child’s sense of identity and his relationship with others and
with the environment’, in that since a child invests emotionally
in relationships following a change in his surroundings
through the absence of a person he is able not to fear death
yet remember the deceased and carry the memories and any
sadness with him.
(Graham 2013, p.2)
In some models, the emphasis was on moving through stages of
bereavement to an ‘acceptance’ of the death, a letting go of the
deceased. In the 1980s, there was a growing suspicion of professionals
and those who said that emotional ties between the bereaved and their
loved ones should be broken. Walter (1999, pp.19–20) suggested an
integration, the bereaved carrying with them the deceased, since the
latter was part of their present life story.
There is an upward spiral of grief which allows acceptance and
then the return to an earlier stage; for example, if six months after a
loss the bereaved feels really tearful and sad one day, she may worry
that something is wrong. However, the person is likely to be in a
different place to the black hole in the beginning; feelings may be the
same but with less intensity. The bereaved will have moved on and
made some adjustments. By using the spiral a bereaved person can
alleviate the pressure of having to move on through the stages. It may
become less frightening. The idea of acceptance can be misleading; it
is rather ‘adjustment’ – the deceased is part of the bereaved’s being
and history.
Children’s and adolescents’ experiences

of the grieving process
All children develop at different rates and it is important to remember
that the parents know their own child the best. Winston’s Wish states,
‘A death in the family is always hard. It’s even harder when you don’t
understand what death is’ (Winston’s Wish 2002, p.1). Chapter 1
indicated children’s understanding of the concept of death in relation

to ages. This knowledge forms the basis of how children grieve. We
now look at the behaviour that emerges as a result of death and how
adults can respond to a child’s grief in a positive way to forward the
child’s grieving process.
Babies
A baby has not yet got any understanding of death. However, if the
deceased is close to the baby, for example a parent who feeds or baths
the child, there may well be ‘separation anxiety’. Elizabeth Kübler-
Ross notes that up to the age of three a child is concerned only about
separation. This may be avoided if a familiar adult or parent is able
to provide continuity and some normality. The baby may react by
signs of irritability, some change in eating patterns which may become
erratic, disturbance of sleeping patterns, crying or tummy upsets and
temporary withdrawal from carers until security and stability are
re-established. Providing support means keeping normal routines
and structures whenever possible. Positive bereavement depends on
nonverbal communications: physical care, affection, reassurances and
the tone of voice. This is done by giving verbal and physical affection
with words of reassurance which show healthy coping mechanisms. It
is important to provide a warm, loving caretaker when the parent is
not available.
Toddlers
Toddlers have no real understanding of death; however, they understand
more than you might think. They can sense when there is excitement,
sadness or anxiety in the home, when a significant person is missing or
the presence of new people. A toddler will overhear conversations in
a hushed voice. Her reactions are sensory and physical. Any child old
enough to smile or express an emotive reaction to a situation is
old enough to grieve. When verbal skills are limited, grief is expressed
through behaviours and play.
The toddler is likely to become attached to another adult in the
family. Behaviour may include crying; health problems such as skin
rash, tummy upsets, coughs and colds; clinging, tantrums, erratic sleep
patterns, fussy eating; repeated questions (within speech and language
limitations) and the need for the adult to provide a repeated response
and explanations. The responses given will vary with the needs and
personality of the child and include consistent physical care, cuddles

and comfort and maintaining a consistent routine. Responses can
include activities such as messy paints, drawing, toys and puppets to
encourage spontaneous, imaginative and creative play to help a child
to express their feelings. Three-year-old Susie’s mother had died at
home. After this event Susie constantly wanted the book Where the
Wild Things Are (Sendak 2000) read to her. In the story, Max in his
wolf suit causes mischief. His mother sends him to his bedroom. Here
everything changes, and he is taken to a faraway land of wild creatures
who he faces by looking at them without blinking. The creatures
submit to Max. When he returns home, his supper is waiting and ‘it
was still hot’. The story addresses facing and conquering the wild
things in life. Could death be like this for a three-year-old, a horror
you must face? The death of a parent is a threat to a child’s whole
life and the resources of the remaining parent may be limited. In this
particular case, the father quickly went back to work, and a friend
was able to move in to look after Susie and her older siblings for
the first nine months of their bereavement. When Susie went out in
her pushchair, she said to everyone she met whom she knew, ‘My
mummy’s dead.’ There are many books about loss for children, some
of which are included in the Further Reading section at the end of the
book. A comforter such as a blanket, dummy, pacifier or a particular
soft toy may assume a special importance at this stage.
Three- to five-year-olds
Children of this age have a limited concept of death in which it is
not final. Death is rather like going to sleep and waking up or going
to work; believing the deceased will come back, young children may
search for them. This may lead to an apparent lack of reaction when
told about a death and the child may act inappropriately after news of
a death, perhaps asking ‘Can I have another biscuit now?’ or to go out
to play. Tantrums arising from insecurity and difficulty verbalising can
result in acting out feelings in increased aggression – more irritable,
aggressive play. The child often asks repeated questions in an attempt
to make sense of the loss and these are often matter of fact; these
may disturb and upset the adult, particularly if it is the death of a
parent and the bereaved parent is trying to cope with her own grief.
The experience of death undermines a child’s confidence and her
world becomes unreliable and insecure. She may cling to other adults
in the family and not want to be parted from family members in

case someone else ‘disappears’. The child is only capable of showing
sadness for short periods of time and then escapes into play or may
exhibit little anxiety due to belief that the deceased is coming back.
Adult response needs to offer as much continuity as possible with
routines and activities, which gives security in what may be a changing
world for the child. A reassurance can be given, for example, ‘I will
pick you up after school’. Family can provide opportunities to play,
draw and paint, helping the child to express feelings. Sharing books
on death and loss which treat loss as something natural can help the
child to verbalise feelings and fears and can also help to identify
feelings and reactions. The child may need much physical affection.
Five- to nine-year-olds
A five- to -nine-year old begins to recognise that she too will die, which
is a frightening concept and may lead to psycho-somatic symptoms
such as headaches and chest and breathing pains. These may be the
body’s unconscious attempt to draw attention to mental distress.
Behaviour may be aggressive – verbal and physical. Some children
may play ‘dead’ in the playground. The child can see death as a ‘taker’
or ‘spirit’ that comes and gets you. Fear that death is contagious and
other loved ones will ‘catch it’ and die too may result in a phobia
about illness and doctors, a fear of the dark, nightmares and difficulty
in getting to sleep, regression to an early stage of development such as
baby talk, bedwetting, trying to gain attention or being afraid to go to
school. This phobia is especially noticeable if a parent dies.
Children are sometimes fascinated by issues of mutilation and
very curious about what the body looks like. They may connect death
with violence and may ask, ‘Who killed him?’ yet may worry how the
deceased can eat and breathe.
In response, it is important that the child is supported, reassured
and listened to; it is important to be honest and tell a child if the adult
has no answers. The adult should ask questions to ensure that the
child’s thinking is understood. It is important to avoid such clichés as:
‘Don’t worry, things will be OK’, ‘You’re such a strong boy’, and using
euphemisms. Avoid, ‘Grandma went to sleep and is now in heaven.’
Instead say, ‘Grandma was very sick and the sickness made her die.’ It
is important to identify specific fears, distortions and perceptions. For
example, make sure the child does not feel responsibility and guilt and
is not blaming herself for the death. Since language is still concrete,
a child may have difficulty expressing feelings verbally. Patience is
needed and answers to questions need to be concrete. Helping a child
to share bad dreams is significant.
Children of this age need information and reassurance that life
will go on for them, for example that they will be taken to football
practice or dancing lessons, coupled with the reliability of other adults
in keeping promises they have made. Having a pet can be significant,
since touch is highly important, as is responsibility for the care of
an animal, drawing or painting to express feelings and books which
deal with loss and death. Adults should help a child with positive
memories of the deceased and model healthy coping behaviours: give
treats as well as routine; make a memory book; look at photos of
the deceased; show physical affection; visit the cemetery together; do
physical activities and read books together.
Nine- to eleven-year-olds
At the age of nine to eleven, the child’s perception and understanding
is nearer to that of adults. Children are aware of the finality of
death and the impact the death has on them. With this comes a self-
consciousness about fear of their own death, and if a parent has died,
fear of a remaining parent dying. There is a concern with how their
world will change; with the loss of the relationship often come blunt,
factual questions: ‘Who will go with me to football now?’ These are
sometimes called, ‘landscape questions’; they are not self-centred, but
the death of a parent is likely to mean change, for example the necessity
of moving to a cheaper house or eventually a new ‘step parent’. Change
takes time. There is a fragile independence, a reluctance to open up
delayed reactions. At first, it seems as if nothing has happened. Then
grief reaction sets in, with increased anger and for some guilt over the
death. There are mood swings and somatic symptoms.
At this age when friendships and groups are significant there
may be disrupted relationships with peers and school phobia.
There may be the beginning of developing an interest in rituals and
the spiritual effects of life.
Providing support includes encouraging discussion of the
child’s concerns but be honest and tell her when you do not have
an answer. Address the impulse towards acting out and allow a
child the opportunity to identify their feelings. Allow for regressive
behaviours. Avoid clichés such as, ‘You must be strong, so I don’t have
to worry about you’ or ‘Big boys don’t cry’. Gently relieve the child
from attempts to take over adult responsibilities; this is particularly
important when a girl has lost her mother and her father feels lost
and becomes dependent on his daughter. Provide and encourage
expressive experiences such as writing or drawing while modelling
healthy coping behaviours.
Adolescence
Adolescence is an emotional time of upheaval with waves of differing
feelings as a result of physical and hormonal changes. Finding a
balance between dependence and independence is tough; the adolescent
needs security yet boundaries to push against. Discovering and forming
an identity is particularly hard if a parent dies when an adolescent is
trying to achieve her own separation and identity yet relies on a parental
gender and social role model. It is a time of rebellion and self-absorption,
searching for meaning and a questioning of all that the family takes for
granted. Since grief is predominantly emotional, adolescents are familiar
with turbulent waters and often handle it better than adults do.
There is likely to be an increased capacity to see a situation from
another person’s perspective – for example, empathy with the parents
of a peer group friend who has died, or empathy with their parent on
the loss of one of their own parents – but this can fluctuate, with the
adolescent having episodes of self-centred thinking. Adolescents have
special needs. They oscillate between forgetting and remembering; the
unremitting pace of adult grief is too intense, too much an interference
with the necessary work of growing up. Certain books are helpful (see
the sections for Key Stages 3 and 4 in the Further Reading section at
the end of the book).

Judaism
There is an immense diversity of practice within Judaism, since 25
per cent of Jews in the UK do not belong to a synagogue. There are
secular Jews, Conservative, Orthodox, Reformed and Liberal Jews. The
notes here represent the rituals of many Orthodox Jews.
In Judaism death is a natural process. The grief process is not an
expression of fear or of distaste for death. It has two purposes: to
show respect for the dead, kayod ha-met, and to comfort the living
who will miss the deceased, nihum avelim. Grief is a marked time with
prescribed, detailed and practical rituals, allowing the full expression
of grief, while discouraging excesses of grief and letting the mourner
gradually return to normality. This period must be a comfort to Jews,
since decisions do not have to be made at a time when emotions may
be raw as a way is mapped out beforehand, giving a framework for the
psyche to begin processing the loss.
Within Judaism, mourning is at home: in the Shiva house, the
house of mourning of the close relatives parents, spouses, children
and siblings. A memorial candle is lit (yahrzeit), which symbolises the
soul of the dead and in some homes mirrors are covered. When a
person dies, adult or child, traditionally the family tear clothes; if the
death is of a child the parent tears clothing over the heart. The blessing
is recited which describes God as the ‘true judge’, an acceptance of
God’s taking of the life. A period of a day or two follows when the
family are left alone to allow the full expression of grief. Burial takes
place as soon as possible, after which a close relative or near neighbour
prepares the first meal for the mourners, the meal of condolence.
Traditionally this consists of eggs, a symbol of life, and bread. After
this visitors are permitted. Shiva, the next period of mourning, begins
on the day of burial and lasts seven days. Mourners sit on low stools
or the floor instead of chairs, do not wear leather shoes and men stop
shaving and cutting their hair. Women do not wear cosmetics, do not
work and in traditional families abstain from actions for pleasure such
as bathing, having sex, putting on fresh clothes or study, except for
the Torah. These are markers of loss and of the utter separation of
bereavement from daily life. Mourners wear the torn clothes they wore
when recognising the death. Prayer services are held with friends. If
the Sabbath occurs during Shiva it counts as one day. The next period
of mourning is known as Shloshim, meaning 30, because it lasts until
the thirtieth day after burial. During this period mourners do not
attend parties or celebrations; men do not shave or cut their hair
nor listen to music (de Lange 1987, pp.128–9). The final period of
mourning is avelut and this lasts for a year after burial. The son of the
deceased recites daily the Kadesh: ‘May His great name grow exalted
and sanctified in the world that he created as he willed. May he give
reign to his Kingship in your lifetimes and in your days… Amen.’ This
is an affirmation of faith in God and might seem strange at the death
of a child, yet it expresses a belief in a Being beyond, which Jews hold

despite possible feelings of anger and injustice at such a young death.
Christianity
Suffering and death, particularly of the young, raises many questions
for those who believe in a loving, all powerful God. Children and
adolescents are quick to ask, ‘Why did it happen?’ when someone they
know and love dies, particularly if it is a child they know. The response
of Iris Murdoch in her novel The Unicorn (1966) was: ‘Suffering is no
scandal. It is natural… All creation suffers. It suffers from having been
created, if from nothing else. It suffers from being divided from God.’
The children at an after school club were exploring the bible story
of the rivalry between the brothers Esau and Jacob who were twins
(Genesis 27.1–46). Tom, a seven-year-old, suddenly blurted out, ‘I’m a
twin.’ No one knew this. Tom continued, ‘She died ’cos I was stronger
and pushed her out of the way as we were being born, so she died.’
There was silence. Tom’s underlying sense of guilt was palpable. In one
moment, he had raised issues of responsibility, guilt, shame, death and
loss. The adult leaders wondered how Tom knew about his birth and
could only assume that it was still significant in the conversations
and grieving of his parents. The occasion opened the ‘flood gates’ for
other children to share their losses, one that needed pastoral care and
sensitivity for Tom in particular but also for the other children in the
group.
There are no answers to the question of suffering for most
Christians, although there are those who see suffering as a punishment
from God. I find this impossible to accept since suffering and death
are no respecter of persons. There are exceptions such as terminal and
inherited conditions and the suffering that is self-inflicted, such as
that of a heavy smoker when the risks of cancer from this are known.
The Christian belief is that God created the world, and death and
disease are part of that world. Through the love of friends and family
God’s love can be experienced: a love that does not end in death, but
is the beginning of something more. Grief is important, as noted in
several biblical incidents: David’s grief at the death of Saul and his
son Jonathan (1 Samuel 1.1–12); David’s grief for own son Absalom
(2 Samuel 18.31–19.2); the Psalms of Lament; the Beatitudes
(Matthew 5.4); Jesus at the death of his friend Lazarus (John 11.30–6);
Jesus’ concern for the dying daughter of Jairus and the widow of
Nain’s son; and Jesus’ anticipation of his own death.
A belief that has troubled Christians is that of praying for
the dead, which can be a great source of comfort to the bereaved
particularly to those losing a child, signifying that the child is
with a loving and merciful God. Praying for the dead is found in 2
Maccabees 12.41–6, found in Catholic Bibles but not in Protestant
Bibles. Anglicans abolished it at the Protestant Reformation (1517–
1648), stating it had no scriptural warrant. However, in Westminster
Abbey on All Saints’ Day, 1919, Archbishop William Temple said in
a public sermon:
Let us pray for those who we know and love who have passed on to
the other life… But do not be content to pray for them. Let us also
ask them to pray for us. Growth continues beyond the grave and we
pray for the dead not because we believe that God will otherwise
neglect them, but because we claim the privilege of uniting our love
for them with God’s. (Wilkinson 1978, p.178)
Another rite is a modified version of the Book of Common Prayer
(1928) known as ‘Series One’ and influenced by the wastage of life in
the 1914–1918 War and the subsequent grief. The 1928 Prayer Book
introduced alternative Psalms and Scripture readings and new prayers,
more than one expressing the belief that Christians could legitimately
pray for the dead, or at least for the ‘faithful departed’. Series One
became authorised in 1967. Praying for the dead has continued to be
a problem. Perham believed that the issue was theological, hinging
around the question, does the individual come to God’s judgement at
the moment of death, or not until a final universal judgement (Perham
1997, pp.159–60)? Classic Anglican theology believes that prayer
for the dead is improper because at death destiny is settled. Yet the
debate continued within Anglicanism, many believing that prayer
for the dead was improper. Bishop Ian Ramsay chaired the Doctrine
Commission, which attempted an approach for all, ‘May God in his
infinite love and mercy bring the whole Church, living and departed in
the Lord Jesus, to a joyful resurrection and the fulfilment of his eternal
kingdom’. This became part of the Alternative Service Book (Church
of England 1980) and Common Worship (Church of England 2000).
At the funeral service of a child the words used are ‘we have come…
to give thanks…to commend him/her to God our merciful redeemer

and judge’ (Church of England 2000).
For Christians there is the hope of a life beyond this; though
this is never spelt out it brings comfort to many in their grieving.
Some Christians, such as those of the Salvation Army and those
from the Caribbean culture, celebrate death at the funeral with cries
of ‘Hallelujah’. This needs to be balanced by a time for grief to be
expressed.
Christian belief spills over into action. A clear example is that of
Sister Frances Dominica, a nun of an Anglican Order, All Saints Sisters
of the Poor. Sister Frances was the founder of Helen House Children’s
Hospice Oxford in 1982, the first hospice for children in the world.
It offers respite care and terminal care to children with life-limiting
illness, offering friendship and practical help to families that continues
after the death of a child for as long as a family needs. Sister Dominica
also founded Douglas House in 2004, which offers ‘respite’ for those
between 16 and 40 with life-shortening conditions.
Islam
Islam considers death, ‘divinely willed and when it arrives it should
be readily accepted’ (Opposing Views 2015). Death is considered to
be from God (Qur’an 4.78), yet since God is most loving, it must have
purpose though we not be able to see it. This may be a reminder in
busy human lives that the purpose of life is to worship. Expressing
grief is through quiet tears; there is to be no wailing since this can
be understood as a rejection of God’s will. The body is prepared and
bereavement lasts for three days when prayers are recited.
Hinduism
At a death, the body is bathed immediately, often by women. The
ritual marks of the community are put on the body while the priest
says holy mantras. Flowers are put on the body and rice as food for
the soul is put in the mouth and coins in the hand. The body is put
on a bier ready for cremation. Children under the age of puberty are
buried rather than cremated. The family in a state of grief do not
cook until after the cremation; the saying is ‘the fire in the house is not
lit until the fire in the cremation pyre has gone out’. The ashes of the
deceased are taken and scattered in a particular river. After that, friends
bring vegetarian food. In the place where the person died a lamp is
lit and water provided to light the soul and nourish it on the journey.
After the death, there is a period of purification for between 13 and
40 days from pollution, during which time prayers are said and parts
of the Bhagavada Gita are read. These speak of the soul that never dies
and are as the touch of a soothing hand to the bereaved. Gifts of food
are given to the poor in memory of the deceased. This is meritorious.
Buddhism
Buddhism understands grief as real, realising our human experience of
pain at the death of a loved one. We need to adjust to living without
her presence and missing her as part of our lives. The world may seem
empty leading to a sense of desperation and feeling sorry for oneself.
Yet as we lose, through the death of loved ones we recognise our own
mortality and the universality of death. The Buddha explained this,
illustrating it by a story. A woman came to the Buddha in anguish
carrying in her arms the body of her dead child pleading for the
child’s return to life. The Buddha said that he would grant her request
if she could bring a mustard seed from a household where no one
had died. The woman returned a year later having found no such
household, realising the universality of death.

Childhood is a time of change in physical capacities, in language
and in intellectual, emotional, social and spiritual growth; it is not
surprising therefore that there are some challenges. Developmental
norms help us to know what we might expect of children at different
ages, yet growth is varied. Recently, child psychologists have called
this holistic growth ‘a web’ with interacting developments rather
than a process of even growth in marked stages. However, in physical
development there is a natural sequence; for example, an infant sits
and crawls before she walks. Similarly, in conceptual development
there are stages as seen in Chapter 1. The emotional and physical
reactions to bereavement also show stages. A grieving child needs an
adult she loves, respects and feels safe with; this is usually a close
relative. If the death is of a parent, this is a threat to the child’s whole
life and she needs to know that life will continue in some way for her.
The resources of a remaining parent, may be limited as a result of her

own grief. The adult needs to be one who respects the child and can
recognise that children grieve differently from adults – a person who
can receive the child’s questions as the child jumps in and out of grief,
even when these questions seem callous. Children need to know that
grief takes many forms and that it is fine to feel angry, to cry, to sob or
to be silent; these are all normal acts of grief. They also need to know
that grief continues well after the funeral.
Accepting loss is part of the growth to maturity. Losses, as mentioned
in Chapter 1, are many and varied – the physical loss of the first tooth,
the loss of childhood at puberty. Helping children and adolescents to
confront and learn about loss, grief and bereavement and to develop
emotional resources is too important to leave until occasions of personal
or public crisis. It is what we make of our losses and how we use them
and can grow through loss that matters. In learning how to grieve
we are learning skills for life. Children tend to return to a death in a
natural way – adults to quit and get on with life. Age-related concepts
and behaviours of children and adolescents with an adult response are
shown in Table 2.1.
Two useful resources are Heather Butler’s (2013) Helping Children
Think About Bereavement: A Differentiated Story and Activities to Help
Children Aged 5–11 Deal with Loss, and Muddles, Puddles and Sunshine:
Your Activity Book to Help When Someone Has Died (Crossley 2000).
Table 2.1 Age-related concepts and behaviours around death

Age Concepts Behaviour Adult response
A baby/ No understanding of May be signs of Normal routines
newborn death, though senses irritability, change if possible
the sadness in the in eating patterns, Verbal and physical
house disturbed sleep patterns affection
Concern re. separation
Toddler No understanding Threat to child’s world Consistent care –
that death is final and Signs of insecurity: physical:
inevitable, though colds, clinging, cuddles; a comforter/
may have some tantrums, erratic sleep pacifier; books read
experience of pets patterns, repeated by carer, messy paints,
dying/seeing questions creative opportunities
a dead bird
cont.
Age Concepts Behaviour Adult response

3–5 yrs/ Limited Affected by parent’s Continuity, routine,
kinder- understanding emotional state; reassurance, security,
garten of death as sleep so undermines confidence using concrete
stays awake; or the in world – asks many language, physical
absence of a parent questions to make sense affection,
who works Clinging; has difficulty reading stories
verbalising – acts out
aggressively, escapes
into play
Regressive behaviour,
bedwetting,
thumb sucking
5–9 yrs Beginning to accept May be afraid of Talk with child –
impermanence and dark, nightmares, listen to her concerns
inevitability of regression to baby talk, Help her share bad
death, though it only bedwetting, gaining dreams demon/
happens to older attention skeleton
people. Model positive –
Fills gaps in assure that life will
understanding with go on – will be taken
fantasy/magical to football/dance
element lessons
Involve in decisions
Draw, express grief
creatively
9–12 yrs By ten years most ‘Landscape’ questions – Consistency –
children understand change is likely Admit when you do
death as universal, e.g. house, new partner not know answers
irreversible, non or parent
Encourage joining a
functional, i.e. dead Independence support group – other
things cannot do
Fragile youngsters
what living things can
Increased anger and Anticipate mood
Impact of own death
guilt swings
Some struggle with
School phobia –
death as final possibly
bullying
because of religious
views of afterlife Wonders about own
death and those around
them
Anger – why death?
Adoles- More mature attitudes Awareness of own These are not yet
cents mortality – so adults – be there for
depression them
Risk-taking behaviour Support when needed
– drugs, alcohol, fast
cars, bikes

Below are three case studies. Respond to the questions from both your own
professional experience, and your experience as a mature adult.
Case study 1
Gerald is ten and his father died ten months ago. Gerald lives with his
mum and two brothers. He showed no emotion at the funeral, does
not talk about his dad, and if others speak of him, he leaves the room.
His mum has become concerned because Gerald is not achieving at
school; he is withdrawn and losing friends.
• Why do you feel Gerald is reacting this way?
• How do you think Gerald could be helped and supported
with his loss?
Case study 2
David is five. His mother, Anne, died recently after being ill for many
months. Often when his mother was very poorly or in hospital, David
would stay with his grandma, since his dad worked long hours. His
grandma lives some distance away. After one visit to Grandma he
did not see his mother again. David didn’t ask where his mother was
and Grandma has suggested to David’s dad that all photos of Anne
should be put away in case they remind David of his mother. Recently
David has begun to say he can see ‘Mummy’.
• Why do you feel David is reacting in this way?
• How do you think he could be supported in his loss?
Case study 3
Jason was eight when his mum died. His parents were separated
yet seemed to be beginning to understand one another again. Mum
had dropped Jason off at school as usual and later that morning had
been killed in a car accident. That evening his dad picked him up from
school, which was very unusual, and took him to his nan’s where Dad
was living. They told Jason what had happened to his mum. He asked
lots of questions to find out things and tried to imagine his mother
and the accident. Dad took him back to Jason’s home and picked
up some clothes before returning him to Nan’s. Nan did not think it
was suitable for children to go to funerals, but Dad asked his work
mate who had lost his wife and he said it was OK. So Jason went.
He did not like talking about what had happened to his mum for fear
of upsetting his nan and dad. His dad was worried about him since
Jason was so quiet. Jason would spend long periods in his bedroom
at his nan’s and one day Dad heard him crying.
• Why do you think Jason was so quiet?
• What could Dad do to help?
• What long-term solutions might help in this situation?
The questions in these case studies can be tackled using the process model
shown in the figure below.
Factual description
Action plan of bereavement
Evaluation of
Conclusion feelings/emotions of
bereaved
Analysis – what
other actions
were possible?
3
Challenging Factors
Influencing Grief
It’s just goodness and happiness and warm.

(Cameron writing about heaven, Marshall 2003, p.23)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
The smoke alarm in the hospice was set off following Janice’s visit
to the chapel. She had lit all the tealight candles in the bowl of sand
available for anyone to light as rising prayers to God. She lit them as
prayers for her dad, who was a patient in the hospice suffering the last
stages of Parkinson’s disease.
63
Many people would think this a desperate and pointless action –
Janice felt the only thing she could do was pray since she was fearful
of losing her beloved father. Visiting the hospice regularly, Janice had
noticed her dad getting worse. Now he could no longer walk though
he had been a keen football player, and his speech was unclear. Janice
longed for his healing. Healing can mean many things including
freedom from pain; some believe that death is the ultimate healing as
a release from pain.
Sandra was 14 and in her public examinations year. She was very
sensitive and such a caring girl that other girls came to her with their
problems. Some girls, perhaps out of jealousy, bullied her. Eventually
life became too much for Sandra, and she wrote in her journal that
she wanted to end it all. A friend happened to see the journal and,
worried by its content, reported it to their form teacher. The head
teacher was told and called for a meeting as soon as possible with
the school counsellor and Sandra, whose mother was then informed.
The mother came to the school greatly distressed. Sandra met the
counsellor and warmed to her, finding their conversation helpful. The
father was telephoned and was furious that the school were interfering
and said that this was a family affair
The school acted quickly since the staff and particularly the counsellor
were trained in the volatile behaviour of adolescents. They know the
signs when all is not well with a pupil and had measures to deal with
this in Sandra’s case. However, in the case of a minor, parents must be
involved, particularly in this instance where the attitudes of mother
and father were very different. In the ongoing care of Sandra it was
necessary to see her father. The head teacher arranged to see him at
home, on his own territory, to help him understand that while it was
a family affair, it was helpful to Sandra to work with someone outside
the family whose expertise was adolescence and who maintained
strict confidentiality.
Challenging Factors Influencing Grief 65
The link of adult, child and

adolescent experience
Children and adolescents are much more ‘hands on’ than adults.
They take action and do the practical thing in the present moment.
Janice expressed her grief about the possibility of losing her father
by lighting all the tealight candles in the chapel as a prayer to God.
Sandra was practical in that she wrote a journal in which to record
her thoughts including what she might do in the future. Adults tend
to ruminate and think carefully. In the examples in this chapter we
address difficult situations affecting children and adolescents where
adults do not always recognise the implications for them. For example
following a miscarriage or a stillbirth, siblings will feel the pain of
loss but their grief can be ignored. There are other situations, such as
the terminal illness of a parent with young children, when there are
long-lasting repercussions for the wellbeing of the children. Often it is
thought that they don’t understand as much as adults involved.
Sociological, psychological and historical

insights to factors influencing grief
Models of grief were discussed in Chapter 2 and these refer to
normal grief. While recognising the variety within normal grief,
and an overlap between normal and complicated grief, the latter has
distinctive features. Difficulties in complicated grief are conceptualised
in terms of the grief process and the ‘tasks of grieving’ following a
complicated death.
Difficulties in the grief process are considered to be:
• the absence of grief after a major bereavement
• delayed grief, when the bereaved delays beginning a grief
process and later is overwhelmed
• inhibited grief, that is grief that is limited
• unbalanced grief, since the bereaved is grieving but appears
stuck in one emotion
• chronic grief, because the bereaved appears stuck in one
particular phase of grief.
The tasks of grieving following a complicated death are as follows:

• Task 1: The reality of the loss has not been fully acknowledged.
• Task 2: The bereaved has not allowed himself to experience
the pain of loss.
• Task 3: The bereaved is unable to adjust to living without the
deceased.
• Task 4: The bereaved is unable to let go and does not have the
energy to go forward and rebuild a life for himself.
Conceptualising grief in these two ways helps in knowing what
responses are possible.
Certain factors make grief more likely to be difficult, though this
is not always the case:
• A first factor is the nature of the death: uncertainty of death –
for example, the disappearance of someone while swimming
but no body is found; unnatural death, such as murder,
terrorism, soldiers in war zones; sudden unexpected death;
multiple deaths in a road accident; death accompanied by
other losses; suicide.
• A second factor is the nature of the relationship of the
bereaved with the deceased. Was this a dependent relationship,
such as that between a baby and a mother; an extremely
close relationship such as parent and child; or an ambivalent
relationship between adolescent and parent? The nature of
the relationship will indicate the grief, though it must be
recognised that each bereavement is unique.
• A third factor is the nature and circumstances of the bereaved
person: their age; their psychological strength; how they
coped with previous losses; the presence of other stresses, such
as financial worries; social support; the presence of a close
friend to share confidences; idiosyncratic needs and cultural
differences.
These three factors will now be applied in several particular situations
with indications of how grief is addressed.
Miscarriage, stillbirths and cot deaths

A hundred years ago the death of a child was commonplace, as was
that of a woman in childbirth. Today in the West these events are rarer
but stillbirths and cot deaths do occur and adults may feel outrage and
anger such that even humanists might turn to say that God did nothing
to prevent the death, appearing powerless to intervene. Sadly in Britain
the death of a baby is not uncommon; a quarter of pregnancies do not
end with a live birth. In the UK each day 17 women experience a
stillbirth (James 2004, p.136). In 2012 stillbirths were 4 per cent of
live births, the lowest figure ever. This is still an unacceptably high
level and this necessitates an emphasis and a political will to pay for
research into the reasons for stillbirth. In 2013, 2767 babies under a
year old died.
An article about Laura’s stillbirth brought responses of silence.
Her mother, Alice, wrote, ‘We live in a society that is in denial about
death. Get the dead under the sod with the minimum of fuss and
move on to the next thing straight-away. That’s the current approach’
(Jolly 2007, p.3). The contrast is made with the mourning rituals of
the Victorians and today Italian and Spanish graveyards with their
photographs and the importance other countries attach to All Souls
Day (see Chapter 7). Laura’s parents already had a son and a month
after Laura’s stillbirth, he had his third birthday. Alice said, ‘My son’s
questions went on and on. Do people come alive again? How will my
sister grow if she’s in the ground? Can we buy a new baby?’ Young
children need to make sense of a death in their own way, expressing
their grief through questioning, although this is very difficult for a
mother alongside her own feelings of grief. There is help for grieving
mothers, and Alice found it through the community sharing of those
who had similarly lost a baby, in the Stillbirth and Neonatal Death
Society (SANDS).
Mothers suffering a miscarriage, stillbirth, cot death or the
termination of a pregnancy may have a specialist midwife to support
and facilitate culturally and spiritually appropriate care. The baby
may be washed and dressed; hand and footprints taken and a lock
of hair cut and preserved; there may be photographs. The challenge is
giving a mother choice by asking in a way that is not offensive, but right
for her. Chaplains may ‘bless’ dead babies and say prayers for the baby,
with or without parents present, which may be helpful for the grieving
mother and her wider family and friendship network; this may also
include naming the child. Some mothers prefer not to name a baby;
an example is the case with mothers of African heritage ‘as naming is
something that happened days after the birth and has its own cultural
and religious pattern’ (Rhodes 2013, p.132). There may be a religious
or non-religious ceremony to acknowledge the death when parents
talk of their hopes for and feelings about what might have been had
the baby lived. Chaplains may give a ‘blessing card to affirm the reality
of a child and offer something to remember it by, in a place where there
perhaps seems little to hold on to’ (Rhodes 2013, p.133). Hospices
and hospitals may offer memorial services. All these actions of care are
significant in a traumatic experience, for the mother in particular, but
also the father or partner.
In Alice Jolly’s situation, her three-year-old son persisted with
questions about her miscarriage, questions which were very relevant
and natural for his age but difficult for her to handle. Parents may find
explanations difficult. There can be a tendency to forget the siblings
of ‘a baby to be’ who may be traumatised. It can be that the life of a
sibling may be dominated by memories of the baby who died. (See
the example of Jamie whose early life was dominated by the death
of a twin sister in Chapter 7.) Stories that can be used with children
include Goodbye Baby: Cameron’s Story (Griffiths and Mcleod 2010), a
book to read with young children who have known about a mother’s
miscarriage, and The Very Hungry Caterpillar, a story of transformation
in nature (Carle 2002).
A child with a terminal illness

The news that a baby is born with a life-threatening illness requiring
constant medical attention is one of the hardest events that a couple
or a parent face. It can cost a marriage. The feelings of guilt and anger
may dominate at first, followed by living with the uncertainty and
having to continue life while adjusting to a new situation. The siblings
of the child may be affected through picking up parental emotions.
For some there is a feeling of what might have been and a period
of anticipatory grief – grief before a death, but one that progresses
through the ‘normal’ stages of grief. In this situation the parent’s grief
is profound, shattering life, since no parent expects to pre-decease
their child; it does not seem natural. Yet approximately six thousand
children a year die in the UK. Many grieving adults find it very
difficult to talk about the illness and likely death to friends, family or
even each other. Winston’s Wish comments, ‘this can sometimes cause
strain. However, it can also be helpful if you (parents) have different
strategies and ideas that might work for each other at different times’
(Winston’s Wish 2001, p.6).
David Cameron and his wife Samantha’s first child, Ivan, was
born with severe epilepsy and cerebral palsy. Samantha reflected on
their realisation that something was wrong with Ivan saying, ‘It’s your
worst nightmare. They did a lot of tests, you go into the office with the
doctor and they push the box of tissues towards you and you feel like
you’re in an episode of Casualty ’ (a British hospital ‘soap’ TV series).
She later said:
It changes your life for ever. It’s tough, lonely and isolating initially.
You’re living in a completely different world to your friends who’ve
had babies at the same time. You’re suddenly in this weird world of
doctors and social services. You know your child is never going to
meet the normal milestones. (Prince 2015)
They knew Ivan’s life span was limited and for six years he was in
and out of hospital. During that time the Camerons had two other
children, Nancy and Arthur. His sister and brother did not seem to
perceive Ivan’s disability as making him different from them.
Ivan died on 25 February 2009, aged six. Nancy was then five
and Arthur was three. Ivan’s sudden loss was heart breaking for them
as well as for David and Samantha. His siblings will find it difficult to
understand what has happened to Ivan and they will wonder where
Ivan has gone and when he is coming back.
The emotional rollercoaster of parents with a baby born with a
severe defect, or exposed to disease which becomes life threatening
or an accident, is devastating. Working with a child with a life-
threatening illness is especially demanding. Care is about dispelling
guilt in both child and parent, honesty, open answers, listening to the
child’s understanding of the illness, showing love, offering security
and explaining in a language the child can understand. The sick
child suffers, but so do the child’s siblings, perhaps because, almost
inevitably, most of the available time is focused on the sick child.
Sister Frances, in charge of St Helen’s Children’s Hospice, tells of
an incident with two brothers: Harry aged six and his five-year-old
brother Cameron. They had grown up together and played together.
Now Harry was on a syringe driver in the Children’s Hospice.
Cameron spent part of each day with his brother. His brother had to
be told of the seriousness of Harry’s condition and while he played
in the corridor, Sister Frances knelt beside him and told him that his
brother was going to die in the next day or two.
Cameron looked as if he’d been hit by something that had knocked
all the air out of him and then he carried on playing. The news had
to sink in slowly… I felt as though I had taken away his innocence
and something died in me too… Cameron was out of the room when
Harry died the following day, but we brought him in immediately and
he said his own goodbyes. His shock was indescribable but totally
visible – it hurt me to the core to see Cam suffering like this, but I
knew I couldn’t shelter him from it, just as no one could save us from
the pain either. (The Guild of St Raphael, Children’s Hospice 2002)
Bereavement support is offered to parents and siblings of a child
who dies and a child whose parent dies by organisations such as
Children’s Hospices and websites. In the USA there is an organisation
called ‘Bereaved Parents’, a national self-help group offering support,
understanding, compassion and hope to bereaved parents, grandparents
and siblings struggling to rebuild their lives after the death of their
children or grandchildren. It holds monthly support meetings called
‘chapters’ and produces a newsletter and brochures (see the Useful
Websites and Organisations section).
The sudden death of a child

A sudden death may happen as a result of an accident or undetected
illness. The latter was the case with Tom who died in his sleep on
Friday 5 October 2007. His father, Paul, found him and called the
ambulance. As an unexpected death the police became involved and
arrived at the home. Tom’s sister, a year younger, was at school; she
realised that it was bad news when she was taken unexpectedly out
of class. On Monday the coroner called stating that Tom had died
from an extremely rare heart condition and that nothing could have
predicted it nor anything been done to prevent it. The funeral was a
celebration of Tom’s life at which his sister spoke through her tears.
His father commented on grief, ‘Life carries on with a Tom-shaped
hole in its fabric. Sometimes it rips further, sometimes it’s less frayed,
but it’s always there…when your child is cut from your life you bleed
and keep on bleeding.’ The effect on his thirteen-year-old daughter

must have been immense. He says of her:
Ellen, meanwhile, is both my greatest hope and my greatest fear. Hope
because I now see a young woman who appears, despite everything,
to be a rounded human being. Sure, she’s spent her teenage years
discovering booze, fags and goodness knows what else, but she
seems to have done this in a way all teenagers do. Fear because who
knows what goes on in somebody’s head, especially that of your own
teenage daughter? It’s not the easiest or most communicative of ages.
Do I just see what I long to see? However, we think we dealt with
Tom’s death as parents, (she) will have a different perspective. I simply
hope for the best. (Clabburn 2013, pp.30–31)
Paul felt the pain and agony of Tom’s death. In the death of a child,
if the pain of grief is blocked, harm is done. Jim would not hear the
name of his teenage daughter spoken after she was killed in a car
accident, neither has he ever mentioned her name. He refused the
help and counselling available. His daughter’s death has changed his
character and his relationship with a younger daughter, whose grief is
also blocked by his attitude. Pain can be blocked by silence, or as for
Jim, by drugs, drink and sex.
Friends and family want to help the bereaved parents cheer up, but
this does not help, neither do easy answers nor platitudes such as, ‘She
was like a beautiful flower and God wanted her for His garden.’ It is
important to give the bereaved plenty of time and opportunities to say
what they really feel; to be available; to accept the story of the death
repeated again and again. Sometimes there is the anger of guilt: the
father who didn’t see his child and backed his car, killing her. Guilt
is an emotion that gnaws inside if not addressed; expert help may
be needed – if the person is religious a sympathetic priest may help.
Listening to the bereaved frees them to be themselves at whatever
stage they are. In some situations, sympathetic touch is appropriate.
The death of a child is never forgotten by a parent but remembered
through photographs, carried within memories and in the heart. There
is also a danger that such a death and its ensuing grief can blight the
lives of the siblings of the deceased who themselves will be expressing
grief, though their grief is different.
A child who has a terminally ill parent

If the family can cope the best place to die is at home. However,
statistics show that 53 per cent of terminally ill people die in hospital
compared with 21 per cent at home (see Chapter 3). Reasons for a
final hospitalisation and death are varied. They include the distress of
the family, who cannot cope now and don’t want to continue to live
in the house where the parent died; lack of room to provide privacy
to the sick parent; or a family’s fear of being ill equipped to deal with
medications. The gain from being at home is the opportunity during
the illness to get together as a family and share what has happened
during the day, school activities, the doctor’s visit, memories of past
happy times and times to come. It can also be relaxing together as a
family, maybe each tea time, simply enjoying the positive things that
have happened. Constant visits from professionals, friends and distant
family can be intrusive to the ordinary routine of family life, but this is
not ordinary time. Children can feel left out and need specific chores
to do for which they are responsible, as part of a carefully ordered
routine. It is important that illness does not take over the family life.
A partner as a carer needs to recharge batteries; maybe a friendly
neighbour can sit with a sick mother, while Dad and the children go
out together and have a short break.
Using the illustration of a wife and mother dying as an example,
gradually a father will spend more time caring and have less time
with his children so he will need others to help with the household
chores. These may be extended family, neighbours, other professionals
or a social services carer. At this time children may notice a change of
identity in the sick parent: Mum, once seemingly omnipotent and who
could do anything – make breakfast, eat it and create packed lunches
while having conversations about the need of clothes for a gym lesson
– now cannot stand to do jobs and they have to be done one at a time
gradually. Janice, who lit all the candles in the chapel, had noticed
the deterioration in her father’s health and condition; for her, he had
changed. In the future there may be a stepmother who has not been
part of the relationship with the child during a period of their life
when the children have experienced emotional turmoil.
For some sick parents there is a desire themselves to prepare for
their children’s future lives without them. Violet was concerned about
her grandchildren who were young – too young to understand the
idea of death’s finality. Violet wanted to write a letter to be given to
them after her death. She wanted to assure her grandchildren that
death was something positive and not frightening. She thought of
her grandchildren’s fun on the slide in the park; death was like this,
there was the effort of climbing to the top of the slide and then the
excitement and freedom of letting go and sliding down. This was
a letter her grandchildren would want to keep and treasure. Anne
decided to write a letter to each of her daughters to open on their
eighteenth birthdays. This said how proud she was of the child, now
an adult, and that she was still close to them and always would be in
their memories. Anne thought about a present that could be given to
her daughters after her death: a necklace for each with a heart-shaped
case which could contain a small photo of her. Dan, her husband,
helped her in this. These actions were a solace to Anne’s teenage
daughters and showed them that she had continued to love and think
about them when she was dying.
In the hospice, family support staff helped terminally ill
patients choose, make and fill memory boxes for their children and
grandchildren. These contained a variety of things such as a lock of
hair, the remnants of a favourite bottle of perfume, a recorded message
and photos of the family holidays. They were a comfort to families
after the death; some families keep the boxes in special places and
bring them out on significant occasions, such as the anniversary of
the death, and may add other pieces of memory. For some patients,
however, making a memory box was beyond their ability in accepting
the possibility of their death.
Some terminally parents die in a hospital or hospice. Visiting
times in hospitals are limited but there is usually a lounge from which
children can come and go from Mum’s bed, which is useful for a young
child’s short attention span. Older children can be encouraged to take
homework to do and Mum might be well enough to take an interest
and help. A young child can rearrange the greetings cards, draw a card
or tidy the bedside cabinet. However parents may be reluctant to allow
children to go to the hospital for fear of what else a child might see,
particularly in oncology wards where people are very ill and may be
hooked up to a variety of machines.
Ana Draper is a Macmillan consultant specialised in working with
families facing a life-threatening illness and the author of Good Grief:
What Will We Tell the Kids? (Draper 2008). Sensitivity is central to the
care of children with a parent who has a life-threatening illness. Ana
recommends listening to children and asking them whether they want

to ask anything. Usually the child knows intuitively what is happening
but sometimes a conspiracy of silence prevails. On occasions there is
a half-truth told to children. Amy, a seven-year-old, was told by her
maternal grandmother that her mother who was dying at home with
cancer was getting better. When her mother died a few days later,
Amy’s anger was significant. We maintain silence because we think
that childhood innocence should not be broken, and children should
be free from difficult and challenging life events. Many parents want
to protect their child when one of them is terminally ill, but it is more
helpful to talk about the progress of the illness so that children feel
included in what is happening.
In these difficult circumstances of a terminal illness, adults worry
about what to say, saying the wrong thing to children or being asked
questions they feel they can’t answer (see Chapter 4). When children
want to know, answer them realistically, honestly and frankly, without
recourse to euphemisms; the result will be that trust continues to build
between adult and child. The support services such as the Macmillan
and hospice nurses need to work in parallel with parents and the
schools that children attend. A child’s need for information or choice
not to talk should be respected. It is important to consult children and
to involve them in decisions so that they can recover some sense of
control in a world that has suddenly been turned upside down.
For children facing the imminent death of a parent and challenging
grief experiences, it is about working with them, perhaps in play using
appropriate media such as puppets, books and creativity, discovering
from the child what he knows and wants to know. It is important to
respond to children honestly for young children are matter of fact;
they also soon forget and will ask again. A book which may help is a
Winston’s Wish publication, As Big As It Gets, which contains ideas to
help parents and carers to involve their children in what is happening
when a parent is seriously ill (Winston’s Wish 2007).
When the death happens, in some ways it can be a relief for
the child. Care after the death will continue through support at the
funeral. For the father losing a child suddenly, for example through
an undetected condition (usually a heart attack), a downloadable
booklet for bereaved fathers at the Cardiac Risk in the Young website
may help with bereavement support (see the Useful Websites and
Organisations section).
Tragic events: reaction to the events of 9/11 in New York

The total killed in the bombing of the Twin Towers in New York
was 2823. These included employees in the Towers, firefighters,
paramedics, police and Port Authority police officers. There were
161 families with no remains to grieve (Templeton and Lumley
2002). Many of those who died left children. Those who died came
from 115 nations making it, in this sense, an act of indiscriminate
bombing. These figures come from a year after the disaster when the
psychological stress, trauma, anxiety and depression continued.
Children heard the news in the UK from shocked parents at the
school gates. At home those who had family and friends in New York
wanted to check that they were safe. Children saw in the media the
repeats of planes flown into the two towers resulting in the death
of many. Children cannot be shielded from such events which
dominate the media. At school the following morning head teachers
acknowledged what had happened and expressed the sadness of the
loss of life. Children were encouraged to talk openly in response to
the event. The younger children, who tend to ‘puddle jump’, moved
from sadness at an event in which they were not personally involved
to getting on with life. Grant, age 11, rationalised, ‘It was a cruel
thing to do, but they only do it because they are sick and selfish’ (Duffy
2008, p.12). Most of the youngsters were outraged as they watched the
TV in horror. Adolescents might discuss the implications of some of
the events, for example that these so-called ‘terrorist’ attacks are often
indiscriminate in their victims, particularly their nationality. Contacts
with the local Muslim community and a visit to a local mosque and
discussion there might help.
Children and adolescents are affected by tragic events even when,
for those in the UK, these are far from their own homes. Adolescents
can identify with the emotions of grief of others and the anger of an
unprovoked action. In the UK on the 7 July 2005 terrorist bombs
killed 52 in London and injured more than 700. Services were held
on the tenth anniversary in 2015 marking the ‘ocean of pain’. More
recently there was an accident with the loss of six lives, with 15 others
badly injured in Glasgow when a bin lorry crashed on 22 December
2014. The media headlines cannot be avoided by children.
Soldiers killed on duty

Soldiers often have families. These deaths are taken seriously by
the military and funerals given honour, since those dying in these
situations have died while working for their country. Families are
helped by the annual Remembrance Day parade and service when the
dead are honoured and children participating realise that they are not
alone in their grief. Winston’s Wish have a book to support bereaved
children in this situation: The Family Has Been Informed (see the Useful
Websites and Resources section).
Murder
When it is children who are abducted and murdered, as happened to
Holly Wells and Jessica Chapman in 2001 in Soham, Cambridgeshire,
their close friends show bewilderment, confusion and fear. Duffy
commented:
they may have shown anxiety at being separated from parents…
perhaps fear of the dark and of having nightmares. They will have felt
vulnerable for a while, afraid something of the same could happen to
them – feeling jumpy or ‘spooked’ as they read ‘danger’ into ordinary
sights and sounds. (Duffy 2008, p.48)
When tragic events happen and our children and adolescents become
fearful, parents and teachers must listen and help them to understand.
Adults need to be realistic, since there are individuals who perpetrate
terrible acts, but they also need to reassure children that these events
are not the norm; there is a great deal of kindness and truth in the
world and the adults in their lives love and care for them. Winston’s
Wish publications have produced a book for youngsters called Hope
Beyond the Headlines (see the Useful Websites and Resources section).
Suicide
In the past, if the person who died by suicide was known to a child,
there was pressure not to tell the child that they had taken their own
life. This could be because adults find it difficult to understand the
motives of someone who dies by suicide, and we do not know how
to explain the event to a child. There is a tendency to say that the
person died in an accident or that the person has gone away, but in
the long run the truth will come out. If a child is not told they may
hear the news from someone else, or an adult or another child will let
it slip by accident or teasing: ‘I know what happened to your mum.’
Sometimes when children are not told they may feel that the suicide
was somehow their fault, that they caused the death; they fill in the
gaps in their knowledge with their imagination and feel guilt.
If the person who died is very close to a child, for example a
parent or an older sibling, then explanations are difficult but must be
addressed, since the grieving emotions are manifold. Winston’s Wish
suggests that a parent could say something like: ‘I have something to
tell you. It’s something that has made me feel very sad and at first I
didn’t know what I was going to say to you. But it’s something you
need to know. Yesterday John died.’ It adds that:
It’s important that children understand what has happened and
although details can seem painful and unnecessary, children often
need to know what happened, why and how it happened and
what happens next. It helps to give children clear facts rather than
complicated words. (Winston’s Wish 2001, p.10)
Children are profoundly affected by a devastating grief; emotions
may include guilt, and self-blame. Sometimes, for an adolescent, if
the parent had a history of alcoholism, depression or sexual abuse
then there may be a sense of relief that this experience of life is over,
but quickly guilt and remorse fill the gap because of the initial sense
of relief. A child may fear that the surviving parent will take the
same action causing insecurity and mistrust, and an adolescent may
question, ‘When I am older, will I do the same?’ The best person to
talk to a child and work with his grief is the surviving parent, but his
own grief may make this impossible to bear. However, this difficult
grief needs addressing for the child and adolescent and it is sometimes
possible for another member of the family to help or someone outside
that family such as a close neighbour, a teacher or school counsellor.
It is significant to realise that until 1961 suicide was a crime in
the UK, and a failed attempt warranted a prison sentence. The Church
would not bury a suicide victim in consecrated ground. Fortunately
our understanding has largely changed and we are more sympathetic
to a person who attempts suicide, though old ideas still linger. The
Alliance of Hope for Suicide Survivors states that according to World
Health Organization statistics, approximately one million people
die by suicide annually (see the Useful Websites and Organisations
section). In the UK a range of support for those affected by a death

by suicide is offered by SOBS, Survivors of Bereavement by Suicide.
Well at School is a website maintained and developed by Chelsea
Community Hospital School in conjunction with teachers, hospital
schools and health care professionals. It produces resources for use
in schools on general medical and mental health including signs of
depression in adolescents and self-harm, which may be a physical
manifestation of a deep emotional problem. For parents worried about
their children and dying people’s mental health the YoungMinds ‘Save
the Parents’ helpline is a useful resource (see Useful Websites and
Organisations).
A further useful resource for young children is Luna’s Red Hat: An
Illustrated Storybook to Help Children Cope with Loss and Suicide (Smid
2015). The book also includes a guide for parents and professionals by
grief expert, Dr Riet Fiddelaers-Jaspers. The book tells of a beautiful
spring day, and Luna is having a picnic in the park with her family,
wearing her Mum’s red hat. Luna’s mum died one year ago and she
still finds it difficult to understand why. She feels that it may have
been her fault and worries that her dad might leave her in the same
way. Her dad talks to her to explain what happened and together
they think about all the happy memories they have of Mum. This is
a tool to be read with children aged six years and above. The author
of Luna’s Red Hat had a schoolmate who died by suicide when they
were both 16. At 21 her aunt died by suicide leaving daughters aged
11 and 14. Winston’s Wish has a book called Beyond the Rough Rock
giving practical advice for families and professionals in the immediate
days and weeks following a suicide; the book includes child-friendly
activities (see the Useful Websites and Resources section).
Children and adolescents who die by suicide

Statistics on the suicides of children and adolescents are hard to find.
The latest details from the Office of National Statistics relates to
2009 when 952 males and 534 females died by suicide aged 5–34
years. In 2011 the YoungMinds organisation reported 194 suicides of
15–19-year-olds. Articles in Patient Plus are written by UK doctors
and are based on research evidence, UK and European Guidelines (see
the Useful Websites and Organisations section). This source suggests
depression as an increased risk of suicide, with risk factors ranging
from family discord; bullying; physical, sexual or emotional abuse; a
history of parental depression; homelessness; refugee status; and living

in institutional settings. Ritalin may be prescribed by GPs which may
help temporarily but does not get to the root of the problem.
Children and adolescents may display sadness and helplessness,
feel unloved and unfairly treated and have a poor self-image. One
outcome is poor eating and playing with food. Management is
through support and listening by someone confidential outside the
family, perhaps a teacher or a school nurse. Later if behaviour does
not improve there may be a need to approach a child psychologist.
For adolescents, behavioural symptoms include use of drugs, erratic
behaviour, insomnia and feelings of guilt and despair. Assessment is
particularly difficult with adolescents, since questions may be answered
with silence, and young people can be manipulative and therefore
require a second opinion. Self-harm can be regarded as a form of
communication and is not always picked up. It is sometimes difficult
to decipher the adolescent’s exact intentions. Deliberate self-harm
is common in adolescents, especially females, and there should be
an immediate referral. Management of an adolescent client must
be taken seriously through referral to paediatricians, social workers
or teachers trained in counselling. Suggested techniques include
cognitive behaviour therapy and anti-depressants, though the latter
can increase risk of self-harm and attempting suicide. Teachers need
to be alert and act with others when there are distinct behavioural
changes in a child or adolescent, since parents may be unaware of the
situation. The increase in self-harm in children and adolescents needs
an urgent response.
Babies and infants dying

Infants born pre-term who struggle to survive, or those born with
congenital abnormalities or suffering from birthing difficulties, such
as lack of oxygen, bring emotional pain and challenge to parents and
paediatricians. In the past the doctors – parents were not consulted –
fed and kept the baby warm, while allowing nature to take its course.
Death usually resulted. Today many paediatricians make strenuous efforts
to help the infant survive, though he may be disabled or have a limited
life span, while others are beginning to advocate infant/child euthanasia.
The Netherlands
In late 2000, the Dutch parliament voted to legalise euthanasia for
adults suffering extreme pain and with no hope of recovery. Between
1997 and 2004 there were 10–15 cases of infant euthanasia a year,
but only one fifth were reported, due to doctors fearing a murder
charge. After decades of discussion, guidelines were written by Eduard
Verhagen, head of the Department of Paediatrics at the University
Medical Centre, Groningen. In 2005 the Netherlands recognised this
‘Groningen Protocol’ as the set of criteria outlining the circumstances
making it permissible to end the life of a baby under the age of one.
Euthanasia can only be undertaken if an infant’s diagnosis and
prognosis are certain and confirmed by an independent doctor; there
is evidence of hopeless and unbearable suffering; both parents give
their consent; the procedure follows medical standards and all details
are documented (Verhagen and Saucer 2005).
Since 2005, there have been only two cases of euthanasia, the
decline correlating with an increase in late terminations, up to the
24th week of pregnancy, particularly in cases of spina bifida. Since
2007, free ultrasound scans have been offered at 20 weeks when the
condition can be detected, severity determined and, in some cases,
surgery is possible. If the condition is severe, mothers are able decide
to terminate or continue the pregnancy; most decide to terminate.
In June 2015, the Dutch Paediatric Association asked for the
current age limit of 12 years for the right to die to be considered
arbitrary, so that each child under the age of 12 who asks to die will
be evaluated on a case-by-case basis. Verhagen stated that if a child
under 12 satisfies the conditions outlined above, euthanasia was an
option; paediatricians are currently powerless to help and it was time
to change. The Association want a commission set up to examine the
question further. Euthanasia remains technically illegal for children
under 12, however doctors are not prosecuted if the Protocol’s criteria
are met (Nuwer 2014).
Belgium
Euthanasia was decriminalised for the terminally ill over 18 years old
in 2002 and for some infant euthanasia seemed the logical next step.
There were paediatricians on both sides of the debate, many signed
an open letter against any law, claiming that modern medicine was
capable of alleviating pain. They warned of a slippery slope where
very sick children could be pressured into choosing death. From the
dominant Roman Catholic church there were religious and ethical
arguments against any law. In 2014, the Belgian Parliament faced
these challenges and gave children the opportunity, in exceptional
circumstances, to choose the time and nature of their death allowing
euthanasia for terminally ill babies and children without any age limit,
by 86 votes to 44 with 12 abstentions (BBC News 2014). Belgium
was the first country in the world to pass a law allowing a terminally ill
child to choose euthanasia. The law has strict checks. The child must
request euthanasia on several occasions; be in a terminal condition; be
in constant, unbearable pain that cannot be alleviated by medication;
they must understand the meaning of ‘euthanasia’ and be assessed
by a psychiatrist to ensure they understand the implications of their
decision; parents and doctors must agree to the request. If there is any
doubt that the decision to die is not the child’s, doctors err on the side
of life.
The challenge is whether or not a child has the capacity to make
the judgement to live or die. Does the decision place an inappropriate
burden of responsibility on a child? Tom Riddington, a doctor,
wrote a response to the Belgian decision in The Guardian newspaper,
noting that:
the new law at least allows a discussion to take place, without fear of
legal repercussions. It gives parents and children a chance to know
all the options available… For the terminally ill child, their parents
and their doctors, this dilemma is a daily reality. (Riddington 2014)
The UK
In 2005, the Nuffield Council of Bioethics launched an enquiry into
critical care in fetal and neonatal medicine, and the ethical, social and
legal issues which might arise when making decisions surrounding
treatment (Nuffield Council on Bioethics 2005). The Royal College of
Obstetricians and Gynaecologists submitted a recommendation that a
public debate be started on options of ‘non-resuscitation, withdrawal
of treatment decisions, the best interests, tests and active euthanasia’
for ‘the sickest of newborns.’ The College stated that there should
be discussion over whether ‘deliberate intervention’ to cause death to
severely disabled newborn babies should be legalised. While it was not
necessarily in favour of the move, it felt the issues should be debated

(Royal College of Obstetricians and Gynaecologists 2005).
Details of this argument and ethical implications can be found in
Appendix 4.

Judaism
The traditional rule is that standard mourning practices do not apply
to a child (or, by extension, a foetus) that does not survive until the thirty-
first day after birth. This seemingly harsh rule arose from the high rate
of neonatal mortality that prevailed universally well into the Victorian
era. Today with differing streams within Judaism, traditional Jews may
still follow the old laws. But increasingly Jews will follow mourning
practices for a stillborn or neonatal death to a greater or lesser extent
as they find appropriate or comforting in the same way as for any
other death. Since there are no rules, it is up to individuals in their
own circumstances, and in consonance with the local community’s
practices, to do what they find appropriate. Mourning for an aborted
foetus is similar. The ceremonies for a child that lives more than
30 days are the same as for any other person.
A resource that may be used in response to difficult death is the
Psalms of Lament in the Hebrew Scriptures, shared by both Jews and
Christians. For example:
Rouse yourself ! Why do you sleep, O Lord?
Awake, do not cast us off forever!
Why do you hide your face?
Why do you forget our affliction and oppression?
For we sink down to the dust; our bodies cling to the ground.
Rise up, come to our help.
Redeem us for the sake of your steadfast love.
(Psalm 44.23–6)
These psalms provide insights that could illuminate the human

condition.
They are a Theology of Vulnerable Presence; after the anger which
may follow a loss, there may be a time of waiting, which cannot be
bypassed. This giving of unhurried, supportive, acceptance of emotions

is a God-like characteristic.
Christianity
Suffering has challenged belief in an omnipotent and loving God. The
question of how to justify God in the face of innocent suffering –
theodicy – has been the domain of philosophers and theologians for
centuries. Omnipotence is not a description of God’s being, rather
it is a veto against the apparent reality that not God, but suffering
and death, wield ultimate power in the world. Research findings and
a recommendation can be found in relation to children in Korneck
(2012). It relates to Germany where religious education is taught in
state schools. ‘Theology for and by children’ has recently received
debate and academic interest. Children, like adults, ask ultimate
questions about the reason for suffering and the final meaning of life,
often being more radical than adults since they are not impressed by
complicated philosophy. Most teachers agree that asking questions
is the most important methodological tool for the task. Children
experience suffering in may ways: through an increasing number
living in poverty; suffering illness, particularly chronic illness; suffering
inadequate or absent relationships; living in an environment that fills
them with fear; and the awareness that their future is being threatened
(Oberthur 2006, pp.44–45). Yet in Children’s Bibles the image is
of a nice God, omitting the reality of evil and fear which children
experience in their lives.
To talk about God as the one who is in control of hopeless situations
and who is able to turn them around is an important task that we
are not allowed to avoid by simply hiding the misery. Children will,
and justifiably so – when they are becoming older at least – classify
biblical stories as meaningless and ‘childish’ if they are not able to
describe their reality comprehensively or even just euphemistically.
In the stories that cause fear, children take part in the whole range
of human experience, which people in the Old Testament have made
with God and which children already know, based on their everyday
life. (Korneck in Lawson 2012, p.429)
Stories of fear that are cited include the flood, the sacrifice of Isaac and
the Exodus from Egypt. The Old Testament is full of an angry God,
for example Psalms 10, 88 and 137, yet God is seen on the side of the
weak, poor and oppressed and, in the history of Israel’s suffering, God
takes away the fear of dying.
[A discussion] with a first grade class in primary school with incessant
input by the pupils on the topic ‘always against the little’ made
obvious…how especially the topic ‘violence towards weaker people’
is relevant among children…they have a very clear understanding of
the fact that violence can proceed from them i.e. they can be victims
as well as offenders, they…told about incidents, in which the first
grade was maltreated by the fourth graders or about conflicts among
siblings…would we fade out biblical texts that contain violence for
children, we would once again take away possibilities of identification
with situations in their life we would not be able to prevent them
from experiencing anyway. (Korneck in Lawson 2012, p.430)
The research was done using a survey of twelve rural and urban primary
schools in North West Germany. Children were asked to state, ‘What I
would ask God…’ and given no guidance. The 2634 responses were
analysed and classified according to strict categories. The result showed
the deep need in primary education to ask theological questions, and
as children grew older the question of suffering and theodicy occurred
more and more. More than 56 per cent of all questions concerned
suffering. The response was to advocate Children’s Bibles containing
the story of Job. Job is a story which handles suffering, fear, sorrow
and doubt with Job, like children, challenging God to respond and
change the situation. For me the answer is an acknowledgement of
the mystery of life and God through those wonderful chapters on
creation (Job 36.24–41.34) and Job’s repentance (42.1–6) and his final
restoration (42.7–17). The researcher’s conclusion is that talking with
children about the book of Job avoids creating barriers for children
with readymade answers.
We cannot leave children alone when they search for answers in this
area (suffering, death)…in honest dialogue, the educator should not
put down any position, but motivate all participants to think further.
Like Job, children are able to ask questions. (Korneck in Lawson
2012, p.431)
Islam
Islam is a religion, a civilisation and a way of life, having its roots in a
reformation of Judaism and Christianity which had become distorted
by pagan influences. Mohammed, born in Mecca (570–632 ce), was
given a message to learn and repeat to others, now collected in the
Qur’an (the Recitation). Knowledge of Islam comes mainly from
the Qur’an which is divided into 114 suras each of which begins
‘In the name of God, the Lord of Mercy, the Giver of mercy.’
This world is transitory; Muslims accept it because it is what
they experience. Life is a journey to find the meaning of existence
and contentment. Mohammed found this through the message that
was revealed to him: belief in one God, prayer, fasting, pilgrimage,
giving to the poor could lead to a transformed life. Humans are free
to choose to follow God’s way and accept a life which is God’s gift.
Death is not to be feared for it is a meeting with God who desires to
call back God’s creation to himself. The time, place or type of death is
not known. Life after death, resurrection, is an act of faith, the Qur’an
states ‘Who will give life to bones while they are disintegrating? …
He will give them life who produced them the first time; and He is, of
all creation, Knowing’ (Qur’an 36.78–80). At death there is a judging
by a merciful God for the Muslim to give an account of his life. The
judging is a response to God’s attributes of justice and mercy, which
have no meaning if there is no life after death. For those who have
followed God’s way, there is a garden of paradise; for those who
have failed, the fires of hell. Children are not judged by the Qur’an’s
rules, since they are learning, so if death intervenes they go straight
to Paradise.
The Qur’an states that each child is born free from any sin or
blemish. The newborn is born in a natural state fitvah which is inclined
towards good. The idea of inherited sin is not found in Islam. There
are three developmental stages in childhood: the first seven years are
for play and exploration, the child is encouraged to discover creation;
the second seven years are those of discipline and learning, the child
learns the consequence of actions and human interrelationships; at
fourteen following the introduction to the tenets and beliefs of Islam,
the Qur’an states that the young person is accountable for his or her
actions (Syeed and Ritchie, p.298). The above suggests that, while
grieving is done for a child who dies, the devout parents can know
that they will meet their dead child again in Paradise.
Hinduism
Hinduism is flexible; it is more like a family of religions:
It is difficult…to say who a Hindu is. To be a Hindu, a person may
observe a complicated system of rules – or none at all. One may give
up the world, or accept it; one may worship one god, or many gods.
One may worship a man as a god, as many do in India, or one may
worship no god at all, and yet be a Hindu. (Brown 1975, p.63)
Yet central to the different expressions of the religion is the doctrine of
Karma since karma is the belief that whether or not the atman (soul)
returns to this life, in a higher or lower animal/human form, or ceases
to be born and becomes one with Reality, depends on the actions
of the individual Hindu. However there is hope in that Hinduism’s
sacred book the Gita says, ‘whenever there is an imbalance between
the power of good and the power of evil, then I, Krishna, appear in a
form to balance them up, to cut down the evil and increase the good’
(Brown 1975, p.251).
Buddhism
Buddhism is challenging; it differs from other religions since it has
no God, nor Saviour, it puts salvation completely within the grasp of
a human. Siddhartha, his own name, and Gautama, the family name
(563–477 BCE), lived a life of luxury in Bihar, destined to follow his
father as king. But outside the palace he discovered old age, disease and
death as unavoidable sufferings for all humans; he also saw a hermit,
tranquil and serene and decided to be like him. These challenging,
existential encounters led Siddhartha to leave and seek liberation from
suffering by leading the life of an ascetic. After years of fasting, almost
to death, and facing temptation to give up he sat under a Bodhi tree.
One night an answer came, and from then he was called the Buddha
– the Enlightened One. He taught for over forty five years, dying in
his eighties.
The Buddha taught the Four Noble Truths: to recognise life as
suffering, disease and death; to see the origin of suffering as a craving
for impermanent achievement and possessions; to cease attachments,
finding liberation from these in joy, happiness and peace – Nirvana;
to follow the path that leads to cessation between self-indulgence and
asceticism: the noble eight fold path of right view, right thinking,
right speech, right action, right livelihood, right diligence, right
mindfulness and right concentration which leads to peace. A man must
trust himself and summon the powers within him to achieve his goals
in life: ‘be ye refuges unto yourselves; be your own salvation with
earnestness and high results, work out you salvation with diligence’
(Brown 1975, p.129).
The law of Karma, or action, is created with the body, speech or
mind and leaves a subtle imprint on our mind which has the potential
to bring future happiness or future suffering, depending on whether
our actions bring happiness or suffering to others; the positive brings
life; the negative death. A person is born and reborn, that which is
successively reborn is not a continuing entity, ‘the karma-bearing
“subtle body”, but the stream of karma itself ’ (Hick 1989, p.491) since
there is no belief in a soul. Parallels are drawn with the caterpillar and
the butterfly – they are the same but not the same. The goal is Nirvana
which literally means ‘dying out’. Nirvana is called ‘the harbour of
the refuge’, ‘the cool cave’, ‘the island among the floods’. The end of
suffering’, ‘the calm of existence’ will continue as long as there is a
desire for existence (Brown 1975, p.131).

There are several events which potentially result in difficult grieving
for children. These include the loss of an expected sibling through
a mother’s miscarriage or a stillbirth; the terminal illness of a close
relative, particularly that of a parent and sometimes a close grandparent
who has been significant in the life of the child; the terminal illness of
the child and the effect on child siblings; the loss of a child through
an accident and the grief of a sibling; the suicide of someone close
including a child or adolescent. Young children are very resilient.
They pick up the sadness emerging on these occasions from the adults
in their lives, though if they are protected and not told in suitable
language what has happened they may feel guilt and think that they
are in some way responsible for the death. Informing children using
language appropriate to them is tough but necessary. Resources to
help adults sustain bereaved children are varied. Many adult hospices
have a bereavement department with trained volunteers who are able
to work with the children of the patients. Sixty per cent of adults
die in hospitals where bereavement counselling for the children of
patients is limited in the UK, due to government cuts to the NHS.
However, chaplains are able to help. Another source of help is the
Childhood Bereavement Network whose website (see Useful Websites
and Organisations) provides a geographical directory of available
support services. It is campaigning for better provision with the slogan
‘Grief matters for children’. In June 2007, the UK government set up
the Bereavement Advice Centre offering a freephone helpline and a
range of literature. A useful download from its website is My Grandad
Plants People! (Earl n.d.), a simple guide for adults when children ask
questions about death.

1. Think of an experience you have had in which a death was difficult
to handle. Write down what you did to help and what you could have
done with the knowledge gained from this chapter.
2. Look up one of the websites mentioned and assess its use to you.
4
What Should We Tell
Children and Adolescents?
What scares me is the forever part. I wish they would make life
longer and Heaven shorter.
(Julia in Marshall 2003, p.29)
I like the idea of heaven but I’m not in any hurry to get there.
(Paul in Marshall 2003, p.85)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
Jim’s grandad died just before Christmas. Jim was six. His grandad
had owned a bakery in a village, and people would queue to buy fresh
bread every morning. He had also made wonderful cakes, especially
89
special cakes for birthdays and weddings. Jim was matter of fact when
he was told of his grandad’s death, since it was near Christmas, and he
said that grandad would be able to cook Jesus a birthday cake.
Children can be very matter of fact when told of a death. Jim came
from a home where Christian festivals had meaning. He associated
Jesus’ birth and childhood with his own experience of birthdays,
which included celebrating by having a special birthday cake made
by Grandad. The timing of his granddad’s death coincided with
preparations for Christmas, so Grandad would be busy making a cake
to celebrate Jesus’ birthday. Jim’s understanding of heaven was a
continuation of life as he experienced it here, grandad making cakes.
Jenny was twelve when her mother died of cancer at the family home.
Her mother had been looked after by her own mother. Whenever
Jenny asked her grandmother about her mother’s health, she was told
that her mother was getting better. One day she returned home from
school to find her mother and her grandmother gone. The bedroom
was empty. Jenny later discovered that her mother had died and her
body had been taken to the funeral directors.
Although Jenny was shocked when she saw her mother’s empty bed,
she had already begun to anticipate her mother’s death through
noticing changes in her mother. She was getting weaker, sleeping
more and having increasing doses of painkillers, including a syringe
driver. Young people need to be told the truth, even if it is hard to take
and has difficult life-changing repercussions. Adolescents observe the
situation and are wise enough to know what is actually happening.
Being deceived by an adult family member sows the seed of a lack of
trust in other adults.
It may well be that Grandma was in denial of her daughter dying.
However, it could not have been easy for Jenny’s grandmother to
think about the possibility of her own daughter’s dying and death: a
young person who had a future and children to bring up. It is never
What Should We Tell Children and Adolescents? 91
easy when a person is predeceased by their own offspring. She was

also of an age and generation that did not talk about death.
As adults we need to listen to children and adolescents. This
listening will give us clues to our approach and what to tell them
to help them understand the situation of a terminally ill parent and to
reassure them that life will go on despite a death. They can be helped
to see that they will be able to carry the lost parent, and memories
of their parenting, with them throughout their future lives, as part of
their own life story.

How do we tell children that someone close to them is terminally
ill? How could a family member have prepared Jenny and her younger
sisters for their mother’s death? This chapter will look in detail at the
relationship between the child or adolescent and an adult, who may
be a parent, teacher or nurse, in preparing the youngsters for the death
of a terminally ill mother, telling them about dying, helping them at
the death, and being available to be alongside the child or adolescent
after the death.
Many parents still shelter their children from death, for example by
replacing a dead pet in the hope that a child will not notice and will not
have to be told about death nor the parent answer difficult questions.
This can also be done by not allowing children to attend the funeral
of a grandparent, teacher or school mate. Parents fill every moment of
life, ignoring mortality, turning off media reports of war and famine in
far-off places, until the truth is brought home when the troops return
in coffins. Yet children cannot be protected from death since they are
aware of it from an early age, when they see a dead bird which has
fallen from a nest, a squashed hedgehog on the road or their pet is
discovered to be cold and still, as was Alex’s guinea pig in Chapter 2.
Adults do not respond to young children’s questions about death,
yet children experience death and accept it without question. Examples
are noted in Chapter 3, such as the experience of Patricia’s body lying
at home on the settee with her younger siblings playing around her
and the cat curled up on her feet. In a BBC Radio broadcast (Woman’s
Hour, Radio 4, 5 December 2015) a mother spoke of keeping the
body of her dead child at home and the siblings playing naturally in
the dead child’s bedroom, stroking his hair and kissing him.
It is not morbid to talk to children about death; it is their right

to be helped to understand and be informed if they ask questions.
As adults in a western society, we are reluctant to talk about dying
and death, and we have certain ideas about children, believing that
they have an innocence of suffering and mortality which must be
preserved from such dark subjects, but an understanding of death is
part of a child’s ‘primary socialisation’, which is crucial for a basic
childhood psychological grasp and interpretation of reality. Yet today
many parents are reluctant themselves to visit a deceased parent
in the Chapel of Rest and do not think it suitable for children to
visit, neither do they allow children to attend a funeral (see Chapter
6). Therefore children and adolescents do not learn how to grieve
through observation, since family members attempt to hide their grief
lest the children see adults crying. We do not want to expose children
to the fact of death if, as adults, we can avoid it.
Whether you are a parent, or one of the professionals involved in
bereavement care, you need to bear in mind a number of things if
you are to tell children and adolescents difficult news and respond
to their subsequent questions. ‘Telling’ is a tough journey, though a
necessary one. A parent may opt out of telling her children, hoping
that someone else will do it, but if no one does a child may feel isolated
from others, abandoned and deserted. Adults don’t like to talk about
death, especially if it is of a young parent who shouldn’t be dying
and who is needed by her children, nor is it right for a child to lose
a parent. Ana Draper in her booklet Good Grief: What Will We Tell the
Kids? notes that:
studies show that good communication really helps the grieving
process – and a good process before someone dies can really help a
child to re-establish their life and to re-imagine their future without
their loved one – one without their loved one, yes, but a positive
nevertheless, in which the memory of, and connection with the
person they’ve lost helps them to live their own lives as fully as they
can. (Draper 2008, p.2)
Time spent preparing when faced with this difficult task of telling
youngsters that Mum is dying is valuable. It is important to build
up trust with the child since the process of bearing bad news is a
continuing task; children will have further questions and anxieties as
the illness progresses, creating a need for ongoing information.
A parent telling a child

Using the example of a mother dying, the father has his own grief to
face when he hears of a terminal diagnosis. He has to come to terms
with an emotional whirlwind. One husband whose wife, a nurse, in
a routine examination found a sinister shadow on her pancreas said:
From that moment there was never a morning that I did not wake
without a sense of dread, not unlike fear, buried the gnawing hole I
felt in my gut… I would gladly and gratefully have given anything
for it to be me and not her. (Oliver 2013, p.1)
and later:
Watching the one you love most go through so much, and over
a relatively long and intense time, is profoundly traumatic, and is
probably made worse by the fact that much has to be suppressed
simply in order to cope with what is happening day by day. (Oliver
2013, p.7)
A parent who has a relationship with a child from birth knows the
personality of that child and can talk honestly and appropriately. She
is the closest resource to the child. However, a parent needs to be
aware and accepting of her own mortality since a child, when told of
her mother’s illness, may suddenly feel scared, or angry, or have the
thought and ask the question, ‘Will you die?’ For a young parent who
has not thought of her own mortality this may itself be a frightening
and daunting question, but it needs to be answered and the child
reassured that the parent is healthy and has a long, healthy life to share
with the child, but, ‘Yes, I will die at some stage in the distant future, since
all living things die.’ The information may need to be repeated since it
may be a shock and may take the child time to assimilate.
When to start telling a child or adolescent?

Starting to talk is difficult; there is no good time to begin to tell a
child bad news. There is no blueprint which indicates the relationship
between age and understanding, how much the child wants to know
or if the child would rather not know anything. Conversation with
a young child is difficult since her attention span is limited, and,
particularly with the emotions stirred by the news, she will jump from
one thing to another, in and out of grief. The amount of information
that a child can handle at any one time is limited; when that is reached
a child may ‘turn off’ and substitute feelings they can handle for those
they cannot. Give information a bit at a time – like pieces of a jigsaw
which eventually build into a picture, or sections of an orange which
you cannot eat all at once. The information can be put together by the
child when needed.
What to tell a child if the cause of the illness is cancer

Winston’s Wish has a useful resource: a book called The Secret C:
Straight talking about Cancer (Stokes 2009). It is aimed at supporting
parents or carers with the task of telling children and encourages open
communication and questions about cancer through pictures, captions
and straightforward language, while stressing the need to keep routines
and still try to have some fun. It is aimed at children aged seven to ten.
A suggested way of approaching things is to ask the child what
she has noticed about Mum. ‘Have you noticed that Mum gets tired
quicker or sits down more? Or begins to doze in the middle of a
conversation?’ Through these types of questions the father can discover
where the child is in understanding the situation. It also gives the
child some control of the conversation. The challenge of telling a child
about a death and responding to questions about death is talking in a
way a child will understand through knowing the stages of concept
development. A baby up to about two has little language; what the
baby has noticed is that the prime provider of security and love is
missing and the baby feels unsafe. The mother is no longer available
in the usual way, for example she may no longer be able to pick the
baby up. A young child of two to five years realises that the ‘mum that
was’ is not coming back so the child’s security is threatened. The child
needs a great sense of being cared for and comforted. A six- to twelve-
year-old has become aware that everyone dies and may withdraw from
family life and close adults in case they die. An adolescent is fully aware
of mortality and may become detached, show anger or withdraw into
a private world of her own. It is important when alongside a child or
adolescent to recognise that each child moves at her own pace and
grieves in her own way. Try not to be surprised, shocked or angered

by what a child might say.
It is important to allow silence between parent and child. Don’t be
afraid of silence, it allows time for the child to gather her thoughts and
try to make sense of what she is feeling. Adolescents want the facts.
They want truth and honesty in what a parent tells them; it is likely
that they will then confide and talk with their peer group. During
puberty an adolescent is forming her own identity and is more distant
from a parent. However, an adolescent is more aware of mortality.
Adolescents are able to think in abstract terms, and handle news of
a terminally ill parent and subsequent bereavement in very different
ways from children. They can anticipate when a person is ill and dying,
as Jenny did, and grieve in their own ways, which may be silence, a
grief which is just as real as that of loud outbursts. Yet adolescents are
complex creatures, since at the onset of puberty they are beginning to
move into the adult world and gradually become their own person as
they separate from the family. A girl will, however, need a mother as
a model of the female gender, though she may later rebel against her
mother’s model and create her own.
An interesting resource to help with ‘what to tell’ a child is
an American website called ‘Aha Parenting’. Parents write in to a
consultant, Dr Laura Markham. A particular request is from Lisa, the
mother of a twenty-six-month-old daughter (Aha Parenting n.d.).
Lisa’s father is in hospital. The granddaughter bonded instantly on
meeting her grandfather but geographically lives a long distance away
so communicates by webcam. The letter is headed ‘Explaining death
to children’, a request from Lisa for help in telling her daughter when
her grandfather dies. Dr Markham suggests saying:
Grandpa is very sick. He is old and his body doesn’t work so well
anymore, so it was weaker and got a disease. That disease is slowly
shutting his body down. He will get weaker but will still be able to
hear us even when he is lying very still. Eventually, though, his body
will shut down totally. When that happens we will bury his body in
the ground.
You will be able to see his body and you will see that it doesn’t
really look much like him because his wonderful loving, laughing
spirit is not there. We honor the body that is left, but it is more like
a home where Grandfather lived, more like a shell he has cast off
because he no longer needs it.
As the illness progresses, so the situation changes for the family.
Gradually the ‘well’ parent or partner may get more involved in the
caring. This is an opportunity for the carer parent to ask the child why
they think this is happening and how everyone in the family could
make life more positive for Mum. Draper comments:
An illness can challenge any beliefs about the future in an instant.
This makes a child feel as if they have lost all control over their
circumstances. You can help them to deal with this lack of control
by talking about how you can all begin to take control of your new
circumstances more effectively. (Draper 2008, p.7)
The children and adolescents in a family might come up with ideas
like having a rota of household chores or each in turn spending time
with Mum reading her a story. If Dad becomes the main carer, it could
mean giving up his job and the family living with less money.
Telling of the death

The father’s grief at his wife’s eventual death is expressed by Oliver at
the death of his wife:
The convulsive, body-racking, uncontrollable flood. Anguish and
lament. Sorrow and soundless scream. Protest and passion…I was
exhausted, and I had to remind myself that I was not the only one
grieving for (her). There was a growing torpor, and a heaviness like
wading through deep water. (Oliver 2013, p.3)
It may therefore be difficult for a father to tell his children about
their mother’s death, nevertheless it is significant that outward grief is
shared by both father and young. Child Bereavement UK states, ‘seeing
adults expressing emotion can give a child of any age “permission” to
do the same if they feel they want to. Hearing how you are feeling
may help them to consider their own feelings’ (Schools Information
Pack: Supporting Parents and Carers; see their website for details). Dr
Markham suggests:
We are all very sad because we love him so much and when his body
shuts down we will never be able to hug him again. That’s why we
cry so much. It helps us to cry, just like it helps you to cry when you
fall down and get hurt. You cry and then you feel better. Because this
is such a big hurt, we do a lot of crying. If you see me crying it is ok,
it is because I am sad and miss my dad.
For a child the strong emotions around a bereavement may overwhelm.
It may be the first time that a child has experienced the death of a
close person, and it will take time for her to make sense and meaning
of it in relation to her existing knowledge.
Draper believes that emotions are neither good nor bad:
It is what you do with them that matters. The parent talking about his
emotions can really help his child to understand what is happening. It
is easy to withdraw from a child rather than show emotion. But that
can make things harder because it seems like a punishment. Families
tend to hide their emotions to protect children, which can lead a
child and the family, to feel isolated. It is OK to express emotions…
(Draper 2008, p.7)
Emotions in children are volatile. ‘How could you leave me?’ anger
is followed by guilt that the child could even think such thoughts;
children can use the feeling of self-pity to manipulate adults. There
can be depression and the dead parent can become idealised. Boys in
a family can be very violent in their grief, reacting to a death through
fighting each other and trying to make each other cry, climbing and
falling from trees, ending with scar-covered knees. Each emotion needs
to be worked at as it is part of a journey: not to achieve closure but an
ability to move on. Draper calls it ‘re-imaging’, taking the deceased
with the child in their memories of Mum.
The journey of loss continues into a journey of life. Ana Draper
writes that ‘Grief is all about constructing a lasting story that enables
the living to integrate the memory of the dead person into their
ongoing lives’(Draper 2008, p.17). Freud expressed it that, ‘We will
never find a substitute (after loss) and actually, this is how it should
be, it is the only way of perpetuating that love which we do not want
to relinquish.’ Dr Markham states that for the toddler, Lisa might say,
‘Grandpa would want us to keep living and enjoying life. We have
to live extra full and good lives because we are living not just for
ourselves now, but also for Grandfather, since he is in our hearts.’ The
advice given in the response of Dr Markham emphasised creating and
reinforcing memories and sharing adult and child emotions over a death.
Resources to help when a parent dies

The Gingerbread website for single parents provides practical
advice (see the Useful Websites and Organisations section). The
bereavement charity Winston’s Wish has a book called A Child’s Grief
(Stokes 2005), which helps any adult supporting a child through
bereavement and death, offering practical suggestions and ideas.
Another book produced by Winton’s Wish is Milly’s Bugnut (Janney
2002). Milly knows that when people die they can’t come back,
not in the way we want them, but this doesn’t stop Milly wishing
a secret and very important wish. She finds an unexpected answer
to her heart’s desire. The story was written by Jill Janney following
the death of her children’s father. ‘It’s OK to be Sad’: Activities to Help
Children Aged 4–9 Manage Loss, Grief and Bereavement (Collins and
Drakeford 2005) and Supporting Young People Coping with Grief, Loss
and Death (Weymont and Rae 2006) are also helpful for both parents
and professionals. A useful novel written by Max Porter, Grief is the
Thing with Feathers (2015), has emerged from the writer’s experience
of the loss of his own father when he was a young child. The novel
explores the lives of a man and his two young sons at the sudden
death, in a fatal accident, of his wife and their mother. The man
tries to cope on his own with great difficulty and the progress of
his loss is followed and helped by a crow. The main character is a
Ted Hughes scholar and the bird is an image taken from the late
poet and writer Ted Hughes. The crow stays with the family, saying
of himself, ‘Perfect device doctors, ghosts and crows. We can do
things other characters can’t, like eat sorrow, un-birth secrets and
have theatrical battles with language and God’ (Porter 2015, p.15).
Dr Markham has an interesting section in her response to Lisa
about her toddler, she writes:
It is possible that your daughter will remain very connected to her
grandfather. There are many accounts of people who remember
when a grandparent died during their childhoods, who say that they
continued to speak with, and even see, their loved one. The younger
the person is, the more likely they are to actually see the loved one
after the death, because there is no cultural overlay to tell them it’s
not possible. Some people may say this is real. Some people may say
it is a defense against the finality of death. I believe it does not matter,
since it is a very adaptive response that has only healthy effects on
the child. But even if she does not see him, it will help her if you
encourage her to speak with him inside her own head. If she can have
a small object of his to keep and hold, it will facilitate this. Kids who
are able to maintain a relationship with the person they’ve lost, even
as they have permission to go on living fully and joyfully, make the
healthiest adjustment to loss.
Research is sparse, particularly among children, on questions of contact
with the deceased. Many religious circles believe it to be wrong.
Their reasoning is based on references in the Old Testament such as
Deuteronomy 18.11: ‘No one shall be found among you…who seeks
oracles from the dead.’ Humanists, agnostics and atheists are critical,
asserting that these experiences are ‘grief-induced hallucinations’
based on wish-fulfilment, imagination, magical thinking, fantasy,
memories and emotional needs. An organisation called After-Death
Communication Experiences (ADCs) researched 2000 North Americans
aged 8–92 years from diverse cultural backgrounds, collecting over
3300 accounts from people who believe that they have been contacted
by a deceased relative or friend (1995–2016). They estimated that
at least 60 million Americans, 20 per cent of the population of the
USA, had such an experience. The result was an incredible sense of
peace providing comfort, hope and profound emotional and spiritual
healing. Dr Markham suggested that the younger the person was,
the more likely it was that she could communicate that she ‘saw’ a
deceased person. A Scientific American article notes that bereavement is
a time ‘when hallucinations are particularly common…the presence of
the deceased is the norm rather than the exception’ people ‘find them
comforting as if they are re-connecting with something of the positive
from the person’s life’ (Bell 2008). A website Perceptive Children
Support Forum receives parents’ questions. One of the children for
whom advice was sought was two years old. The response from
Athena Drewes, a licensed child psychologist, parapsychologist and
consultant to the Rhine Research Center at Duke University and the
Parapsychology Foundation of Children’s psychic experiences, can be
read on the website (Drewes n.d.).
The use of euphemisms

Adults sometimes avoid the word ‘death’ by using euphemisms
when talking to children. The Oxford English Dictionary defines a
euphemism as ‘a mild or less direct word used rather than one that
is blunt or may be considered offensive’. The word is derived from
Greek meaning, ‘to speak well’ or ‘good talk’. The word was used as
a euphemism by the ancient Greeks meaning, ‘to keep a holy silence’,
that is ‘to speak well by not speaking at all’. Underlying the word is an
attempt to disguise and refuse to take responsibility for a truth since,
as adults, we want to escape thoughts of our finitude and mortality.
A real problem with euphemisms is that young children are
concrete, literal thinkers and so understand words at their face value.
The statement, ‘Grandma’s gone to be with Jesus’ may get the response,
‘I love Grandma. Can I go with her?’ Cranwell (2007) reports an
incident when ‘Pat aged ten, remembered that at an early age she was
told that her great-grandmother had “gone away”. After a few weeks,
she asked: “When is she coming back?” The response was: “sorry, I
forgot to tell you – she died.”’ He continued:
Five years after the event, she summed up her feelings: ‘If somebody
said to me now: “She’s gone away,” it would be like telling a lie. It’s
best if you say, “She’s died”. Then you’d cry, and then it’s over with.’
It is to be noted that the hindsight is that of an adolescent whose
understandings of death are different from that of a child. (Cranwell
2007, pp.20–21)
The statement on the death of a favourite granddad, ‘Grandad’s gone
on a journey’ or ‘gone on a holiday’, or ‘gone to a better place’,
may each receive the child’s response, ‘When is he coming back?’ or
‘Where’s he gone. Can I go?’ Similarly in response to the statement,
‘We’ve lost Joe’, a child may ask, ‘Where did he get lost?’ In newspaper
‘death notices’ similar euphemisms are used. Does it mean that adults
cannot face talking about death? The euphemisms we use can have
detrimental effects on children, who may become angry about the
death or feel guilty that they are somehow responsible for the person
‘going away’. The statement that a loved one has ‘gone to sleep’ may
lead a child to be fearful of going to bed. A friend told me that when
her mother died, her nephew who was on holiday with her, looked
into the sky and said, ‘that star shining brightly is Gran.’ Another
child looked up into the starry sky and asked, ‘Which one is Granny?’
Euphemisms may be suitable for very small children who will not
have the concepts of death and finality, but as the child gets older, this
will change and evolve, as children are able to understand concrete

language.
On occasions, in religious families, comments can be made to
children such as, ‘Jesus wanted her for an angel’, or ‘God took him’.
One lad, whom a colleague worked with and whose parents were
Christians, said that God had taken his grandfather and he was now in
heaven. Bob was very angry with God, for he wanted his grandfather
to play football. God wasn’t fair taking grandfather. The colleague was
not religious yet knew that she needed to honour the family’s beliefs
but was not sure how to tackle the anger. Eventually, she helped Bob
to see that it was the cancer that took his grandfather and not God.
The death and family members

At a death, other family members who would normally help to protect
and support the child may be caught up in their own grief. It seems
only natural, in this context, for a parent to try to protect a child from
her own grief. The trouble is that when everyone becomes too afraid
to speak about how they are feeling, or about the person who has died,
it is unhelpful. The silence that follows can stall the entire process by
which collective grief can help a new, positive story to emerge.
When a parent dies, the surviving parent may become dependent
on the child or children, for instance the older child becoming ‘a little
mum’, but this must be avoided; a child or adolescent needs to be just
that, having time with friends her own age, not swallowed up in adult
roles. This will need the help of other family members. It is likely that
the surviving parent may be too wrapped up in her own grief to talk
to the children, then family members, neighbours close to the family
or professionals may help. Being there is a comfort and reassurance to
children.
Involvement of others in the support

of children – school
A child living with a parent with a terminal illness will value the
regularity and stability of school, the ordinariness of it. Yet a parent
needs to tell the school of an impending death in a family. News of the
terminal illness of a mother will affect a child and this will be carried
into everyday life in school.
It is important for the parent to inform the school of the death of
his wife. The school should liaise with the family, where possible, and
establish what the child knows since young children may fantasise to
gain attention, while conflicting information from home and school
confuses the child, who then loses trust in the adults. At a convenient
stage, agreement needs to be reached as to what information is to
be given, and to whom, before the pupil returns to school. On the
death of a child’s parent, permission should be asked from the child
before telling the school. Conversations between school and family,
including the bereaved child, will determine how the news should be
given to the school community, the child’s class or whole school in a
primary school and the tutor group in a secondary school.
A bereaved child may be encouraged by her family to go back
to school soon after the death, since it is a routine and the agenda
of school work is life rather than death. School may be particularly
significant to a child with friendship groups. School may well be a
refuge for a child from the emotions and the ongoing grief of family
at home, bringing a sense of normality to life.

Judaism
In the Hebrew scriptures, Jacob was travelling across the trade route
home to his own country to meet and be reconciled with his twin
brother, Esau, whom he had wronged many years before. He travelled
with wives, children, slaves and animals. His feelings and emotions
must have been jangled, one minute wanting to rush ahead and get the
meeting over, the next wanting to hold back from a difficult encounter.
This went on until he recognised that neither his flocks with their
young, nor his children could be rushed; he had to go at ‘the pace of
children’ (Genesis 33.4–15). Today adults need to learn this lesson.
We need to recognise the conceptual development of children/
adolescents, so that what we tell them is age related and be guided by
their pace.
For Jews in biblical times, education began early. As soon as children
could speak, they learnt by heart the first phrase of the Shema ‘hear
Israel, the Lord is our God the Lord is one…’ (Deuteronomy 46.4–9),
which ends with the words of the commandments, ‘to love the Lord
your God with all your heart and with all your soul and with all
your might and you shall teach them (the commandments) diligently
to your children’. To ‘teach them’ means ‘impress upon them’. The
Shema represented the central affirmation of the Jewish faith and was
recited morning and evening by adults (Deuteronomy 6.4–5). Children
were to be taken seriously: their purpose was as learners of the Torah
(Deuteronomy 6.6–9, 11.13–21; Numbers 15.37–41). Within the
legislation all, including children, were called every seventh year to
the public reading of the Torah (Deuteronomy 31.10–13). As soon as
he can speak, his father teaches a boy the Shema, Torah and the sacred
tongue; otherwise, it were better he had not come into the world
(Tosefta Hagigah 1, 2).
Children learnt by being alongside parents in the fields. There was
a rhythm of work and leisure: the weekly Sabbath and the annual cycle
of the major festivals, associated with agriculture (cf. Exodus 23.14–17;
Deuteronomy 11.13–15, 16.1–7; Leviticus 23.4–44). The Passover
festival marked the beginning of the barley harvest and recalled the
Exodus. Pentecost followed, marking the wheat harvest and the giving
of the Torah on Mount Sinai. The feast of Tabernacles at the end of
September celebrated the end of the grape harvest and retold the
wilderness wanderings. The festivals were celebrated and explained in
the home, with children taking a leading role (Deuteronomy 6.2–22;
Exodus 12.26f ). The seder (Passover meal) required the meal to begin
with a child asking questions about the purpose of the meal and the
ritual. It ended with a child bargaining for the return of the afikoman
(hidden matzoh bread) in Passover. There were four types of children:
wise, wicked, simple and those who do not know how to ask. Each
child has to be answered according to his own question and in line
with his own attitude…these…encompass all of the combinations of
learning and moral religious identity. At Passover, the major Jewish
festival of national and personal liberation, four types of children are
used to symbolize how all Israel struggles with growing in wisdom
and goodness (Yust et al. 2006, p.51).
Josephus claimed that the Jewish tradition was distinguished by
the care taken to instruct children. His claim is made within the context
of emphasis on the special character of a lifestyle and commitment to
preserve inherited Jewish piety as ‘the most important duty in life.’
Philo (25 bce to 50 ce) claimed Jews had been trained ‘from a very
early age’, even ‘from the cradle to honour the One God alone and to
observe the Jewish law’. Before the destruction of the temple (70 ce)
there were 480 synagogues in Jerusalem, each of which had a Bible
school. Schools supplemented the teaching of the parents in the home.
They were not a replacement for the home. The second-century rabbi
Judah ben Tema said that children should be taught Scriptures at five
years, the Mishnah at ten years, to fulfil the law at 13, and the Talmud
at 15 years.
There was no education adapted for children. Children memorised
sections of the book of Deuteronomy, becoming a people of the book.
The degree of literacy cannot be determined. It is likely that learning
was still a prerogative of the wealthy and largely that of male children.
It is questionable whether children were of intrinsic worth for any
innate qualities of character. It was through their preoccupation with
learning and practising the Torah that children became significant.
Rabbi Juda Nesiah stated ‘the world stands only upon the breath of
the schoolchildren’ (210 ce).
Christianity
For suffering like that of Jenny’s mum, Jenny’s question is, ‘Where is
God in letting my mum die?’ For those who have no faith the answer
is that death is simply the natural end of a life. However, for Jenny’s
mum it was a life cut short by suffering. For a believer there are two
questions. If God is love and in control, omnipotent, why do awful
things like terminal illness happen? Second, is there a life beyond
death, which gives hope and courage and might sustain through pain
and suffering? Does suffering occur because this world is contrary
to God’s will or because God made it this way but intended it to be
otherwise?
The dominant model of a Theology of Creation from the fourth
to the eighteenth centuries was that: God created ex nihilo signifying
that matter is good; Creation is finite and closed – everything has its
God-given place, a closed system of cause and effect, a stable home
for humans to prepare for eternity. Creation has a purpose. Humans
are free agents who can choose or reject a relationship with God; at
the end, suffering is justified in the overall plan of God. Irenaeus, the
second-century bishop of Lyons, questioned this model. He taught
that creation is emergent and purposeful, moving from innocence
and immaturity to knowledge and complexity towards an end, the
eschaton, when suffering is transformed in a new creation (Revelation
21.1–4).
Anthropologists state that the first humans struggled with a hostile
environment, necessitating selfishness and violence to survive, but
gradually became capable of the moral awareness of love and sacrifice,

putting the need of others before personal needs. When God is not self-
evident, there is a distance between humans and God, so that humans
have freedom in relation to God. God is the world’s foundation: not
intervening but able to influence it through God’s presence within human
hearts. Hauerwas considers that: ‘historically speaking, Christians have
not had a “solution” to…suffering. Rather they have had a community
of care that made is possible for them to absorb the destructive terror of
evil that constantly threatens to destroy all human relations’ (1990,
p.53). Much suffering has no sense, but some sufferers use it creatively
to grow, to develop fortitude and perseverance. For others their suffering
challenges their faith in God, which may be lost.
If God loves, then this must include God’s ability to suffer, for it is
when I love that I can suffer for the loved one. When the mode of God’s
power is vulnerability, God is willing to be pushed to the margins
becoming good news to suffering. In the cross the Son suffers God-
forsakenness, the experience of many sufferers. It might be thought
that this is in bearing the world’s sin and rejection of him. Jesus said,
‘I am the Resurrection and the Life’, and often spoke according to
the Gospels of the ‘third day’; certainly the Resurrection of Jesus was
central to the kerugma of the Early Church. Whatever happened on
that first Easter day is a mystery.
As Christians we have hope and that hope is in a loving God.
Nothing lies beyond the compassionate love of God. Paul encapsulated
this in Romans 8.38–9 when he wrote:
For I am convinced that neither death, nor life, nor angels, nor rulers,
nor things present, nor things to come, nor powers, nor height, nor
depth, nor anything else in all creation will be able to separate us
from the love of God in Christ Jesus our Lord.
Islam
The Islamic scholar Said Nursi believes it is necessary to expose
children early to belief in God and spirituality. ‘The more children
are exposed to a community observing religion and the easier it will
be for them to understand religion and spirituality later in life’ (Nursi
2002).
This is not necessarily done through teaching children, but through
them watching their parents and the community observe and practice
their faith. Yet children’s faith is tested in the everyday of Western

society. However, an example was set in the life of Mohammed, who
was tested by the death of his father before he was born and his
mother when he was only six, leaving him an orphan. Mohammed
knew grief as a child himself through losing his parents, and as a
father grieving the death of two sons as infants. He was sorely tested
through experiences of death and children. The story of Mohammad’s
life is told to children and may well bring comfort in their situations
of grief and bereavement.
Hinduism
Hinduism is so diverse that it is difficult to say what is particular
to children. The stories found in the scriptures of Krishna and the
different gods are told to children and may well help and inspire them
to live lives helping others.
Buddhism
There are no teachings specifically for children, yet at the heart of
Buddhism is the Buddha’s Discourse on Loving Kindness: ‘Cherish
in your heart’s boundless good will to all that lives’ (Brown 1975,
p.150). Buddhists send out thoughts of love and compassion, arising
out of their own hearts, to family, friends, enemies, animals and to
worlds beyond, giving strength to live the eight fold path that leads
to the end of suffering and coming of Nirvana, joy. This is a ‘feature’
of Vesak, the name of the lunar month that falls in May, with the full
moon day in that month called Vesak day. This sacred festival day has
threefold significance: it is said that it is the day Buddha was born,
attained enlightenment and died.

What children are told in regard to death depends on their age, level of
maturity, their parents, their faith background, if any, and the culture
in which the child is raised. Cultures differ; for example, in Papua New
Guinea, the deceased’s body is ceremonially laid in a boat, a lit candle
inside and the vessel launched out into the water. This is a very visual
ritual, suggesting the image of death as the last journey, and one into
light.
We live in a global village where children, through the media,
discover and hear about varying attitudes and customs connected with
death and bereavement. Many of us live in multicultural areas where
practices vary in the information given to children. Difference should
be respected, yet children also need respect and to be encouraged to
openly question and explore, particularly when they are faced with
the terminal illness and death of a parent. A child can live through
most things as long as adults talk to her and tell her the truth.

1. Use the account of the letter published on the ‘Aha Parenting’ website
referred to in the text and given in full below. Read through the piece
and comment on it, if possible in consultation with a parent who has
a toddler of between two and two-and-a-half years.
Dear Lisa
…it is possible that your daughter will remain very connected to her
grandfather. There are many accounts of people who remember
when a grandparent died during their childhoods, who say that they
continued to speak with, and even see, their loved one. The younger
the person is, the more likely they are to actually see the loved one
after the death, because there is no cultural overlay to tell them it’s
not possible. Some people may say this is real. Some people may say
it is a defense against the finality of death. I believe it does not matter,
since it is a very adaptive response that has only healthy effects on
the child.
But even if she does not see him, it will help her if you encourage her
to speak with him inside her own head.
The fact that your daughter bonded with your dad during his hospital
stay suggests that they have a special relationship. The more
connection they can have prior to his death, the better it will be for
both of them.
As for what to say to her? Grandpa is very sick. He is old and his body
doesn’t work so well anymore, so it was weaker and got a disease.
That disease is slowly shutting his body down. He will get weaker but
will still be able to hear us even when he is lying very still. Eventually,
though, his body will shut down totally. When that happens we will
bury his body in the ground.
You will be able to see his body and you will see that it doesn’t really
look much like him because his wonderful loving, laughing spirit is
not there. We honor the body that is left, but it is more like a home
where Grandfather lived, more like a shell he has cast off because he
no longer needs it.
Why is there death? That is one of the great mysteries of life. But look
around at nature. Everything alive is born, grows up, has a full life,
gets old and dies. It makes room for new life. Grandfather had a full
life and one of the best parts was having his granddaughter to love.
When Grandfather’s body goes, he will stay in our hearts. If we listen
we will be able to feel him smiling at us and even speaking to us. One
way to express our love is to tell stories about him and honor the life
he led, so that is what we do at the funeral.
We are all very sad because we love him so much and when his body
shuts down we will never be able to hug him again. That’s why we
cry so much. It helps us to cry, just like it helps you to cry when you
fall down and get hurt. You cry and then you feel better. Because
this is such a big hurt, we do a lot of crying. If you see me crying it is
ok, it is because I am sad and miss my dad. You can always give me
a hug, but you don’t need to take care of me. I will be ok. Grandpa
would want us to keep living and enjoying life. We have to live extra
full and good lives because we are living not just for ourselves now,
but also for Grandfather, since he is in our hearts.
There are also wonderful books to read to your daughter, which
will help her (and probably you) to continue to process this major
transition in your lives…
I wish you all blessings and the consolation of love.
Dr. Laura (Aha Parenting n.d.)
2. Think about a child or adolescent with whom you work. How would
you tell her about the impending death of a parent? Write your
response as a dialogue.
5
Schools Coping with
Bereavement and Death
If you believe in God, he’ll take care of all the details.

(Winston in Marshall 2003, p.13)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
A young child wanted to draw a card on Father’s Day but was not
allowed to by his teacher because she knew that his father had died.
The boy said that it wasn’t fair, ‘I do have a father; I just can’t see
him’ (Job and Francis 2004). Another child said about her first day at
school that at the school gate she noticed all the mums, and ‘there I
was with Dad, because my mum has died’.
109
Some dates may be distressing to a bereaved child such as Father’s Day
or Mothering Sunday. Young children can feel left out if they have
been bereaved. They want to be like their classmates, yet in some ways
they are not. A child may feel sad and tearful at the death of a parent,
or angry that the parent has ‘deserted’ and left him by dying. A child
may be bullied in the playground for not being like other children,
embarrassed or not sure how to react. For a young child, school is in
some ways an extension of home in that there are adults who are the
authority and dependable figures. Teachers need to know how best to
support a bereaved child.
An adolescent began unconsciously writing all her school work in
mirror writing. The girl was disturbed about her involuntary squiggles.
Her teacher recognised what was happening and took her aside. The
teacher, with the use of a mirror, showed the girl that she was reversing
the words. Later the teacher discovered that the girl was missing her
mother who had died the previous year and was upset because she
could no longer ‘picture’ her mum. The teacher asked if her mother
had a sister and discovered a favourite aunt living nearby who had
photos of her sister. She suggested that the girl asked her aunt if she
could see the pictures. Being able to look at the photos and talk to her
aunt helped the girl to remember and gradually in school her writing
returned to normal.
Adolescents are finding their own feet and don’t want to be ‘exposed’
in front of their peers. The teacher realised that something was
upsetting the girl and took her aside on her own to see if she could
help. The teacher had played about with mirror writing as a child and
realised what the squiggles were. The sensitivity to her pupil’s needs
enabled her to come alongside the girl and help her.
Schools Coping with Bereavement and Death 111

In the early part of the twentieth century, adults considered that death
was not a ‘subject’ to be talked about with a child since children were
innocent of such events, nor should it be mentioned in school since
death was a private, family affair. It is now realised that young children
may experience death and bereavement. From an early age, a young
child is trying to make meaning from experience and integrating it
with existing knowledge. Experiences of death are events that need
such integration and could be introduced as part of their early life. The
process of integration continues at home and at school.
In one nursery class, the home corner was decorated as a hospital
with bottles of coloured sweets for pills, stethoscopes and nurses
uniforms to encourage imaginative play. One three-year-old was
sitting on a row of chairs very still. When asked by the teacher what
she was doing, the child looked up in astonishment that the teacher
did not know; ‘I’m dead, of course’ was the response. The teacher
quickly took the child to another part of the room and a different
activity rather than discover why she associated hospitals with death.
The teacher did not attempt to explore with the child her thinking.
What experience had led the three-year-old to associate hospitals with
death rather than view them as places of healing, though sometimes
recovery is not possible and a person becomes too ill and dies? Death
for this teacher was ‘swept under the carpet’. It may have been that
the teacher did not know what to say (see Chapter 4) or did not
know how to tackle the subject with such a young child (see concept
development in children, Chapters 1 and 2).
Many adolescents are more ‘worldly wise’ about death and
bereavement. Rosie, an only child, was 14 years old and preparing for
her mock GCSEs when her mother died of cancer in the local hospice
following a recurrent brain tumour. The death had been expected and
Rosie and her father were present at her mother’s death. She did not
want her school told of her bereavement. However, she lived in a rural
area and news travels fast so members of the school knew without
being told by the family. Rosie chose to return to school several days
after her mother’s death. Rosie’s behaviour is a route that adolescents
and children may take in the face of death. School represents
normality and a friendship group beyond the immediate emotional
suffering of family, a peer group with whom to share confidences rather
than the adults in her life. Adolescents are hormonal and have their
own identity in process of formation. Rosie wanted to get on with her
life. She also thought that getting on with her exam preparation was
what her mother would have wanted.
Ninety-two per cent of children and young people will experience a
‘significant’ bereavement before the age of 16. Up to 70 per cent of
schools have a bereaved pupil on their roll at any time. One in twenty-
nine school-age children will have been bereaved of a parent or sibling;
one in eighteen has been bereaved of a close friend (Child Bereavement
UK 2009; see the Useful Websites and Organisations section).
The school community has a central role in being alongside pupils
and staff in bereavement. Current research explores grief as a social
construct, varying across communities. This involves considering
proactive and reactive strategies associated with good outcomes for
bereavement and loss. The social context of school is vital. Research
demonstrates the significance of bereavement support from peers and
trusted adults in the school community, in addition to that given by
parents. This social support is enough for some children; for example,
if, following a critical incident such as an accident involving a school
bus, ‘experts’ come into school from outside, the bereavement process
may be prolonged: the ongoing support from known, caring adults in
school is more significant than that of outsiders. Children are resilient
and may cope by simply knowing that each of them is valued, as an
individual, and that help is readily available should they ask.
The significance of schools working with the family

Loss is part of our everyday lives, not separate from the ordinary life of
home and school – pupils need an integrated approach within home
and school, of pastoral care and their learning. A school is a social
community and can offer a necessary routine to a child for whom
home and family life following a significant death, such as that of a
parent or loved grandparent, may have become emotionally charged
and chaotic. School may even be an escape for a bereaved child or
adolescent, since there are no reminders of a loss. If showing grief is
the need of the pupil, school is a safe place since school personnel are
diverse; for children there are the adults, teaching and support staff; for
adolescents there is the peer group of friends and pastoral care staff.
Together, these people represent a potentially broad range of help.
The adults in school are not necessarily emotionally involved in the
loss and, since they are outside the family, they can act as ‘a listening
ear’, a confidant and a resource for a pupil. School staff can access
specialist outside service providers, including counsellors, psychiatrists
and social workers; these are a significant resource. A school library
can include a section on bereavement and loss. There can be story
books, factsheets and videos, and for adolescents in particular, access
to telephone numbers of confidential ‘helplines’ which, with social
media, are an important resource for adolescents in particular. A list
of appropriate websites and phone numbers can be made available
by a school on a piece of laminated card the size of a credit card
ready to give to a needy adolescent. (See the Useful Websites and
Organisations section.)
The approach to death in schools can be varied

Some schools’ approach can be called ‘crisis management’, in that
when a death occurs the school takes some reactive action. A second
approach is when schools see anything to do with an actual death, or
education about death and bereavement, as ‘pathological’ since death
is still something of a taboo subject. A third approach is when schools
see death as part of life and are prepared for it by a bereavement policy.
These schools work in two ways: first, pastoral care, in other words
how to work with and support the pupil, the family and the school
community in bereavement; and second, sensitive teaching across the
curriculum. Both pastoral care and the curriculum promote, cultivate and
educate about healthy grief and ways to be supportive to a grieving pupil.
Creating a school policy for the pastoral

care of bereaved pupils
A pupil may experience the death of a close family member, a fellow
pupil or a favourite teacher and his grief may spill out into life in
school. Having a policy in a school helps when a bereavement arises,
particularly with sudden, multiple or traumatic circumstances. The
Critical Incident Procedure is the prerogative of the head teacher.
The policy needs to be a framework rather than prescriptive, agreed
by school staff (teaching and non-teaching) and the governors; parent

governors can be helpful as ‘sounding boards’. The area of ‘loss’ is
particularly emotive and therefore needs a policy statement which is
sensitive enough to meet the needs of different situations of loss. It is
likely that a policy may need to be formulated in the same format as
other policies in the school so the information below is a suggestion
only. It is important that the policy is regularly reviewed in the light
of experience (see details in Appendix 1).
Examples of pastoral care in school

A school supporting a pupil with a
life-limiting illness and their family
It is distressing for a teacher to discover that a pupil is suffering from an
incurable illness. This will inevitably bring challenges to the classroom
and the school, yet it is in sharing the individual’s journey that the
lives of those in contact with the pupil can be enriched. Many pupils
with a life-threatening illness want to continue to attend school for
as long as possible, since it gives a normality to life with an emphasis
on living rather than dying, a continuation of friendships, and a sense
of child or adolescent identity rather than that of patient identity. It
is useful to have one person, staff or ancillary member of staff, as a
regular contact with the family, so that all the school staff are aware
of changes in the health and medical treatment of the child and can,
if needed, change their methods of support. This also gives a message
of support to the family.
If a pupil is receiving treatment at a local hospice or hospital, it may
be possible for a nurse to come in and explain to the class how they
can help. This will need the family’s permission. At the point when
the health of the child begins to deteriorate and attendance at school
becomes more intermittent, or the child enters a children’s hospice,
his class can be invited to write and draw pictures to send to the child
telling him what they are doing and keeping him in touch. When later
the child dies, with family permission the class can be informed. It is
important to decide who breaks the news to the class so that rumours
do not abound and questions are answered by staff. At this point, how
the school might respond needs to be thought through: if pupils can
be represented at the funeral, whether the school might hold its own
special assembly, and whether a lasting memorial is appropriate. The
members of the class will grieve in their own ways.
The death of a member of staff

This is likely to affect the whole community in a primary school, since
with the relatively small size of many such schools, particularly in a
rural area, the deceased will be known by almost everyone. Helping
pupils and staff will need great sensitivity, particularly if the death
was sudden and unexpected. Contact with the family is helpful by
phone or a visit so that their wishes may be honoured in the giving
of information. It is helpful if this is done by an identified member
of staff (see Appendix 2). It is important to give the information to a
meeting of staff as soon as possible, ensuring that absent or part-time
staff are also made aware. With the family’s permission, the pupils need
to be told in words that are clear and suitable to their developmental
stage. This is best done in their class groups by a familiar teacher
or the head teacher if the class teacher is young and may not have
had experience of the death of someone close. The information may
need to be repeated since it will be a shock to pupils and take the
children time to assimilate the news. My youngest sister died of a brain
tumour. She was a classroom assistant in a school for children with
learning difficulties. When her death was announced, one boy refused
to believe it saying, ‘But she was my friend’.
The children may well ask questions which need to be answered.
Feelings and emotions may be shown. The teacher should be willing
to show her feelings as an adult: this helps children to realise that
death is painful and final and it is appropriate to be sad. Children may
want to talk and share their memories of the person, make a memory
board, write a message or draw a picture to send to the bereaved
family, or make cards of condolence for the family. This will help the
bereaved to know that they are not alone and will be a positive way
for children to express their emotions. Story books can be used to read
to the children, which again helps them to explore death through the
eyes of another person, for example The Cooper Tree (Robinson and
Straky 2014), an illustrated book for young children on the death of
their teacher.
The death of a pupil’s parent

Some children in the class may need particular help in their grief.
Informing the school is important for the parent. The family may decide
to convey the message of the death by sending a letter to be read out
in school; the bereaved child may or may not wish to be present when
this happens. The school should liaise with the family, where possible,
and establish what the child knows since young children may fantasise
to gain attention, while conflicting information from home and school
confuses the child, who then loses trust in the adults. Pupils need to
be told – this is best done in their class groups. The teacher giving
the news could be prepared to respond to any questions the children
might have. There may be such questions as ‘Where is she now?’ (the
deceased parent), which may be metaphysical about a life after death,
an appropriate answer being that people believe different things about
life after death. Others may ask a straightforward question about where
the body is now. There may be questions about what happens now,
including some about cremation and burial. It is important to help
children understand that after death the body does not feel anything
and does not need food or drink, so cannot be hurt or feel pain or fear.
The class teacher of the pupil whose parent has died needs to
keep a record of significant dates – the date of death; the birthday; of
Mothering Sunday or Father’s Day – and be sensitive when the school
breaks for Christmas, when there will be sadness with an empty chair
at home. These will be significant occasions in the grieving process
and will reoccur. This ‘bereavement history of significant dates’ should
be in a child’s file throughout the pupil’s school life.
Pastoral care of a pupil returning to school

Returning to school may be frightening for a young child; he may
think of death as contagious and therefore fear that while away from
home someone else in the family might die. This may be a ‘trigger
time’ which causes emotions to be freely expressed. Teachers need to
read this sign and act appropriately when the time comes.
If a child acts differently from what is considered ‘normal
behaviour’ a teacher could wonder, ‘What does the child believe that
is making him act differently?’ If the belief can be addressed that will
help. For example, sometime after her mother’s death, Susie, Jenny’s
youngest sister, heard a friend of her mother’s say at the school gate
that if it hadn’t been for the pregnancy with Susie, her mother would
still be alive (see ‘An adolescent’s experience’ at the beginning of
Chapter 4). Susie came to believe that it was her fault that her mother
had died. She became withdrawn and quiet. A teacher helped Susie
to unpick this information, so that she could understand that actually
pregnancy would have slowed a cancer that was already present in her
mother’s body and not caused it. With this knowledge, Susie regained
her resilience.
The school is likely to need to cope with behaviour patterns that
differ from the norm. Taking a bereaved child aside, a teacher can
acknowledge what has happened. Allow crying if that is what the
pupil needs; make sure that he has an ‘escape’ from class if he cannot
cope; make allowances for loss of concentration or problems with
school work; and be aware the child may experience bullying for
‘being unusual’, ‘an oddity’ and for not having a mother. The child
may begin to bully others, to show that he has some authority and
control of a situation. Teachers working with children in the context
of a death can rely on their own humanity. The wisdom gained
through their life experience underlies their work with bereaved
children. A professional should trust themselves and their intuition,
having built a level of trust with the child. A child needs to feel safe
to trust and talk.
A major way of supporting a bereaved child or adolescent is
to listen and encourage him to talk about his loss and express his
feelings, whether anger or sadness, but always with a box of tissues
handy. Listening is the key requirement at news of a death. Listen more
than talk. Allow emotions, letting the child openly express feelings of
anger, guilt and sadness. Tell the child that it is OK to show emotions;
crying releases us and begins the process of healing. Professionals
should not be shocked by the questions and need to say when they do
not know the answer. Listen intently to children’s strivings to make
sense of a loss. Do not force children to talk but encourage and answer
questions simply and honestly when they appear interested. A teacher
might need to listen to a repeated story; even if it is the same story
each time, give the pupil time. Say ‘mmm’, ‘yes’, ‘I see’ in such a way
that the child knows that you are listening. The teacher should be
guided by the child who will ‘go in and out of grief ’. Be there when
needed and respond ‘little and often’. Let a child or adolescent grieve
in his own way. Note that some pupils show little emotion; this may
be because the death has not sunk in.
It is helpful for children and adolescents to talk to others who knew
their mother and have memories which are different from their own.
These ‘memory holders’ can be encouraged to write down their stories
for the bereaved pupil and give them to him. I remember when my
youngest sister died, many of the condolence cards contained such

stories; and they were a source of great comfort.
There may be one person to whom the child has turned for help
during the time of mum’s illness and final death. That person has had
the trust of the child placed in them. Duffy comments on this:
the strong relationship that will be built up between you over a period
of time is to be treasured; it will always be part of you, and special.
Make sure that the child knows where to get in touch with you at any
time in the future – just in case for whatever reason, your reassurance
is needed. (Duffy 2008, p.53)
Pastoral care responding to an incident in the media

This might be a car accident resulting in adults in the school, known
to the pupils, being killed, or an accident involving a school bus
with fatalities which effects the whole school. It is important for the
administration to recognise the impact on pupils. Teachers will need
information on trauma symptoms and know how to respond. In this
sad event, how the children are told is very significant. It needs to
recognise the media reports; pupils may need to share what they have
been told about the accident and what they think actually happened,
yet central is the grief which pupils and other staff will feel. It needs
sensitivity. Time and silence will be needed.
There are international and national events where pupils have no
personal involvement but are nonetheless, through the media and
social networks, affected by them. Such an event arose from those
fleeing from war in Syria to Europe by crossing the Mediterranean
Sea in small boats at the hands of traffickers. On 3 September 2015,
the international media was flooded with pictures of Aylan Kurdi,
a three-year-old lying on the beach of a Greek island. As a police
officer went towards the child, he prayed that this would not be
the body of another migrant. The body of Alyan was cradled in his
arms, the picture challenging the world to recognise the migrant
crisis and the risks being faced. Children in school saw these pictures
and wondered what they could do to help. Wendy Duffy comments
on the importance of encouraging communication and openness in
response to a situation like this cannot be overstated: parents need
to feel confident that, in a crisis, the school has the interests of their
child at heart and will respond to such crises with common sense and
sensitivity in partnership with parents, to ensure that the message and

support given is along the same lines (Duffy 2008, pp.45–6).
Pastoral care in response to the suicide of a pupil

An adolescent’s experience is found at the beginning of Chapter 3 and
indicates the significance of a school to such a sad incident. Thoughts
of suicide arise within the child and adolescent due to a multitude of
reasons and come within the remit of the Mental Health Services. In the
UK only 0.6 per cent of the NHS budget is allocated to children and
adolescents with mental health problems; waiting time for treatment
can be six to nine months and in some cases two years. The prevalence
of childhood depression is estimated to be 1 per cent in children in
primary schools and 3 per cent in secondary schools and academies.
Children show signs of sadness and helplessness through factors such
as abuse and bullying. For example, a young child returning from a
parental bereavement may be told by others in the playground, ‘You
can’t join in because you haven’t got a mother.’ Adolescents may feel
unloved and unfairly treated. They may experience cyber bullying,
are encouraged to ‘sext’ until it is used against them by an ex-
boyfriend and are sexually abused, each type of experience resulting
in guilt and despair. Ten per cent of those with depression recover
spontaneously within three months, 50 per cent remain clinically
depressed at 12 months, and 20–30 per cent at two years. For parents
who are concerned about depressive type behaviour in their child or
adolescent, websites can help immediately and be a life-saver, giving a
phone number for advice (see the Useful Websites and Organisations
section). Some children, however, contemplate suicide.
I found no figures for child suicides, though they exist (see NICE
Clinical Guidelines 2015). There is a prevalence of around 1–3 per cent
for medically serious suicide attempts in adolescents and a substantial
risk of recurrence of suicidal behaviour ranging from 5–15 per cent.
Suicide can be preceded by self-harm injury on purpose such as burning
oneself, overdosing, using drugs for highs, pulling hair or picking
skin. This behaviour is an attempt to feel detached from the world and
is a cry for help. Self-harm is a way of punishing the self which is often
kept secret; clues may be the refusal to wear short sleeves or to take
off clothing for a sports lesson. Other signs that a teenager has got to
a deep place and is thinking of suicide may be ringing a friend to chat
at 3am or listening to loud music. Some adolescents, such as Sandra,
keep a journal of their most intimate thoughts, particularly if they are

being bullied or are having feelings that they think are absurd and
don’t want anyone else to know about (see the adolescent experience
in Chapter 3). The adolescent may contemplate suicide as the only
way out. If his journal goes missing or another youngster picks it up,
and the school has a robust ethos of pastoral care, then the youngster
finding the journal is likely to tell a trusted teacher if he thinks a friend
is in trouble, upset or showing signs of harming themselves. Friends
may worry about betraying a confidence but self-harm can endanger
lives and therefore should never be kept secret.
Many large secondary schools have a trained counsellor on the
staff specialising in adolescent behaviour or can call in the outside
resource of such a person. The head teacher may call in the parent
and inform him about the evidence. A parent may be devastated by
the news, having thought strange behaviour was normal adolescent
growing up but be only too willing to receive the help the school can
offer. On occasions a parent may refuse to believe, and must gently
be shown the evidence and told the consequences of not acting. This
area of school work is very sensitive and confidentiality is essential.
A source of help is the website for the MindEd Trust (see the Useful
Websites and Organisations section).
The suicide of a known adult

The suicide of a pupil’s parent or close relative may evoke feelings of
abandonment, shame and social stigma. Pupils affected need to know
that they are not alone; be helped to learn how to manage anxiety and
feelings of guilt; and have opportunities to talk openly to a teacher
about why a person chooses to die by suicide. School may be the place
where a child feels able to talk if the person who died by suicide is a
parent. Sources of help are available (see Chapter 3, pages 76–79 and
the Useful Websites and Organisations section).
School responses to incidents of

bereavement – assembly
There are times when a grief is private. At other times, following the
death of a child, or a teacher who was known by everyone in a primary
school, it is helpful to come together for an assembly. This will be

a time of quiet reflecting, remembering, thanking and celebrating
the life of the deceased. It is important that the family of the person
should be consulted. Pupils may well have ideas of what should be
included in the assembly and might like to write or draw pictures of
their memories, and fundraise to buy a permanent reminder of the
deceased, chosen by the children. If appropriate invite the family to
attend. The occasion needs to be sensitive to the faith culture of the
pupils and be a positive experience, with a clear ritual beginning, a
middle and a positive end.
On some occasions the assembly is very simple with a brief naming
of the person and their significance to the pupils and staff, followed
by several minutes of silence and quiet music. It could involve the
ritual lighting of a candle, singing, listening to the favourite music
of the deceased, prayers, reading poetry written by the children or
memories written on paper leaves in the classroom and hung on the
branch of a ‘tree’ during the assembly or stuck in a memory book for
the family. At the end of the assembly, the leaves or memory box could
be given, or sent, to the family, the remembrance candle blown out
and balloons released outside with messages attached, for example.
The school where my late sister worked planted a rose tree in her
memory. It is useful to have playtime after such an assembly giving
children time to assimilate what has happened before carrying on with
the daily routine. Playtime can also be an occasion when children may
use the member of staff on duty for reassurance or question what has
happened.
It is important to be aware that some parents believe strongly that
children should not be involved in anything to do with death and
funerals. In a local primary school, an assembly was held to celebrate
the life of one of the pupils who had died from a terminal illness.
On hearing about the assembly, a parent rang the head teacher and
berated him for subjecting her child to this experience. She believed
that children were innocent of such things as death.
An assembly for adolescents

This will be different from the more intimate occasion in a primary
or elementary school when the deceased was known by everyone.
Secondary schools are large institutions and the deceased will not
be known by the whole school. However, it is still appropriate to
remember the deceased and celebrate memories in an assembly. The
content could be organised by a small group supported by the advice
of a member of staff. Those attending might be a year group or a
house group, depending on the person remembered.
Pastoral care as a pupil returns to

school after a bereavement
Sometimes a bereaved child or adolescent has time away from school
following a death, needing to be with his family. Another child may
want to return to the familiar pattern of the school routine quickly.
There are likely, whichever time scale is appropriate, to be concerns
about returning to school. A bereaved pupil may wonder, ‘What do
my friends and teacher know? How will they treat me? Should I talk
about my dead parent?’ The child may be fearful of his emotions and
of being suddenly tearful or angry about what has happened at home.
He may be concerned that he will have missed school work and not
understand, nor be able to concentrate.
The class teacher can help in several ways, first, if possible by
visiting the pupil at home or asking the pupil to come in one day after
school so that decisions may be made and to reassure him of support.
Second, the class teacher can help by preparing his fellow pupils. The
former can be achieved by agreeing strategies if there is distress, such
as a yellow ‘exit’ card, or a ‘time out’ card given to the pupil and
carried in his pocket. The pupil shows it to a member of staff and has
permission to leave the classroom, without being asked, when feeling
upset, out of control or just to get ‘personal space’. It is important
that all staff teaching the pupil know about the card. It is essential that
the pupil knows a designated place to go and that an adult will be
there for as long as it is necessary. Simply having the card may act as a
resource to the pupil who may then not need to use it.
A pupil can carry something small such as a shell or a pebble in
a pocket as a comforter, which will be known only to him and the
teacher. Holding onto something solid such as a pebble or a small
shell can act as grounding, helping the pupil to feel in control if he is

upset. A small picture of the deceased or a piece of fabric or garment
that belonged to the deceased can provide a comforting memory. For
a bereaved child or adolescent who finds it difficult to communicate,
a small notebook can be used in which the child can write or draw
what he is feeling. The pupil can leave this diary on the teacher’s desk
for the teacher to know, respond and return to its owner. Alternatively,
the diary may be solely for the child’s use. A young child may have
a card with a happy face drawn on one side and a sad face on the
other. The pupil can show the side that reflects what he is feeling
that day and the teacher can respond. These are all helpful strategies
a teacher can discuss with a pupil before he returns to school. See
also the advice in the Childhood Bereavement UK section ‘Supporting
bereaved children and young people in school’ on the website (see the
Useful Websites and Organisations section).
The question of homework or missed work can be addressed by
agreeing what is essential and what is not, or the teacher making a
missed worksheet available, and the promise of extra help and support
at some break times when needed. The class, in circle time in primary
school or tutor time in secondary school, can be prepared for the
return of their fellow pupil by exploring the thinking and feelings that
emerge when a child loses something precious: what must it be like
never finding the precious thing? This could be applied to the loss of
a pet that wanders off and is lost, then thinking of the permanent loss
of a parent. Some role play of feelings and being in someone else’s
shoes might be useful. The class could work out strategies of help and
support and who would be the most suitable person to do this so that
the bereaved pupil is not overwhelmed. The help should always be
mindful of the pupil’s wishes.
The child or adolescent’s reactions to a death will vary depending
on age, conceptual development, personality, relationship with the
deceased and the nature of the death; each will be unique. There is no
set pattern or time limit to grief. Table 5.1 shows the typical responses
to death in school pupils. The pastoral care of pupils goes hand in
hand with exploring and teaching through the school curriculum.
Table 5.1 Common responses to a death in school

pupils (The Dougy Center 2006)
Academic Behavioural
Inability to focus or concentrate Noisy outbursts, disruptive behaviours
Failing or declining grades Aggressive behaviours, frequent fighting
Increased absences or reluctance to go to Non-compliance to requests
school Increase in risk taking or unsafe
Forgetfulness, memory loss behaviour
Over achievement, trying to be perfect Isolation or withdrawal
Language errors and word-finding Regressive behaviours to a time when
problems things felt more safe and in control
Inattentiveness High need for attention
Daydreaming A need for checking in on surviving
parent(s)
Emotional Social
Insecurity, issues of abandonment, safety Withdrawal from friends
concerns Withdrawal from activities or sports
Concern about being treated differently Use of drugs or alcohol
from others
Changes in relationships with teachers
Fear, guilt, anger, rage, regret, sadness, and peers
confusion
Changes in family roles (taking on role of
‘I don’t care’ attitude a deceased parent)
Depression, hopelessness, intense sadness Wanting to be physically close to safe
Overly sensitive, frequently tearful, adults
irritable Sexually acting out
Appears unaffected by the death Stealing, shoplifting
Preoccupation with death, wanting Difficulty with being in a group or crowd
details
Recurring thoughts of death or suicide
Physical Spiritual
Stomach aches, headaches, heartaches Anger at God
Frequent accidents or injuries Questions of ‘Why me?’ and ‘Why now?’
Increased requests to visit the nurse Questions about the meaning of life
Nightmare, dreams or sleep difficulties Confusion about where the person who
Loss of appetite or increased eating died is
Low energy, weakness Feelings of being alone in the universe
Hives, rashes, itching Doubting or questioning previous beliefs
Nausea or upset stomach Sense of meaninglessness about the future
Increased illness, low resistance to colds Change in values, questioning what is
and flu important
Rapid heart beat
Creating a policy for the school curriculum

First, it is important to discover if there are a clear rationale and aims for
the exploration of loss through the curriculum. Second, it is necessary
to question how these aims support the overall aims of the school.
Third, it must be asked if there are clear principles for the exploration
of loss, and fourth, how these principles support the principles of:
• access and entitlement
• curricular balance
• differentiation and potential
• preparation for the future.
The curriculum will be academic and intellectually rigorous but will
also include the emotions and the social effects of loss.
The educational aspect of death and bereavement is likely to
include the following: first knowledge, for example, the recognition
of different losses, rites of passage, beginnings and endings, cultural
differences, funeral practices and the irreversibility of death. Second,
skills such as handling emotions and dealing with anger; third, positive
attitudes, for example that death is natural and life is for living and
enjoying.
It is helpful to have a teacher identified to coordinate work on
loss within the school as this will allow a group of staff to plan
work in a systematic way, making clear how different subjects and
other curricular activities contribute to a growing awareness and
understanding. The policy needs to make clear how work on loss
is linked to bereavement support. It needs to indicate the range of
resources available to support work, establish continuity and monitor
and evaluate. Sensitive handling is needed since it is recognised that
certain curriculum subjects may be difficult and bring up distressing
memories for pupils.
The book The Meaning of Death (Feifel 1959) noted that the subject
of death had become taboo in the twentieth century in the USA. The
author challenged individuals to recognise their mortality, suggesting
that this was essential to live a meaningful life in the present. Later
studies showed that children also grieve and can benefit from support,
so programmes for bereaved children were established. The Dougy
Center, a community-based volunteer programme in Portland, Oregon
was founded in 1985, becoming a model and training centre for

professionals across the nation and creating grief support programmes
for children.
The principle aims of ‘Death Education’ in the USA curriculum are
to promote quality of life for oneself and others, and assist in creating
and maintaining the conditions that achieve this. ‘Death Education’
varies in goals, format, duration, intensity and characteristics of
participants. It can be formal or informal and offered at elementary,
middle and high school levels. Informally it arises through occasions
in the home recognised as ‘teachable moments’, such as the birth of a
sibling and the death of a pet, which naturally lead to interactions that
answer the child’s questions about life. In school there are two distinct
methods: first, the didactic using lectures and audiovisuals to improve
knowledge; and second, the experiential, actively involving pupils by
evoking feelings and allowing death-related attitudes to be modified.
It includes personal sharing of experiences in group discussion, role
play and simulation exercises and requires pupils’ mutual trust. Most
teachers use a combination of the two approaches. Children have fears
and concerns about death, yet studies of older children with life-
threatening illnesses show that by giving information about diagnosis,
prognosis and treatment options, death anxiety is lowered, creating a
measure of control. This may also be true of healthy children. Improved
information and discussion about the consequences of risk taking in
adolescents may reduce existing death anxiety and help prevent risk-
taking behaviour. In the UK, Spiritual, Moral, Social and Cultural
(SMSC) development runs throughout the whole curriculum, defined,
by the government Department for Education (DfE) for schools and
Ofsted education inspectors, as subject matter to ‘explore beliefs and
experience; respect faiths, feelings and values; enjoy learning about
oneself, others and the surrounding world; use imagination and
creativity and reflect’ (DfE 2014). Inspectors look for some element
of SMSC in every lesson, which is problematic when teaching maths.
From November 2014, schools are supposed to promote ‘British’
values through SMSC, and since 1 July 2015, schools have had a legal
duty to prevent pupils from being radicalised. Since September 2015,
SMSC has been compulsory and inspected. In secondary schools, the
Department for Education recommend using the citizenship curriculum
for this. Schools have taught citizenship since 2002. It parallels SMSC
in ‘appreciating diversity, understanding different viewpoints and
collaborating for change’ (Doing SMSC n.d.). SMSC will naturally be

a place topics around loss, bereavement and death occur.
Key Stage 1 (5–7 years)

At this age children generally experience small losses – a milk tooth,
a broken toy, a cancelled outing and the death of a classroom pet.
They will be aware of seasonal changes and of life cycles in insects,
for example caterpillars into butterflies, spawn into tadpoles and frogs,
and perhaps the scan indicating the growth of a potential sibling.
These areas of learning will happen through observation, recording,
nature study, science and story. Emotions at loss will be expressed,
leading to the burial of a dead classroom pet with rituals created.
Stories are helpful since they are objective and children can identify
with the characters and the plot. Literature is a significant resource
to help young children explore challenging areas of life (see the age-
appropriate suggestions in the Further Reading section at the end of
the book).

At this age children are able to take more responsibility. They are still
concrete thinkers. The curriculum will use music, movement and dance
to explore feelings and moods; English can involve writing letters to
comfort others and listening to stories; and in history children can
visit churches and graveyards to look at words on gravestones and
dates of birth and death (maths could be used here). Learning about
the two World Wars and others since and the commemorations of
Remembrance Day is important. A ‘memory tree’ could be made in art
and design, for example, with each pupil drawing a tree to represent
themselves. Ask imaginative questions such as, ‘What sort of tree are
you – an oak, a weeping willow, a silver birch?’ It is important to let
the child decide. The height of the tree shows the age of the pupil.
Show the roots and the branches. Think about the soil that the tree is
growing in, is it good and nourishing? How can the soil be improved?
Think about the losses in life and draw them as branches, the lower
ones representing the first losses. What were these losses? The pupil
might like to write the losses on the branches – for example, the loss
of milk teeth, a pet that has died, a change of school or parents parting
can all be included. The child’s sadness can be shown by leaves falling
from the branches. Sometimes new life can come from a loss – represent
this with a new branch. Then encourage the pupil to think of the good
things that have happened – the first bike, having a pair of roller skates
or a skateboard, hiking and joining the cubs. These things the pupil
enjoys can be shown by flowers or fruit with a word written on them
or at the side.
This exercise may bring up challenging feelings so the teacher
must be very sensitive. The exercise can be made over several sessions,
ending each session with either a good thing that has happened that
day or a serialised story of living with life and its challenges. (This
activity has been developed from a suggestion in The Child Bereavement
Trust Workbook 2000, pp.23–24.)

At 11 years old, children move from primary school to secondary.
Emotionally mood swings denote the beginnings of puberty – the loss
of childhood and movement towards adulthood, yet the loss of being
the oldest in a small school to being the youngest in a large school.
The curriculum becomes more segmented and specialised. Work in
English could look at the purpose of literature and writing poetry,
reading the war poets such as Wilfred Owen and Siegfried Sassoon. A
visit to the war fields of the continent is often made at this age.

These two years are for most young people spent in preparing for external
examinations, though subjects on the curriculum can introduce topics
related to death and dying. Ideas can be found on the website Dying
Matters (see the Useful Websites and Organisations section at the end
of the book). This website includes lesson plans and curriculum links.
Subjects such as English, where pupils study Shakespeare’s ‘Romeo
and Juliet’, could lead to a discussion on aspiration in life and death.
Geography lessons could study the reasons why death rates and age
of death vary so much across countries and include the implications
of ageing populations in the developed world. History could well be a
platform for discussing immigration within changing populations and
religious studies will include work on rituals and faith beliefs.

At this age many pupils will be involved in vocational type training
in further education colleges. These colleges will inevitably raise some
of the big questions, such as an individual’s gifts and inclinations, the
purpose of work, the balance of job satisfaction and pay, working
as an individual and working as part of a team. Other pupils will
be involved in structured courses in preparation for external public
exams and university applications. These pupils will encounter issues
of independent study, research methods, planning time, the balance of
study and leisure, future plans and priorities for their own lives. Many of
these issues are related to ultimate questions such as the purpose in life.
Resources
Child Bereavement UK produce a folder ‘Supporting Bereaved Children
and Young People in School’ as a free Schools Information Pack,
though as they are a charity a donation is useful to them. The pack
includes such subjects as how schools can help; responding to a death;
supporting a bereaved pupil; parents and carers; how to put together
a school policy; children’s understanding of death; pupils with a life
threatening illness; death through suicide; different cultures and beliefs;
books for the various Key Stages and resources for staff – interestingly
there was nothing specifically on the inclusion of material on death
in the curriculum, yet this would be a response to the Department
for Education SMCS requirement and respond to the questioning and
experience of children.
There is a useful website for Schoolswork (see the Useful Websites
and Organisations section), which aims to help schools in a pastoral
capacity.

In our schools there are children from different faith backgrounds and
from none. In parts of the UK, teachers will meet Muslim children.
When helping a bereaved child or adolescent it is helpful to know his
faith background and if possible to be in contact with the local faith
communities, if any, to enable the care and support of pupils.
Faith schools are a significant feature of the UK education system.
The Anglican Church pioneered universal education. The two main
providers in England are the Church of England and the Catholic
Education Service. Until 1997, the UK funded only Christian schools.

Jewish and Muslim schools existed but were privately funded. In
2011, about a third of the 20,000 schools in England were faith
schools, about 7000 in total; 68 per cent were Church of England,
30 per cent were Roman Catholic, 42 were Jewish, 12 Muslim, three
Sikh and one Hindu (Office for National Statistics 2011). These are
the latest percentages available and are likely to distort the number of
Muslim schools now in existence. Muslims also educate their young
in an after-school Qur’an school, a Madrasah; there are 700 in Britain
attended by 100,000 children of Muslim parents. The Madrasah
associated with the Hifdh branch of Islam state:
Our aim is to educate and prepare the younger generation…through
knowledge, wisdom, good morals and manners using successful
methods existing in the Qur’an…moulding the future generations…
who by the permission of Allah will become model British citizens
and beacons of light in the wider society.
Church schools are either voluntary controlled (VC) or voluntary
aided (VA). In 1998, ‘foundation’ schools were introduced and in
2002, academies (state-funded independent schools). These were
expanded in 2010 when existing schools were allowed to convert
to academy status and ‘free schools’ were introduced. In the British
education system for historic reasons religious education and an act of
worship are compulsory. A faith school teaches a general curriculum,
but has a particular religious character, which emerges from its origin
in a religious organisation, while being state funded.
Following the 2010 Academy Act, many schools converted to
Academy status and are sometimes known as ‘faith academies’, as are
free schools with a religious designation. Academies are not obliged
to follow the National Curriculum. However, Michael Gove, the then
Education Secretary, stated the teaching of creationism is at odds
with scientific fact: the Department for Education ‘will not approve
any application where we have any concern about creationism being
taught as a valid scientific theory, or about schools failing to teach
evolution adequately as part of their science curricula’ (Butt 2014).
Since 2014, racist propaganda in schools can be prosecuted. Faith
schools give priority of admission to those connected with their faith,
though if state funded they admit other applicants if they cannot fill
their places and must comply with the School Admissions Code. Since
education is a devolved matter, it differs in Scotland and Northern

Ireland. Local priests are on the management board of Church primary
schools and the governing board of Church secondary schools and
can be supportive to staff as staff are supportive to children.
Faith schools are not without their critics. The British Humanist
Association and National Secular Society have campaigned that faith
schools teach a broader range of beliefs in society. The Guardian
newspaper criticised faith schools for selecting pupils only from well-
off families (Shepherd and Rogers 2012). In 2005, the Office for
Standards in Education (Ofsted) noted that faith schools should be
carefully but sensitively monitored by government to ensure pupils
receive an understanding of not only their own faith but others and
the wider tenets of British society. A 2006 article in The Guardian
highlighted abuse in faith schools: Britain’s 700 unregulated madrasas
need to be monitored nationally to stop children being exposed to
significant physical and sexual abuse, a Muslim body has warned. The
Muslim parliament of Great Britain will today urge the government
to set up a national register for the mosque schools, coordinated and
monitored by local authorities, to meet their local obligations the
Children Act 1989 (Smith 2006). In June 2013, the Fair Admissions
Campaign was launched, supported by religious and non-religious
organisations and educationalists. In October 2013, the Theos Think
Tank produced More than an Educated Guess: Assessing the Evidence on Faith
School (Oldfield, Hartnett and Bailey 2013). The report recognises the
Church as pioneer of mass education in Britain, but states that within
the education sector faith schools have become contentious. In 2015,
further concerns about standards have been expressed, nevertheless
faith schools and academies are a significant contribution to the British
educational system. The teaching of religion has changed, as has its
name from ’scripture’ or ‘religious instruction’ to ‘religious education’.
In Wales the subject has been renamed ‘religion, philosophy and
ethics’. The 1988 Education Reform Act continued the requirement
that it should be compulsory but defined it as a component in the
‘basic curriculum’, not the National Curriculum. It also required that in
schools without a religious character attention should be given to all
the principal religions of the UK, not only to Christianity.
A Commission on Religion and Belief in British Public Life was
convened in 2013 by the Woolf Institute in Cambridge and was
reported on 7 December 2015. The report Living with Difference
(Commission on Religion and Belief in British Public Life 2015)

refers to the above matters in its Chapter 4, ‘Education’. The report
recognises:
If the place of religion and belief in British public life is to be better
understood, and if a society that works for the common good is to be
achieved, it is vital to give attention to what is taught and learnt about
religion and belief in schools…both formal and non-formal. (p.30)
The report takes issue with the admission policy of Church schools,
stating they are selective of the middle class who are determined to get
their children into a Church school and can move house in order to do
so. This is only partly true since Church schools are popular because of
their high standards and achievements, reported in Ofsted inspections,
and are sought by Muslim parents in urban areas since the stance of
the school promotes particular, more spiritual, values.
On the question of the teaching of religious education, Church
schools have a broad syllabus of enquiry, and respecting and exploring
the major faiths is part of the school assembly. This is important as the
Report states that children should be brought together to share their
faiths, and within Church schools there is a recognition of the diversity
of pupils’ home backgrounds. There are challenges with education, for
example the number of Agreed Syllabuses for the teaching of religious
education, but this needs to be addressed by all. Questions continue to
be addressed by Church and State.

Many teachers want to help a child and adolescent coping with issues
around death and dying, but feel anxious about supporting children
in their care and fear saying the wrong thing. On the other hand,
sometimes children and young people may want to talk openly about
what is happening at home, but find that those around them avoid the
issue. There is no one-size-fits-all solution. Teachers need to adjust
their approach to different children.
In schools, work on loss may feature in informal ways. Primary
school children gather in a circle at the end of a school day. Children
sit around the teacher to share news, discuss something they have seen
on the TV or listen to a story. This may well include a topical event
which raises questions for children. Adolescents spend useful time
listening to one another in tutor time. Grieving pupils talk to members
of staff, in incidental conversations, for example in the dinner queue,
before lessons and following something said in assembly.
The curriculum is significant in enabling pupils to explore
important issues around death and bereavement, which are part of life
to be faced and incorporated into life’s meaning.

A book review – pick up a book intended for a pupil you know on the subject
of death or bereavement. Read it. Write a paragraph of reflections showing
how you would use the book or why you consider it unsuitable.
6
Funerals
The Attendance and Participation
of Children and Adolescents
When you go to heaven are you still the same person you
were? If you had a limp do you still have one in heaven or do
you become new?
(Cynthia in Marshall 2003, p.46)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
Betsy and Barbara were sisters. They attended primary school. Their
favourite grandad had died and they were very sad. They asked their
parents where he was and were told that his body was with the funeral
director who would prepare it for the funeral. After the funeral, his
134
Funerals: The Attendance and Participation of Children and Adolescents 135
body would be cremated. Neither girl had heard of cremation. Their

parents said that cremation meant that his body would be burnt. At
this, the two girls shrieked in horror, rushed upstairs and disappeared
into their respective bedrooms crying loudly, slamming the doors
behind them. Neither would talk to their parents, adults who would
let this horrendous thing happen.
It is important that children understand what happens when someone
dies, at a funeral and afterwards when the body is buried or cremated.
The particular behaviour here originated in the lack of discussion
around death and the lack of understanding that at death the physical
body is no longer working and the functions of the body cease. A
friend of mine talked about the ashes from a cremation as ‘divine
compost’. In the book, The Tenth Good Thing About Barney, the cat’s
young owner discovers that when Barney is buried in the ground, his
body changes and Barney becomes like compost and will help ‘grow
flowers. You know, I said, that’s a pretty nice job for a cat’ (Viorst
1988, p.24). A dead body is without life and cannot feel heat or pain.
Fire at cremation is very hot, burns the body and turns it into a fine
powder.
Three young men were killed on motorbikes on a wet, windy night
by sliding into one another going too fast round a bend. It was a rural
area and the lads were well known. Their fellow bikers were distraught
when they heard what had happened and wanted to do something to
express their own grief and sadness and offer their condolences and
solidarity with the family in their grief. With the permission of the
family, and working together with the priest, the bikers made a rota
and kept an all-night vigil with candles around the coffins of their
friends the night before the funeral.
These seemingly tough young lads showed physical emotions when
the death was ‘one of their own’. This is in a context and culture where
‘men don’t cry’. They wanted to show their respect and solidarity with
the families of their mates. Fortunately, it was possible for them to
work together with the families and the local priest, helping thems to
grieve without realising and showing respect, and solidarity with the
bereaved families.

Children and young people are not fazed by death when they
experience it, if they are helped with explanations when they have
questions. It is adults, in the UK particularly, who continue to treat
death as a taboo subject and extend this by attempting to protect their
young children, thinking that children are innocent of such events.
Adolescents are much more like adults in their acceptance of death.
For centuries the whole life cycle in the West, birth to death, happened
in the home. Babies were born in the home and families usually
washed and cared for their dead at home. The family would come
into the room where the body was, often in an open coffin. The body
remained at home for viewing by neighbours and friends until the
funeral which all, including children, would attend. This continues
to be so in remote rural areas and in the developing world. Today
it is very different. Most people die in hospital or a care home, and
the body is cared for and stored by the funeral director, a stranger
to the deceased and to the family. The statistics of the place of death
are (Office of National Statistics 2011):
• 5 per cent hospices (NHS and non NHS)
• 18 per cent residential homes (Local Authority and private)
• 21 per cent home
• 53 per cent hospital.
Many adults have never seen a dead body.
What happens when someone dies?

It is important to explain to children what happens when someone
dies in words appropriate for their stage of conceptual development,
particularly if the deceased is a close family member, a parent, a sibling

or a favourite grandparent (see Chapter 4). Young children understand
literally, so using expressions such as the euphemisms, ‘We’ve lost your
mum’, or ‘Grandad’s gone away’ need to be avoided. Children can be
told that the person doesn’t need their body any more. It has worn
out. They cannot feel any pain. They don’t need food or air nor are
they lonely. The body is taken by men and women called undertakers
to a mortuary, where it is made ready for a special ceremony called a
funeral. The body is washed and dressed, the hair is combed and make
up applied. It is usually dressed in clothes provided by the family.
The body is put in a box of wood or sometimes thick cardboard or
woven branches, which has handles and usually a lid and is especially
made for the deceased. The box is called a coffin. The idea of being put
in a box and buried or burned can be frightening to a child whereas as
adults we take it for granted. Listening carefully to children’s questions
and giving clear explanations are essential. For young children the
book Autumn: Betsy Bear Learns About Death is helpful (Francis and Slee
1996). An older child may be helped by thinking about what we do
with leaves in autumn. The leaves are no longer needed, so we put
them in a black bin bag and allow them to disintegrate and turn into
compost. Or we burn the leaves and turn them into ashes, which is
used for compost.
The funeral directors have a Chapel of Rest in which the coffin
can be placed on a table and the family of the deceased can visit.
Some families do not visit and certainly do not want the children to
see the body after death nor attend the funeral, but children know
about endings from seeing a dead bird in the garden or at the side
of a road. Should children see the dead body of someone who has
been close to them? There is no right or wrong answer; it depends
on the feelings of the parents or carers and the children themselves.
Visiting the Chapel of Rest can help children realise the finality of
death and be less scared. Children are usually more scared about what
they don’t know than what they do. Not knowing is an opportunity
for their imagination to run riot. Allowing children to visit helps them
feel included and enables them to say goodbye. The funeral directors
can advise, and if they know that children are coming to view, they
may be very helpful in adding words to parental explanations. Some
funeral companies produce booklets for children, for example, Dignity
Caring Funerals. The chapel is also a private place. A correspondent to

a Guardian newspaper article wrote:
My father-in-law died when my son was four. He was very fond of
this grandfather and when the family went to see the open coffin
everyone said not to let the children into the room. We asked our son
what he wanted to do, and he wanted to come in with us, so he did.
His reactions? ‘That his grandfather looked nice and peaceful, as if
he were asleep.’ It was all very natural and a good way to say ‘adieu’.
(Hilpern 2013)
Another respondent recorded a three-year-old who was very fond
of her next-door neighbours. When the man died, his wife and her
friend, both ex-nurses, had laid out her dead husband in the bedroom.
The child and mother went to offer their sorrow at the death, the
widow commented:
The three year old asked if she could see him, and her mother, rather
reluctantly, took her upstairs. She stood for a moment looking at him
and said, ‘he can’t see me and he can’t hear me, can he?’ Her mother
agreed that this was so. She gave a sigh and turned to come back
downstairs, smiled at me and went home quite calmly. (Hilpern 2013)
If children want to see the dead body, it is important to tell them
what they are likely to see. It helps to tell them that sometimes when
a person dies their friends and family go and say goodbye. The body
is in a big box called a coffin. The body is the part that is left, but the
part that is special about the person, her spirit and the memories we
have her, will last for ever. The body won’t be like it used to be. The
person can no longer talk or walk or sleep, nor need to eat. The body
might feel cold and look pale, a bit like wax.
John was six. He was not told when he visited his gran in hospital
that she was dying. Gran had lived with the family since John was a
small child. When he started going to school he would run home and
tell his gran all that had happened. Just after the family returned home
from the hospital, a phone call to the parents said that she had died.
John realised from his parents’ expressions that something had
happened and insisted on finding out what the hospital had said.
When told, John did not believe his gran had died, since he believed
that hospitals made people better. This incident made it very difficult
to convince John that his gran was actually dead. His parents told him
that she was old and that her body had gradually stopped working.
John wanted to see her. A friend suggested that the funeral director
be consulted before his parents considered taking John to see his gran
at the Chapel of Rest. His parents repeated what he would see when
he got to the funeral parlour but John insisted. The experience in
the Chapel of Rest helped John to understand what death is and he
decided to go into the local church so that he could light a candle to
remember his gran.
If a child wants to see the body, she can be told that in the Chapel
of Rest it is fine to go and to touch the body, or kiss it or simply stand
at the door. If necessary, and the child gets upset, she can leave early
and go outside with an adult. It is fine if the child says she does not
want to see the body. It is useful to assure the child that many other
families prefer not to go to the Chapel of Rest, but to remember the
person when they were alive, then it can be suggested that she might
like to draw a picture or write a poem or memories of the deceased
and that these can be put into the coffin. If the family attend the
Chapel of Rest leaving a child behind, she may feel excluded or think
that death is too horrible to see.
Why funerals?
A funeral is a ritual, a rite of passage. Young children are likely to
have felt sadness, confusion or even guilt for not caring following the
death of a precious pet at home, at kindergarten or nursery school.
They may have experienced a funeral for the pet, perhaps digging a
hole for the body, reciting memories of the deceased pet and marking
the grave with a lolly stick cross with great ceremony. Children revel
in such ceremony and ritual. Some parents simply hide the pet’s body
from the child, replace the dead pet with another animal, hoping the
child won’t notice. This cheats the child of the reality of death, an
event that is natural and part of life. The book, The Tenth Good Thing
About Barney is the story of the funeral of a cat (Viorst 1988). The
purpose of a funeral is something that children can engage with, since
even young children can understand beginnings and endings. Duffy
comments that adults ‘forget that they (children) too must experience
the fact of death otherwise they are left in an unresolved void’ (Duffy
2008, p.52). A useful story book on beginnings and endings is The
Giving Tree (Silverstein 1964), and a good factual book is Lifetimes
(Mellonie and Ingpen 1983). A funeral is about saying goodbye and
honouring the deceased through, as a community of the bereaved,

sharing sadness and joyful memories of the significance of this person.
It is to recognise, for a child at a parent’s death, that a change has
taken place, which for a child means the regaining of confidence lost
when somehow she felt they were responsible for the death. It is the
recognition for a child that life does not end in death, since there are
memories of the deceased. For some adults, the funeral is closure, but
children will revisit memories at key events in their lives, such as going
to high school, passing external exams, going to college or university,
since the loved one will not be present to share the event with them.
The memoires may be what the deceased taught the child, from tying
shoe laces to learning to fish. A useful book for young children on
memories of the loved one is Badger’s Parting Gifts (Varley 1984, 1992).
For others, the funeral will be about a belief in an afterlife, which is
sometimes a religious belief such as a concept of heaven.
Should children attend a funeral?

The British Social Attitudes Survey of May 2013 showed that 48 per
cent of adults still think it is inappropriate for children under 12 to
attend funerals, yet research in the USA has shown that attendance
at funerals and viewing the body can have long-term benefits for
children (Hilpern 2013).
From about six years onwards, children should not be forced but
given, as a right, the decision of choosing whether or not to attend
a funeral. Children should be told what they will see and what they
should expect. For very young children, up to five years of age, the
parent can generally decide what would be best, when it is the funeral
of a parent, sibling, grandparent or close friend. Being shut out is far
more damaging, being hidden and unknown, than facing a new and
possibly difficult experience with loving support.
Michael Morpurgo wrote of his first experience of death: that of
his grandfather, which happened while he was a child at boarding
school. He was told the news by the headmaster and that he should
have the morning off lessons. He took a long walk, remembered but
didn’t cry, though he commented later:
I never went to see him. I never went to the funeral. I never said
goodbye properly…his death remained unreal and remains unreal…
death and dying continued to haunt me. And I’m sure now the fear
was the fear of the unknown, would it hurt? Would I go to hell?

Or would I just drift off into the blackness of eternity or infinity?
(Morpurgo 2006, p.5)
Years later he saw the body when his grandmother died. ‘This time I
did get to say goodbye. As I looked down on her I simply thought: this
is all death is, the end of the story…We need intimations of mortality’
(p.5).
A funeral enables a child to feel part of a grieving community and
relieves her sense of aloneness. The child sees that other people loved
the deceased and are as sad as she is. If it is the funeral of the child’s
parent, there may be school teachers present and other pupils; the
bereaved child then feels affirmed and encouraged. A child losing a
parent may feel deserted but attending the funeral can help the child
feel important at a time when he or she may feel displaced by what
is happening around them. Duffy comments, ‘Years later a child can
look back and be glad that they were included in an important family
occasion’ (Duffy 2008, p.52).
A seven-year-old was not told of his grandad’s death or funeral.
Grandad just ‘disappeared’ from his life. He harboured resentment
of his parents’ stance until his adulthood. Another ten-year-old,
Emma, said:
My dad died suddenly…one day we were on holiday and everything
was normal, the next thing I knew, he disappeared from my life. To
have gone to his funeral would have acknowledged that and given me
a chance to say goodbye. (Hilpern 2013)
As a late teenager she started having panic attacks at funerals and
sought counselling: ‘I was finally grieving for my dad…not going to
his funeral was a major influence.’ Her mother suffered enormous guilt
over the years, saying:
the problem with an unexpected death is that you’re in shock and
not thinking straight…and you only have days to make decisions
about the funeral…I decided the right thing was for Emma not
to go because I wanted to protect her…but quickly regretted it…
not least because I know what it has cost her over the years…the
crematorium was packed and Emma would have seen how much her
dad was thought of. I now very firmly believe that she shouldn’t just
have been there, she should have been involved in every part of it.
(Hilpern 2013)
Does stopping a child attending a funeral reflect adult insecurity
rather than children’s fears? Children are resilient. A resource to help
in decision making and what to say to children is ‘Talking to children
about dying’, which is free to download from the Dying Matters
website (see the Useful Websites and Organisations section).
It is important to know what might happen at a funeral. There
will be tears among some of the adults, but children don’t normally
see adults crying. It is important that they do and realise that crying
is a positive thing that can help a person feel better, since it provides
a release for difficult feelings. If children see it’s alright for adults to
cry, they are given permission to show their emotions. Adults may also
laugh at a funeral – this may arise from a memory recounted in the
eulogy, for instance – children must see it’s OK to laugh too. If a child
does not want to attend a funeral, or parents don’t think it suitable, this
must be honoured. There are alternatives. If the coffin is a cardboard
one it can be decorated by the children. Vikki Evans recounted how
her children aged four and three decorated a coffin with handprints
and glitter for their grandpa. The grandchildren had no false notions
about his passing; they know once a person dies he is gone for ever.
But they also understood that they had had a wonderful relationship
with that loved one, filled with experiences they would remember for
ever (Hilpern 2013).The children were told about his internment – he
did not want a funeral – but ‘they were unfazed’.They were asked
what they would wear at the ceremony – something Grandpa would
have liked, they were told. The older girl chose a beautiful party dress,
the younger boy dressed as a knight in armour. Their mother said,
‘They had given my father a work of art to sleep in, something from
which my mother, sister and I all drew comfort.’ The article ends:
since my father’s; funeral, my children have been happy to chat about
death – to anyone willing to listen, It hasn’t stopped the panicky
obligatory childhood sobs pleading with me and their father not to
die – I think all children go through that stage. But maybe that’s
the point, I want my children to have a healthy understanding that
death is inevitable and that it’s OK to grieve however they want.
(Hilpern 2013)
On occasions the school might help. Being aware of the date and time
of the funeral, a sensitive adult, for example a classroom assistant,
might take a bereaved child out of class to a quiet place, light a
candle and let her talk about the deceased. If she would like to say an
appropriate prayer or give thanks, the Lord’s Prayer or another prayer
could be said while the funeral is taking place. To share with children
who do not attend, adults can make a recording of the funeral, take
photos or have a video made. A list can be made of everyone present
and these can be part of a memory book of the loved one, shared at
special times, such as later at the birthday of the deceased.
Preparation for the funeral service

Adults are kept very busy after a death in planning the funeral and
simple activities with the children can be done with a sensitive visitor,
a known neighbour or a more distant relative. There are many ways
of involving children creatively at times of loss; working at making
things at these times is very valuable, allowing children to express
the inexpressible, with no need for vocabulary which they may not
yet have access to. The activities can be those children do all the
time, so they are not threatening, such as painting, tearing, cutting
and sticking. It is also a way to break the ice, since the process of
creating something is a distraction which can allow fears, anxieties,
observations and questions to be expressed naturally. The process is
as important as the completion of the activity, since when a chance
conversation arises it helps a child to realise that others are thinking of
her and the deceased. Giving children choices about small things can
also help them to feel they have some control in a situation which to
them feels very uncontrollable. For example, children can be involved
in choosing a favourite story such as The Very Hungry Caterpillar (Carle
2002) or Badger’s Parting Gifts (Varley 1984) and making a list of
attributes of Dad to add to the eulogy, such as Dad’s special gifts
were ‘teaching me to cross the road safely’, ‘helping me learn to read’,
‘playing football with me and my mates’.
Children could cut some tall twigs on which to hang leaf-shaped
tags in the deceased’s favourite colour. As they come into the funeral,
mourners could be given a leaf to write a memory on, the children
collecting and hanging them on the tree during the service. Later they
could be put in a decorated box and brought out on special occasions
such as anniversaries. An alternative is for children to design a memory
card to give out at the funeral for mourners to fill in, which can be
collected and later pasted into a memory book.
Depending on the season, children could pot up bulbs or seeds
and hand them out to mourners at the end of the service. I heard of
a family whose young mother had died after a long struggle with
cancer. There were sunflowers on her coffin, and as family and friends
left the service, the young sons handed to everyone an envelope in
which was a sunflower seed to grow and so remember her.
Children could make simple kites from supermarket bin bags
decorating them with patterns using acrylic paint using a design or
picture linked to a memory of the deceased and adding a tail. Another
possible material is coloured tissue paper. As young children ‘puddle
jump’ in and out of grief, it is useful to have something to play or run
around with after a funeral.
Children can be prepared for a funeral by being told before what
happens, who is responsible and where a funeral takes place. It can be
explained as a special time of remembering with music, words, poems
and a special talk, a tribute called a eulogy, about the person who has
died. The occasion is led by a person who might be a church official,
a minister, priest or lay Christian, the cultural leader of the faith of
the family, a non-religious person, such as a humanist celebrant or a
member of the bereaved family.
It is helpful to children particularly, if the person taking the
rite spends time with the family. The family, including the children,
could choose the words and music for the service. An understanding
celebrant can take the family through the service, explaining what will
happen. If children are to be present at the funeral, they might write a
memory or a poem or draw a picture to go into the coffin.
Children can be told that the funeral takes place in a religious
building, or a crematorium or outside on a greenfield site. It is
important that a child is accompanied by a close family member or
special friend who can be there for her afterwards. This alleviates the
sense of being alone and allows a parent to express her grief for a
deceased partner, child or her own parent. The coffin with the dead
person will be brought in at the beginning. A heartbroken family need
words of comfort knowing that the deceased will be remembered. At
the service children could hand out service sheets as people come in
or light candles at the beginning of the service.
Burial or cremation?
Explanations of why the body is buried or cremated will help to
dispel any myths that children have. A six-year-old thought that God
lived in the ground. When asked by a teacher why, she replied, ‘Well,
when people die they are put in the ground, and we say they are
with God.’ If possible, children should be shown before the funeral
where the grave is or what happens to the ashes. A burial might be
in a greenfield site, an ecological area, a specially designated area of
grass and trees, a churchyard or a local authority site. Children can be
told that the coffin will be taken to the burial ground in a special car
called a hearse, which leads the procession of mourners’ cars. It will
be buried alongside other graves containing the coffins with bodies
of other people someone loved. A large hole will have been cut in the
ground, so that whoever carries the coffin lays it beside the hole, while
mourners gather round. Words and prayers are said before the coffin
is gently lowered into the ground. The family may throw handfuls of
soil on the coffin, some scatter flower petals. The wreaths of flowers
sent by people who knew the deceased are laid beside the grave. There
is then likely to be a quiet time when those attending the burial look
at the flowers and talk quietly. The funeral directors then let their men
fill the hole with soil. A temporary marker of wood shows where the
grave is. Some months later the family may have a stone carved with
the name and dates of the deceased with a verse added. The grave
is a permanent memory, later visited by family. Customs vary. Some
families put fresh flowers on a grave at Easter, a time of the renewal
of life; others on the anniversary of the death or the birth of the
deceased. Others plant bulbs or small plants. The rules about this are
determined by the local authorities that maintain the graveyard.
Families may decide that the body of the deceased should be
cremated. Children can be told that the crematorium has huge
ovens in which the coffin is placed and burnt until it becomes ashes.
The ashes might be placed in a casket and kept in a family home,
buried in a churchyard, scattered at sea or on a favourite walk of the
deceased. The latter means that it there is no ‘permanent’ place to
mourn; it is known only by the family. My youngest sister’s body was
cremated and her ashes scattered on her favourite secluded footpath
overlooking the river. She asked for cremation, since she wanted to be
free from the disease that had limited her. The whole family, including
her teenage daughter and young cousins, helped scatter the ashes.
Later, my brother-in-law planted bulbs at the spot. A close friend was

disappointed that there was not a public place such as an accessible
churchyard in which to grieve.
The ‘get together’ after the funeral

Frequently, the family and other visitors get together after the funeral,
which is difficult for children, since their memories will be different
from the adults present who will have known the deceased longer as a
relative, work mate or leisure companion. Even with family members,
a child may not have met all the relatives and can feel left out. Sharon,
13, wrote, ‘I feel I have the memories I have and the other people have
no right to tell me they have any more. I don’t know what to say to
them. My own memories are very special’ (Duffy 2008, p.53). A way
through this is to give the child or adolescent a task, for example to
write a list of attendees at the get together after the funeral and get
each person to sign it. Or she could be asked to help with handing
out sandwiches and drinks, or to get everyone to write down their
memory of the deceased on a tag. A useful resource with a wealth of
creative and imaginative ideas is Children at Funerals (Burgess 2003).
A ‘wake’ refers to the Irish way of handling life after a funeral.
The wake is a traditional Irish custom, though it is ceasing to exist in
cities and is even modified in country areas. The wake is the practice
of continuously watching over the deceased from the time of death
until the funeral. The origin of the wake may be the ancient Jewish
custom of leaving the burial chamber or sepulchre unsealed for three
days before finally closing it up, allowing the spirit of the person to
leave. An alternative understanding of the origin is the custom of
family members frequently visiting, in the hope that the deceased
would show signs of a return to life. The word ‘wake’ comes from
an Old English word meaning ‘to bring to life; to stir’ in the hope
that the deceased will awake. Typically, the body is ‘waked’ for three
days, usually in the deceased’s home, with an open coffin allowing
neighbours, distant friends and family to visit and pay their respects.
The response to an article in The Guardian by a Northern Irish man
was that he could not understand the taboo of talking about death in
English culture, ‘young or not we all went to funerals, and the wakes
before, where the corpse was laid out…including, on one occasion a
schoolmate’ (Hilpern 2013). The man remembered that a favourite
walk in his childhood was for him and his siblings to accompany their
mother on a Sunday on the three miles to visit the family graves and
to tend them: ‘you could reconstruct the population of our streets from
reading the tombstones, and as you grew older, more and more of the
people you knew as a child started populating the graveyard’ (Hilpern
2013). Another Irish correspondent said:
I think the Irish tradition of a full-on, three day wake in an open house
with catering, music and an open coffin is just about the healthiest way
to kick-off the process of coming to terms with the loss of a loved one
– and a brilliant way to show kids that life goes on. (Hilpern 2013)

Judaism
After a death, the first person to call is the deceased’s rabbi. A Shomer
or ‘watchman’ stays with the deceased from death until the funeral and
burial. The rabbi coordinates the needs of the family, his own time
and that of the cemetery. In respect to the deceased and the mourners,
traditionally Jewish funerals are held as soon after death as possible.
A service may be held in the synagogue, though today many are
opting for a service only at the cemetery. Choosing a casket for the
body is difficult since it is the last thing to be purchased for the loved
one. The service itself lasts about 20 minutes and consists of reciting
psalms, reading Scripture and a eulogy. The Kaddish prayer is recited
after the lowering of the casket and the grave has been filled with
earth. Mourning continues in the home (see Chapter 2) and visits to the
cemetery, but these visits are infrequent less the deceased be ‘deified’.
Christianity
My youngest sister died just before Christmas in the hospice where I
worked. Her death was expected. Most of the family were with her
when she died. Angie left a bewildered husband and a fourteen-year-
old daughter. Since it was near Christmas the family decided to have
a funeral led by one of my colleagues in the church where Angie
had been married and she and her daughter christened, but not to
announce it publicly, since her husband and daughter could not cope
with too many people. It was a service with a wicker, boat-shaped
coffin, symbolic of the journey she was now on, Advent hymns,
prayers, a committal to the God she loved and served and a Celtic
blessing. We knew and said that our Angie was now singing with the
angels in God’s nearer presence.
Angie had been a very popular person in her village, so I suggested
that there would be people who would like to pay tribute to her, and
we could have a service of Thanksgiving at the end of February. This
happened. It was a wonderful celebration, with her daughter playing
in a wind quartet with her school friends, a group from the choir
which Angie, another sister and I had belonged to, our choir master
playing the organ for hymns and my sisters and I giving a tribute. We
had a retiring offering for the charity Cancer Research and finished
the afternoon in the village hall for refreshments while looking at
photographs of family life. It was an occasion at which her teenage
daughter and her cousins could participate.
Children brought up in a Christian environment think about the
‘hereafter’ and the possibility of heaven. Cynthia asked, ‘When you go
to heaven are you still the same person you were? If you had a limp
do you still have one in Heaven or do you become new?’ Here is a
‘concrete’ thinker puzzling about the hereafter and questioning if it is
like our experience of living today on earth.
John is a ten-year-old on the autism spectrum. One day on the way
home from school, the children with their mothers walked quickly
past a dead cat in the road, horrified. John stopped, was very emotional
and asked his mother, ‘What can we do?’ As one of a Roman Catholic
family, his mother suggested saying a prayer. With no inhibitions John
said a prayer aloud and then said to his mother, ‘It’s OK now; the cat
is with Jesus in heaven’ and walked on with determination. Here is the
assurance of faith.
In the New Testament, there is a saying when Jesus refers to an
incident in the market place which he must have observed (Luke
7.32). He noticed children playing at funerals. What was happening?
Perhaps like children today they were replaying something that they
had experienced in order to make sense of it.
A colleague, George, took the funeral of the child of one of his
church leaders. The child had been killed by a reversing dustcart
which had not noticed him. He wept when he saw the small coffin
and continued to cry as he took the funeral. Later in the day he went
to the parents and apologised. The parents said that it was the most
helpful thing that had happened. This was a shared grief.
Scholars cite the story of Jesus at the death of his friend Lazarus
(John 11), when Jesus wept. There is a conversation with Mary,
Lazarus’s sister, about the resurrection. Jesus calls out to Lazarus, who
is buried in a stone sepulchre, ‘Come forth’. When Lazarus appears
bound in the grave clothes, Jesus says, ‘Unbind him, set him free.’
Scholars wonder if the story is a parable of Jesus’ own burial and
resurrection, although knowledge of the raising of Lazarus is one of
the reasons that the Jewish leaders gave for wanting the death of Jesus
as a trouble maker. At the last meal he had with his friends he said,
‘Do this is in remembrance of me.’ Christians believe that although it
is right to grieve at funerals, death is not the end since there is a life
to come.
The adolescent motorbikers whose experience began this chapter
contributed to the funeral by keeping a vigil for their friends who
had died. On the whole adolescent lads and young men personify
the saying, ‘boys don’t cry’. There is evidence that the emotional
development of men is deficient: ‘No matter how modern a society we
have become and how diverse a society we have become, we still seem
to educate our children in a feeling that they have to “man up”, that they
have to be strong, that they can’t talk about emotions’ (Moore 2015).
Emotional education of young men and boys is needed (see Cohen
2001). A funeral such as this one can give a priest the opportunity to
talk to adolescents and for them to ask questions: ‘Why did it happen?
Is there a God? Will they meet their friends in heaven? Is it a problem
that they will be so much older than the deceased friend?’
For the funerals of young people many bereaved families now ask
for a small ‘private’ service, followed by a large memorial service. But
seeing the coffin at the funeral is really important for young friends;
so try to allow as many to come as want to. (Church Times 2014)
Dr Tess Kuin Lawton, Chaplain of Magdalen College School, Oxford
goes on to say:
If one has counselled the parents of a young person who has died the
temptation is to plan the service from the family’s perspective of the
teenagers, which – theologically speaking – focuses on the crucifixion.
If we see the funeral from the perspective of the teenagers, however,

an emphasis on pain simply leads to the response ‘We can go out and
do whatever we want in life, and live it large, because tomorrow may
never come…’ Instead, why not tackle the short life of the young
teenager directly and reflect on the gifts of the Holy Spirit which the
person brought to those who knew him or her? Give those who are
left a blueprint for life now, and try and give a sense that, whatever
the span of days we have, we have the opportunity to be someone
wonderful. (Church Times 2014)
When the motorcyclists were killed many of the adults were left
feeling helpless. Teenagers are probably able to cope better, since they
are used to the emotional chaos of adolescence and use Facebook and
other social media to share memories and photos of those who have
died, thus grieving in an active way.
Islam
Families who are second and third generation settlers in Britain may
continue in the traditions of their forefathers in ‘rites of passage’ and
desire the occasions of dying and death to observe strict practices.
They may return the bodies of deceased loved ones to the country
of ‘origin’. Others have adapted and taken on British customs, while
some have a mixture of practices. Whatever is the case it is important
to be sensitive to the beliefs and rites of others.
In Islam, those surrounding dying person encourage him to say
the ‘shahada’ confirming that there is no God but Allah. At death, those
present say ‘Inna lllahi wa inna ilayhi raji’un’: ‘Verily, we belong to Allah,
and truly to Him shall we return.’ In Islamic law the body should be
buried as soon as possible from the time of death, ideally within 24
hours, a custom that is probably rooted in an age when there was no
refrigeration and no way of keeping the body for long without it
decomposing.
Funeral prayers are said by all members of the community
including children, though in a prayer or study room or the mosque’s
courtyard, not in the mosque itself, facing Mecca in three lines with
the male most closely related to the deceased in the first line, followed
by men, then children and then women. After prayers, the body is
transported to the cemetery for burial. Traditionally only men are
allowed to be present, though in some communities women will
be allowed at the graveside. The grave is dug perpendicular to

Mecca (the qiblah) and the body placed in the grave on its right
side, facing the qiblah, while those so doing recite, ‘In the name
of Allah and in the faith of the Messenger of Allah.’ Once in
the grave a layer of wood or stones should be placed on top of
the body to prevent direct contact with the soil that will fill the
grave. Then each mourner places three handfuls of earth into the
grave. Once filled a small stone or marker is placed at the grave,
so that is it recognisable. Traditionally, it is prohibited to erect a large
monument on the grave or decorate the grave in an elaborate way.
After the funeral, the immediate family gathers to receive visitors. The
community provide food for the mourning family for the first three
days of mourning. In Islam, it is acceptable to express grief, crying and
weeping over a death and at the funeral, but not wailing or shrieking
which may express a lack of faith in Allah.
Hinduism
A Hindu funeral is a remembrance and a celebration service.
Traditionally, the deceased is cremated on the ghats in Varanasi on the
shores of the River Ganges. The body is no longer needed; it is the
soul, the inner self, that is significant. White is the traditional colour
for funerals together with traditional Indian garments. The chief mourner,
usually the eldest son, and the other male members of the family may
shave their heads as a mark of respect. This son lights the funeral pyre.
Sound is part of the ritual with the ringing of bells. If the service is
in the UK, where outdoor cremations are not allowed, the eldest son
will press the button to make the coffin disappear and sometimes be
allowed to ignite the cremator. Sometimes, the ashes are taken back to
India to be scattered in the Ganges, though in some areas where there
is a large community of Hindus, areas of water have been considered as
acceptable substitutes. Mourning lasts for between two and five weeks.
Buddhism
Buddhism emphasises impermanence: the cycle of birth, death and
rebirth. The Buddha recognised that the impermanence resulting from
suffering characterised human life; only by the loss of attachment to the
self through a series of rebirths could enlightenment and freedom be
found. Theravada Buddhists believe in instant reincarnation; The Book
of Death proposes that the art of living well and the art of dying well
are one and the same. Acceptance is a good thing, taught Buddhists,
for it will be followed by rebirth in an endless cycle until you can
break free. It also provides an opportunity to assist the deceased as she
fares on to the new existence. In Buddhism, death marks the transition
from this life to a new mode of existence within the round of rebirths.
For the living, death is a powerful reminder of the Buddha’s teaching
on impermanence.
When Death in all its ferocity has arrived on the scene no bargaining
can ward him off, no gifts, no attempt at sowing dissension, no force
of arms and no restraint. Our hold on life on life is so uncertain that it
is not worth relying on… Who, unless he be quite mad would make
plans which do not reckon with death, when he sees the world so
unsubstantial and frail like a water bubble? (Conze 1959)
Tantric Buddhists believe in an intermediate bardo period, as much
as 49 days between death and rebirth. Tibetan monks guide the
deceased’s spirit through the perilous bardo by reading from the Book
of the Dead. The bardo is divided into three phases. During the first it is
in a swoon, constantly urged to enter the clear light of ultimate reality
and recognise its own Buddha status. During the second the soul
recovers and becomes aware and frightened by its own disembodied
identity. It gradually becomes aware that it has died and sees the
dismantling of its life. Finally it enters the ‘illusory mental body’ of
a child, a dream-like state. The body is carried out in a sedan chair
for cremation accompanied by monks, musicians, relatives and friends.
Fire is considered to burn away attachments as well as sins. Clothes
and personal possessions are then auctioned. Meanwhile the soul in
bardo is buffeted, then judged. Six weeks after death the bardo may
still be buffeted. It may overcome its egoistic goals and overcomes
egocentricity becoming part of the ceaseless flow of life. It may enter
a woman at intercourse and be re-born.

The funeral is a rite of passage, a significant event, usually arranged
by the family of the deceased or, if there is no family, by the local
authority. This is considered a moral obligation to a fellow human
being. ‘Funerals are important since they mark the passing of a human
being from the society of the living to the world of the dead. Death
is a passage which the funeral formalises’ (Sheppy 2003, p.78). Ewan
Kelly, a hospital chaplain and university lecturer, recalls the following
incident:
Several years ago in a large housing estate in Craigmillar, Edinburgh,
a new born baby was found dead and abandoned on some waste
ground. Neither the baby’s mother nor father was ever traced.
However, the whole community took ownership of the baby and
rallied round to pay for the funeral, which the local minster performed
and many attended. A unique human being had lived, albeit briefly,
and died who needed to be respectfully laid to rest in a culturally
appropriate way. (Kelly 2008, p.74)
The ritual was the responsibility of the local authority, but a community
hearing the story were touched by it and wanted the baby to be
recognised and ministered to by people who cared.
Often children are not consulted about seeing the body, visiting
the Chapel of Rest or attending the funeral. Decisions are made for
them. Is this protecting children from death, which continues to be
deemed unsuitable for children? A way of thinking that sees children
as innocent of suffering and death, not thinking about asking children
and adolescents or giving them the information they might need so
that the youngsters can make a reasoned choice. We need to listen
to children to find out what they do understand and know. Is it an
unnecessary cocooning of children if we don’t? One eleven-year-old
on the cusp of adolescence said, ‘Adults don’t help when they don’t
listen to children’s opinions. They make decisions for them when
they don’t know’ (Cranwell 2007; Wordern 1996). Overprotection
from the realities of life, such as suffering and death, leads to a child
lacking self-confidence when dealing with adversity and a consequent
loss of self-esteem.

1. Look at a funeral service sheet, or jot one down from memory. This
should be a funeral at which children were present. How were the
children related to the deceased? What part did children play in
the service? Describe what happened to make children feel part
of the service.
2. Prepare a questionnaire on children/adolescent’s attendance at a
funeral. For example:
• What age were they when they attended?
• Whose funeral was it?
• Where did the funeral happen?
• Did they know what would happen at the funeral?
• Did anyone prepare them for the occasion?
• Did they meet the celebrant before the service?
• Were they asked if they wanted to take part?
• Did any children/ adolescents take part?
• What surprised them about the occasion?
• What were their feelings on the occasion?
Ask a local school if in an RE lesson on rituals such as funerals the questionnaire

could be completed. Write up your findings.
7
Continuing Care of Children
and Adolescents
Do kids get to stay with other kids or do they have to stay with
grown-ups?
(Jackson in Marshall 2003, p.34)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
Jamie was one of twins. At a year old, he and his twin sister had
contracted meningitis. It was treated, but his sister sadly died. Each
week, he was taken by his mother to the cemetery to visit his sister’s
grave. This seemed to him to be a feature of the week and as a small
child he accepted it as normal. Later as an adolescent talking to his
chums, he realised it was not normal to visit the cemetery as a child.
155
None of his chums had such a memory. In fact, they were rather
dismissive of any talk about death. It was ‘emotional girls’ stuff’. Jamie
was getting to the stage when he wanted more independence from his
family and in particular his mother, so he refused to continue going
with her, which caused a rift between them. Now in his late 60s, he
still mentions the death of his twin when any discussion turns to the
subject of death, perhaps because he was never able to grieve in a way
appropriate to his age as a child.
Was his mother right to take Jamie to the cemetery? She needed to
express her own grief and visiting was one way of grieving, but should
she have made some other arrangements for the care of her young son
while she did this? Are we right as adults to extend, or impose, our
feelings and actions on a child? Grief is not limited to adults; Jamie
himself needed to grieve for a twin sister whom he had spent the first
year of his life with and was his companion and playmate; he must
have missed her and questioned her absence. It would seem that at the
time when his sister died, more than 60 years ago, the grief of children
was not recognised.
Rosie was an only child. Her mum had died some three years
previously of a brain tumour. Rosie was the top scholar in the public
exam results in her school and had to get her results from the head
teacher himself. He said how proud her mother would have been at
her success. One day she woke to the cries of her cat Mouser. Her
back legs were paralysed, and she was in obvious pain. Her father was
away for the weekend, so Rosie had to make decisions. Although it
was a Sunday, she rang her friend, and together they managed to get
an emergency appointment at the vets, taking the cat in her basket.
The vet stated that Mouser could be operated on, but the outcome was
uncertain. Rosie decided that it was better if Mouser was made pain-
free through being put to sleep while she held her. Later, with her
friend, she took Mouser’s body home, and they buried Mouser under
her favourite apple tree in the garden. That evening she rang her aunt
who lived nearby and went to see her. She recounted the events of the
morning then suddenly burst into uncontrollable sobbing.
Continuing Care of Children and Adolescents 157
Mouser had been a part of Rosie’s life since childhood. She and her
mum had bought Mouser together as a rescue cat. Now Mouser had
died and another tie with her mother had been broken. Her aunt let her
sob and simply held her tightly and stroked her hair. An adolescent’s
grief at the death of a parent is long lasting, particularly for a girl
when her mother dies. Grief floods in as waves. Sometimes there is
no obvious reason for the resurgence of grief. Often there is a trigger
which is part of the story of the adolescent and the relationship with
the deceased. In Rosie’s experience, it was another death, this time of
a cat, but a cat that held very precious memories for part of her life
and her late mother’s for many years. Mouser’s death brought back all
the memories of a happy childhood with her cat and her mum. Now
both were gone.

There is no set pattern or time limit to grief for a child or adolescent.
Much depends on such factors as the personality of the bereaved, for
example the attitude and acceptance, or not, of loss; the relationship of
the bereaved with the deceased; and the nature of the death, whether
anticipated through lengthy illness or unexpected. Each of these
factors has been mentioned in earlier chapters. Grieving never ends; it
is something that we never get over if the relationship has been loving
and significant. The Dougy Center comments, ‘This is perhaps one
of the least understood aspects of grief in our society’ (The Dougy
Center 2006, p.7). A death of someone close to you leaves a vacuum in
your life, and life is never the same again. Many adults, however, seem
to want to put the loss behind them and get on with life, but a loss
does not mean that they will never be happy and joyous again. The
experience of loss can be transformed into something positive. Draper
called the process of transformation ‘re-imaging’: thinking about the
future and the bereaved so that adult, child or adolescent can carry
the deceased person with him into his future in a new way (Draper
2008, p.7). The sociologist Tony Walter suggested an integration: the
bereaved carrying with him the deceased, since the latter was part of
his present life story (Walter 1990).
Children are different from adults in their approach to death. They are
much more resilient; even young children losing a parent sometimes
adjust if there is another care-giver who is able to fulfil the needs of the
child. Slightly older children oscillate between sadness and getting on
with life, but that tends not to last long: life is for living. Adolescents
grieve at the death of someone close to them, and if they are truthfully
told about the death and involved in the funeral arrangements, they
find support amongst their peer group and eventually move on and
continue in the establishing of their own identity. However, grief re-
emerges at certain milestones in the lives of children and adolescents,
since grief does not have a particular end time.
There is little understanding that a child and adolescent will need
to revisit a bereavement, particularly if the death of a parent happened
at an early point in his life. And as the years pass the bereaved child,
now a young adult, wants to know more about the death, remember it
and share memories of the lost loved one. When the surviving parent
cooperates with anecdotes and memories that the child has forgotten,
it enriches both parent and young person and adds to the quality of
their relationship. These occasions can be ‘rubbished’ and denied their
significance by others, particularly if as a child there was counselling
and returning can be dismissed as morbid curiosity. However, those
early memories are part of a life story. I remember that when eventually
my niece Rosie had a steady boyfriend who had never known Rosie’s
late mother, I brought out some photos of Rosie as a child and some
of the drawings she had done for me and how delighted Rosie was,
wanting to know more about them.
Rosie, as she becomes a young adult, will have occasions of
significance such as gaining a place at university, later graduating,
getting a first job, perhaps getting married. These are occasions when
Rosie will reach a new development level as a person or experience a
personal accomplishment which her mother would be proud of, but
will not be there to share, and she is likely to re-connect and grieve
for her mother’s death. This means that the care of children and
adolescents must be ongoing, so that each has the resources to live
into a positive adulthood.
In Chapter 4, we saw how a young family could prepare for the

ultimate death of a terminally ill parent. The preparation was twofold.
First, it was noticing the changes in the health of the sick parent, and
second, it was changing behaviour in response to the observations. The
family were then able to anticipate the death and begin the process
of building positive memories to carry the person with them after the
death. For some when the death is unexpected this process is unlikely
to be possible and with an imminent death a child may be angry or
sad, which may well be expressed in unusual behaviour at home and
in school. Such emotions as anger may arise after the funeral when the
finality of the death is realised. Anger wells up inside and bursts out.
Other children may be silent and withdrawn. The ongoing welfare
of the child or adolescent is then paramount. This continues to be a
grieving process, until someone is found to whom they can talk openly
and honestly. It may involve a parent or a teacher in school listening to
help a child or adolescent face what has happened and begin to accept
the normality and finality of death and so move on. The recognition
of the significance of grief in developed societies, however, is counter-
cultural in the light of adult reluctance to talk about death.
The public recognition of grief and the culture that surrounds
it, both in public and in private, has changed over the last century
and a half. A major factor was the death of Queen Victoria’s husband
Albert who died at 43 after 21 years of marriage. Queen Victoria
was a widow for 40 years and wore black for 40 years, setting the
tone of an obsessive celebration of grief for her subjects. The First
and Second World Wars influenced attitudes to grief with the high
death rates of soldiers. The historian Jalland notes that the Second
World War ‘marked a deeper break with the past than the Great War
and the process was cumulative. A pervasive model of silence about
death and of suppressed grieving became entrenched in the English
psyche’ (Jalland 2013, p.63). Churchill called for courage and stoicism
during the blitz of British cities: ‘The dark side of the blitz story was
sanitized to sustain morale’ (p.63). Public grief was discouraged; grief
was privatised and despised. The thinking was to ‘keep busy and
pretend to be cheerful’ and to grieve in private and in silence. Women
imitated men in suppressing grief. Subsequently, the atrocities of the
Holocaust shook people’s faith in humanity. It seemed a prostitution
of the advances of contemporary medical science, bringing disbelief.
Nuclear proliferation became a fear. Thoughts about death were
further marginalised with the Welfare State provision of pension rights

and sick leave, relieving some of the financial distress of bereavement;
medical advances resulted in longer life and in death becoming more
remote.
The importance of parents and other professionals recognising the
continuing needs of children and adolescents is significant. For example,
in schools in the UK increasingly there is a policy which recognises
the long-term effects of bereavement in regard to the behaviour of
pupils with the school having access to outside support services if
bereavement issues persist and appear to becoming ‘pathological’.
Following the Harvard Child Bereavement Study in the late
1980s, Dr J William Worden, one of the study’s directors, was
interviewed. Worden found that about 20 per cent of children who
were grieving needed intervention two years after their bereavement,
contrasting with the control group which was closer to 9–11 per cent.
One variable that strongly affected the functioning of a child was the
functionality of the surviving parent, a depressed parent, not being
able to consistently maintain homework and discipline, which resulted
in a child having a more difficult time adjusting to the loss (Hospice
Foundation of America 1990).
What are some more subtle warning signs that a young person
is struggling and needs more help? One significant concern is when
a child exhibits significant sudden changes in behaviour. Of course,
short-term changes may be normal but if the changes are persistent
or striking – for example, the usually social child doesn’t want to be
around anyone – this may be a cause of concern. A few ‘red flag’ signs
that may indicate the need for further assessment by a mental health
professional are, first, a child who cannot speak about the dead person,
or leaves the room when the person’s name is mentioned; second, a
child whose aggression becomes destructive, especially if this is new
or unusual behaviour; third, a child who when a parent dies develops
persistent and increasing anxiety about the surviving parent, which
may develop into phobic behaviour about not leaving that parent to
go to school.
It is important to look at these in the context of the death; many
of these behaviours may be typical soon after the death, but if they
continue they may be more serious. In any of these situations, it is
important for teachers to take the time to listen well, to be patient
and to develop relationships in which a level of trust is increasing
with the children they work with, so they can offer them the best
support through this challenging time. The focus should not be
on the presence of a symptom or behaviour but on its duration. If
any of these behaviours continue for several months, it is likely that
professional help is needed. Symptoms are prolonged bodily distress,
sleep disturbance, persistent changes in eating patterns, aggressive
behaviour, marked social withdrawal, school difficulties or serious
academic reversal, persistent self-blame or guilt, self-destructive
behaviour or expressing a desire to die. Young people report very
different experiences at school. ‘But it is known that how the school
manages the individual is critical. Teachers make a real difference’ (see
the Grief Encounter entry in the Useful Websites and Organisations
section).

For all who have lost a child or adolescent, there is a worldwide
candle lighting ceremony on the second Sunday of December every
year starting at 7.00pm in each time zone. This was initiated by The
Compassionate Friends in the USA as their gift to grieving families.
This candle lighting ceremony unites friends and families in loving
memory of all children who have died at any age from any cause,
transcending all boundaries of global grieving communities.
Within children’s hospices there are regular times when the
grief and continuing care of siblings of children who have died are
recognised. Some hospices, for example, organise balloon decorating
with the name of the deceased child written on an attached tag so
that siblings can release the balloons, which fly away, symbolically
carrying the loved one with them. Such ritual occasions are important
for children and adolescents.
Judaism
Within Judaism there are continuing ceremonies when a child and
adolescent can remember and continue to be in touch with a deceased
parent or grandparent. One such occasion is when the headstone of
the grave is erected a year after the death at Yahrzeit. The headstone,
Matzava, can be as elaborate or simple as the family wishes. Most often
the person’s Hebrew name is inscribed on the headstone along with
the dates of birth and death. There is often a ceremony around this
event. Annually at the anniversary of a death sons recite the Kaddish

for a parent, parents for a child in the synagogue, and all mourners
light a candle in honour of the deceased that burns for 24 hours,
while close relatives recite the mourner’s prayer, ‘May He remember…’
Visitors to those mourning should not offer platitudes but encourage
grief to be expressed.
On the annual Jewish festivals of Yom Kippur, Shemini Atzeret and
Shavu’ot those who have died are remembered. Yom Kippur is the Day of
Atonement with acts of confession and a time of repentance (teshuva)
leading to healing, for example confessing guilt over the lack of care
given to a loved one. Children may think that they were guilty of a
death when a child was angry with a parent and wished the parent was
dead, particularly when the parent was later involved in a fatal traffic
accident. At the festivals of Shemini Atzeret, the last day of Passover and
Shavu’ot all relatives recite the mourner’s prayer. Grief is honoured and
taken up into remembrance of a loved one. Mourners placing pebbles
on graves is an increasingly popular custom. It is likely to have pagan
origins but has come to symbolise the permanence of memory of the
deceased and is honoured by children and young people.
Christianity
Within Christianity grief is recognised as significant, though it is
balanced by hope of an afterlife when Christians believe that they
will meet God and their loved ones again. The young boy Jackson’s
concern quoted at the beginning of the chapter – ‘Do kids get to stay
with other kids or do they have to stay with grown-ups?’ – indicates
the belief in an afterlife, and speculates what it will be like (Marshall
2003, p.34).
At particular times in the Christian year those who have died are
remembered and these occasions are a recognition of the deceased
and for children and adolescents are implicitly examples of continuing
care for those who have lost a close family member. Christmas
can be a time when families notice an empty chair and remember
and comfort one another on the loss of a loved one. At our family
Christmas occasions we always have a toast to ‘absent friends’ and
the significance of this is remembering those younger members of the
family who have ‘flown the nest’ and are now living abroad; and also
those of the family who have ‘passed beyond us’: our parents and in
particular our sister, Angie.
At the beginning of Lent the service of Ash Wednesday reminds

Christians of their mortality, as a cross of ashes is made on the head of
those attending and the following words spoken: ‘God, our Father, you
create us from the dust of the earth, grant that these ashes may be a sign
of our penitence and a symbol of our mortality’, and later, ‘Remember
that you are dust and to dust you shall return.’ Lent culminates in
the events of Easter. At Easter, Christians remember the events of the
passion of Jesus: the crucifixion on Good Friday, followed by the death
of Jesus and his burial in the rock tomb. On Holy Saturday, Christians
remember the desolation of those first Christians at Jesus’ death. This
becomes for some a remembering of the parting from loved ones.
On one occasion, I was asked to visit two children who were
desolate because their beloved grandfather had died on Holy Saturday
and they thought that Jesus was dead in the tomb and so not in heaven
to welcome their grandfather. Together we discovered that Jesus’ death
happened a long time ago, but Christians believe that something
happened subsequently, the mystery called the Resurrection. The
Spirit of Jesus was freed and his presence is with us today so would be
in heaven to welcome the children’s grandfather. This was an occasion
when these two children needed continuing care after a bereavement.
On Easter Day, in some churches, the names of those who have
died during the previous year are read aloud at some point during the
services, bringing comfort to the bereaved, adults and children alike.
The dead are also remembered at the celebration of All Souls. This
occurs on 2 November and has become mixed up with Halloween.
Halloween probably evolved from the Celts 2000 years ago with their
pagan priests, the Druids. The most significant festival of the Druids
was Samhain, the Druid New Year, celebrating the end (or death) of
the summer and its fruitfulness. The festival began on 31 October
and lasted three days until 2 November. Samhain was the festival of
the dead, and it was believed at this time that the spirits of the dead
were very close and visited the living. Today at Halloween, children,
dressed up as skeletons and ghosts, ‘trick or treat’ when an idle threat
is made to perform mischief and a gift of food given as a reward.
Since the eighth century, in the British Isles, Christians celebrated
All Saints (All Hallows) to coincide with or replace the Celtic festival
of Samhain. All Saints Day on 1 November celebrated all saints – the
ones officially recognised by the Church and the many unknown ones.
This was followed by All Souls beginning at vespers on All Hallows.
All Souls Day is dominated by the sense of human mortality and is

centred on penitence and intercession. It is linked with the funeral
liturgy and many churches have latterly used All Souls to help the
recently bereaved. A service of comfort for grief is held and can be
accessed by children as part of their continuing care. Many churches
offer the opportunity to light candles for loved ones who have died.
The names of the deceased are read out during the service.
A few days later, the parade and service at the Cenotaph is held in
London, and around war memorials throughout the UK, to remember
those who have died in the World Wars. Young uniformed organisations
take part in these occasions. Again in the parades children participate
since some have lost a father in war and it must be a source of comfort
to them to be surrounded by others who are acknowledging and
honouring those who have died in war. A recent remembering was the
installation at the Tower of London, ‘Blood Swept Lands and Seas of
Red’, marking the centenary of the outbreak of the First World War,
where the artists Paul Cummins and Tom Piper made 888,246 ceramic
poppies. Thousands visited the Tower between July and November
2014. An exhibition of the poppies is now on tour of UK. Not only
did visitors with families remember losses in the past of the World
Wars, but it evoked in them memories of their own losses.
On the continent, in Roman Catholic countries, there are annual
occasions for the bereaved to remember their loved ones. In Spain,
families gather and eat roasted chestnuts and almond cakes, a remnant
of the custom of leaving offerings with the bodies of the dead.
In France, chrysanthemums decorate the graves of the departed. In
Poland, families take flowers, candles and even picnics with them to
the cemeteries where their relatives are buried. Mexicans celebrate
‘The Day of the Dead’ in honour of their ancestors. The Spanish
conquerors of Mexico moved the event to All Saints Day and All
Souls Day, the first and second of November. The festival honours
and remembers loved ones who have died, believing that the souls of
the deceased return each year to visit the living. On All Saints Day,
children are remembered and their gravestones are decorated with
toys and balloons. All Souls Day remembers deceased adults; they are
honoured by the building of altars, lovingly decorated with flowers,
candles and photos. Family members gather at the gravesides and have
picnics, serving the favourite foods of the deceased; they tell stories
and remember the times they shared with their loved ones. The ritual
is rooted in pride. The family want to create the most welcoming

homecoming for their loved one and to reassure them they will
never be forgotten. These customs and rituals are an indication of the
ongoing remembrance of the beloved departed and are on taking the
deceased with us and recognising their significance in the present to
families, including children.
Some churches also offer services on Holy Innocents Day,
28 December, specifically for those who have lost children either
through death or miscarriage.
Islam
There is some debate about whether or not the dead are remembered.
The period of mourning lasts for 40 days after the death. After this
period, scholars believe that with current knowledge of mourning, to
continue simply reactivates grief, so is unnecessary. However, there is
a belief that the dead may pray and comfort the living.
Hinduism
Hindus traditionally remember their dead with a yearly ritual known
as the shraddha ceremony. Shraddha, coming from a word meaning
‘faith’, is performed annually on the date of a Hindu’s death. It is
tradition to first conduct the rites in the days immediately after
a death in order to help the individual’s soul move onto their next
reincarnation. Death rites are important, not only for the future of the
deceased, but also for the continued comfort and welfare of the living.
Immediately after a death, the individual’s soul is believed to linger
around its living family and may cause them harm until the shraddha
rites are performed, letting the soul move to its next reincarnated life.
In the days immediately after death, families gather for a large meal
to celebrate the deceased. They generally offer rice balls (pinda) to the
dead family member, who is represented by a photograph. Then a
Hindu priest offers four rice balls: one large representing the recently
deceased, the other three small representing the preceding generations
awaiting reincarnation. The large ball is split and combined with the
smaller pieces symbolising how the deceased is reunited with their
ancestors. The ball is then fed to a cow.
The annual shraddha service in remembrance of the deceased is
similar to the rites conducted immediately after death. Family members
often bring a priest into the home in order to make a pinda offering
to both the recently deceased and other close ancestors. The offerings
are food for the soul which has undergone the many ceremonies after
death. The yearly memorial service is generally performed as long as
the sons of the deceased are still living. The service of Hindu death
rituals is traditionally conducted by men, a difficulty if there are no
sons. When the annual shraddha is conducted, it is common for the
son only to mention the names of males in his family’s ancestral lines
when making an offering. In some Hindu beliefs, a deceased woman
is said to merge with her male ancestors, thus including women in the
service.
Buddhism
Some Buddhists believe that a link with dead loved ones can be made,
though others are more skeptical. The link is through a medium; the
experience brings comfort and a continuing relationship with the
deceased.
Care is also evidenced in Mahayana Buddhism’s thinking of
bodhisattvas, a person with serenity, acceptance of things as they are,
and loving. A Zen Buddhist said, ‘In all its dimension, and all its variety,
I see…a quality in someone. In the last place that you’re looking
for it…you see more bodhisattva activities, more holy activities…in
supermarkets than in churches or temples’ (Bowker 1983, p.262;
Brown 1975), these are forms of continuity and care when those on
the edge of nirvana turn back in order to help others still on the way.

It has been noted in this chapter that many children are resilient
and if given time and preparation for the death of someone close to
them, such as a parent or a favourite grandparent, grieve well. Later at
adolescence when they reach a new development level as a person or
experience a personal accomplishment, they often feel the absence of
a birth parent keenly. This may occur in reaching the age of majority,
18 years in the UK, or at a time of personal accomplishment such as
success in public examinations, winning a university place, gaining a
degree or starting their first job. In some ways, the grieving process
never stops, unless we are able to carry memories of the loved one with
us always. This means being able to talk about those memories, the
challenging ones and the joyful ones, freely and openly with family
and friends.
In the early months and years following a bereavement both a
child and an adolescent are likely to need continuing care. This care
needs to be tailored to him at a time when he needs help. With younger
children it is ideal if the surviving parent works with them so that they
can talk about their respective griefs, which can be very helpful to the
child. There are activities that can be suggested and objects that can
be made which will help the process of bereavement and sustain a
child. With older children and adolescents the task can be chosen by
them and they can proceed with it alone, though with encouragement
through progress to completion.
There are a range of tasks which can be attempted. Some of the
following are from my personal experience and some from other
sources. A selection of published resources is included in the Further
Reading section at the end of the book. Some of the tasks need
materials which are easily accessible; others will need to be purchased.
Practical things to do
The following are some suggestions of things to do with, or be done
by, a child or adolescent to remember a deceased parent, grandparent
or sibling – someone who has been close to him and whose absence
continues to grieve him.
A memory box
This involves an old shoe box in reasonable condition, which many
shoe shops will give to you if you ask. This can be decorated with
scraps of paper in the colour that the deceased liked or covered in
handprints in bright poster paint. It can be filled with reminders of
the person, for example someone’s favourite earrings, the remains of a
bottle of perfume, photos. For a male, reminders could be a cufflink, a
tie, one of the cigarettes left, part of his daily newspaper and photos.
The memory box could be added to, with poems written about the
person by the child or adolescent and a story using one of the memories
of the person. It might be kept in a special place on completion and
be brought out at the birthday of the deceased, or the anniversary of
the death, or a family occasion such as Christmas. Winston’s Wish has
a free activity sheet on making a memory box and ‘readymade’ boxes

for sale (see the Useful Websites and Organisations section).
A memory garden
One of my sisters was able to buy a two metre-wide extension to her
small garden which backs on to a local landowner’s property. She calls
it Angie’s garden in memory of our sister. There are cultivated flowers
and shrubs that my sister enjoyed and it is a living memory to her.
Any child or adolescent can use a part of their garden as a memory
garden, or even a large plant pot, choosing what is to be planted or set
in the garden and cultivating it. It could be a place for quiet reflection.
Another idea is to set aside and cultivate a window box.
A family tree
If the deceased is a relative, a family tree could be made on the pinboard
in the kitchen where everyone can see it. Children will need help with
this; adolescents might need advice with names. Talking together and
finding photos to match the names are part of the activity. This is part
of the process to incorporate the living and the dead, and to continue
to support a bereaved child.
Anagrams
This task is from The Dougy Center (2006). Paper and pens will be
needed for this task to ‘remember and memorialise the person who
died’ (p.31), and is suitable for seven- to ten-year-olds. The child or
adolescent writes the name of the person who died vertically on a
piece of paper, a letter per line. Then invite him to write down words,
sentences and phrases which ‘remind them of the person, using the
letters of the name’ (p.31). Following the task his remembrances can
be shared.
A First Aid kit

This activity is adapted from Muddles, Puddles and Sunshine: Your Activity
Book to Help When Someone Has Died (Crossley 2000, p.25). Use an old
shoe box or plastic container and pieces of paper and a pen. The child
can decorate the box as a First Aid kit. Then on each piece of paper
he can write down something you would find in a First Aid kit. He
should then use other pieces of paper and draw a border around each
piece (this distinguishes each set). On the second set of paper with the
borders, he can write down or draw a First Aid kit for a bad day, that
is, a day when grief is hard: for example, phone up and talk to a friend.
The child can share what he has written with an adult. You can buy
‘A Pocket Full of Plasters’ online from Winston’s Wish (see the Useful
Websites and Organisations section). It contains ten ‘plasters’ the size
of a credit card which can be put in a pocket and brought out by a
young person when he is hurting from a bereavement.
A book of thoughts
This activity is adapted from The Dougy Center (2006). You will need
some A4 paper (or if possible A3) folded in half and stapled to make a
booklet. The goal is ‘to facilitate journal writing as a way of processing
grief ’ (p.32). Write a question or topic at the top of some of the pages;
other pages might be left blank for whatever the person is feeling.
Headings might include: memory, colours, emailing, favourite things,
holidays and food. Each page should be illustrated with a story, poem
or drawing about what the child or adolescent is thinking and feeling
at present. The exercise could also be done about the deceased. Later
the child or adolescent can share whatever is desired with an adult,
parent or teacher. An extension of this idea is found in the ‘From You
to Me Journals’ produced by Winston’s Wish. These are beautifully
produced books which have around 60 questions carefully designed
to inspire someone to tell a personal story. There are books for Mum,
Dad, grandparent and friend. A possible use would be when a close
relative is known to have a terminal illness or for someone who is old
and reaching the end of their life, so that when that person dies the
child or adolescent has a treasured memory to read and bring comfort
to them.
Anniversary
On the anniversary of the death or the first birthday, think of an
activity the deceased liked and spend the day doing this, for example
going to the park and having a swing. If the weather is suitable you
could take a picnic of the deceased’s favourite food, or visit the seaside
and sit on the seawall eating fish and chips.
Christmas tree decoration

Each year make a new tree decoration; this could be made from
drinking straws, pieces of real straw, or out of card or playdough.
It could be in the shape of a star, a Christmas tree, a reindeer, an

angel, or anything the child would like to make. Winston’s Wish has a
product called ‘Wish upon a star: Wishing Stars’ to write on messages
such as ‘Dear Dad missing you love’ (see the Useful Websites and
Organisations section).
Winston’s Wish also publish a book called Out of the Blue – Making
Memories Last When Someone Has Died (Stokes 2006). The book has
been written and designed for teenagers to offer support through
bereavement using a range of activities which can be completed by a
teenager on his own, or with a family member or a professional. The
activities allow feelings to be worked at and safely explored.
Practical responses
If a child finds sleeping difficult, a CD playing soothing music can
help. If he is afraid of the dark, then a night light can also help.
Play can be a good way to work through difficult feelings. This
can be of many sorts, for example having a plastic box with dressing
up clothes in it. If it does not cause distress to the partner of the
deceased, it could include some of their jewellery, hats and clothes. An
adult could join this activity and suggest a theme or the child could
choose.

Think about and list the ways your experience as parent or professional
makes you aware of and continues to support a child or an adolescent who
has experienced a loss by death.
8
Care of the Carers
Including Ourselves
Dear God help me to learn from other people.

(Sarah in Durran 1985, p.61)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
I was using a walking stick with difficulty following surgery to my leg.
It was Easter time, and since a family I was visiting were Christians,
they talked about the Easter story of death and new life. Toby, a bright
seven-year-old, was speculating about heaven and what it was like.
Suddenly he blurted out to me, ‘You won’t need your walking stick
when you die. The angels will carry you up to heaven.’
171
I felt that I was being cared for and was humbled by the experience.
Children can be amazing in their sensitivity and in weighing up a
situation and making connections. Toby did just that in seeing my
stick and responding to my lack of mobility. The experience linked
with Sarah’s comment above, ‘Dear God help me to learn from other
people’ (Durran 1985, p.61). I had misjudged Toby’s ability to make
connections between his life and his faith.
After first teaching in a grammar school, since the local authority were
moving to a comprehensive education scheme I thought that I must
get experience with less able pupils and went to teach in a secondary
modern school. One of my pupils was an attractive girl called Julie.
Julie had a difficult home background with multiple ‘fathers’ coming
and going. At the age of 15, she could barely read, but she loved
needlework. Her behaviour was poor, sometimes outrageous, but I
could only guess the reasons. She swore and stole, nothing was safe
on my desk, yet somehow I felt that beneath Julie’s bravado there was
something to cultivate and given the chance, which she had never had,
she could make something of her life. At that time is was possible in
the UK to leave school at 15, and Julie was eager to do so. One of my
tasks was to find jobs for these less able girls. I had contacts with a
firm making high class ties, often a ‘one-off’ for a celebrity. I rang up
my contact and asked if they would see Julie, mentioning her skills
with a needle, but for my own benefit and others who I might send to
this firm, I mentioned that Julie was ‘light fingered’. Julie got the job,
and before she left, came into my room and threw a bunch of wilting
daffodils on my desk.
Two years later I was in the cinema queue when Julie came rushing
up to me, to say that she was still in the same job, and the firm had
opened a savings account for her.
Unexpected incidents happen in life, and the benefits are that as a
professional sometimes you are cared for in a totally unexpected way.
I suspected the wilting daffodils thrown on my desk at the end of
Care of the Carers Including Ourselves 173
term had been taken from the local church graveyard; nevertheless,
they were a gesture of good will and showed Julie’s caring, which
was usually hidden. Julie’s recognition of me, in a totally different
environment from school, and her enthusiasm to come up to me of
her own free will and talk was a wonderful experience. I felt that as a
‘carer’ I was cared for.

Bereavement and grief are no respecters of persons or ages. When
adults, children and adolescents suffer loss, each grieves but in a
different way. Those of us who are parents and professionals, and who
are given the responsibility of caring for children and adolescents
as they work through the processes of loss and bereavement, have a
challenging responsibility. It is an exhausting process working with
children and trying to understand their thinking and behaviour and
then discovering how help can be given in what is always a unique
‘case’, since each individual is different with varying circumstances and
a life story to tell. The Dougy Center comments, ‘Watching students
cope with a death is a difficult and painful journey’ (The Dougy Center
2006, p.19). The Dougy Center works within an education setting
but the comments are equally appropriate for other professionals. The
danger for the adult is ‘burn-out’. Teachers from several schools cited
the following factors as contributing to their stress:
• witnessing pain and distress experienced by the families
• feeling unskilled in dealing with emotional responses
• physical exhaustion as a result of emotional trauma
• poor communication between themselves and families or other
carers.
(from Child Bereavement UK Information Pack Sheet 5:
Looking after Yourself; see their website for details)
It is therefore important to form a strategy so that ‘the carer can be

cared for’. This is the context and subject of this chapter.
Recognising our own mortality and our losses
We all know that life itself is terminal! The one thing we all have in
common is that one day we will die. Nevertheless, working with the
bereaved can arouse strong emotional reactions within you, which may
arise unexpectedly. We need to be prepared for this by being aware
of our own attitudes to death, working through our own losses and
coming to terms with, and facing, our own mortality. It happens some
of these losses might well be ignited again by the grief of the children
we work with (doing the ‘Life Line’ exercise which can be found at
the end of this chapter will help: page 187). If, when working with a
child or adolescent, a previous loss of your own surfaces and it feels
too close to home, do not be afraid to give yourself a little time and
space, perhaps saying something like, ‘Let’s simply be quiet for a few
minutes, before we carry on.’ This is not a sign of weakness; it merely
recognises that we all have our human limitations. I remember as a
hospital chaplain being called to be with a family who had lost a baby
through a cot death. As they told me about their beloved baby Katie,
something welled up within me which I tried to ignore so that I could
concentrate on this family as they told their story. It was not until later
that day that I had an opportunity to attend to my own emotions and
realised that it could have been my niece of the same age and name that
I was mourning. The resonance with our own experience or a personal
connection with the person who has died must not come in the way of
our care. It is an oft quoted truism to say, ‘I know how you feel’, but
we can never know what another person is feeling. We can only walk
alongside and listen.
In school, when a death occurs directly related to the classroom,
it may be that of the relative of a pupil, a pupil or a member of staff,
teaching or ancillary. It can activate memories of losses and deaths in
teachers’ own pasts. Many teachers feel that issues around bereavement
are the responsibility of the home and not of the school, since this is a
personal family occasion and not a public, school one. Other teachers
feel that they do not like talking about death. However, because they
are in a position of trust and outside the emotional whirlpool of the
family, pupils may seek them out believing them to be a safe person
to talk to. For these reasons, it is important that teachers work through
their own agenda about death.
Training to support children and

adolescents in bereavement issues
Many professionals such as teachers, youth workers, social workers
and clergy, for whom bereavement was not their main training nor
the focus of present work, may feel frustration at having to deal
with difficult situations without adequate training to prepare them, a
frustration which increases stress levels. Few have had the opportunity
to learn about the way children and adolescents understand death
or to explore the emotions and behaviour of children who have lost a
loved one. There are several solutions to this.
In-service training
Teachers can ask the administration of the school/academy to include
training sessions on dealing with bereaved children in their classrooms
as an integral part of ongoing in-service training.
Bringing in specialists
These can come from a variety of different backgrounds such as
a children’s hospice doctor or senior nurse, a clinical psychologist or a
Marie Curie nurse. It needs to be someone who works with children
and adolescents and understands how these young people may react
to bereavement and their concept development of death.
Books or online resources

There are an increasing number of books such as the classic text by J.W.
Worden, Children and Grief: When a Parent Dies (1996) or more recently
Lost for Words: Loss and Bereavement Awareness Training (Holland et al.
2005) and Understanding Children’s Experiences of Parental Bereavement
(Holland 2001).
Training courses
If you have a local hospice near you, enquire if they have bereavement
counsellors you can consult or ask them to staff such a course for you.
Those who are working daily in the context of death and dying have
a wealth of ‘hands on experience’, informing and informed by their
theoretical knowledge and their practice.
The knowledge of concept development on the subject of death
will enable you to develop strategies to work with those seeking help.
It also gives more confidence and reduces stress levels. In addition, it is
important for teachers to look at where in the curriculum, as a normal

routine, there are opportunities to deal with loss and death in the
classroom so that it can be seen as a part of everyday life that each of
us needs to face rather than something which is bolted on to another
subject (see Chapter 5).
The task of a professional with a

bereaved child or adolescent
Being alongside a child or adolescent in pain and distress can be very
stressful, difficult and draining, but it is important to remember that
‘the carer’ (that is any professional to whom the child or adolescent
turns) is not responsible for the child’s grief and cannot carry it for
her. The carer can listen and take in what she says, digest it and give it
back to her. The imagery is of a cow digesting and chewing the cud!
What the carer can offer is support on her journey through grief. We
need to care, though with a certain level of detachment so that when
silent and listening we do not feel guilty that we not doing enough.
Professional boundaries must be remembered; we cannot carry grief
for people but we can share their journey by being there. When the
calm and the silence follow, we intuitively know that the mystery we
call ‘Love’ or God is present in the situation.
Know your limitations

However hard the pain is, visible or not, and however great the need
of the other person, do not over commit and offer something that is
difficult to deliver.
It is helpful for the carer to know their own limitations, so do not
offer more than you can deliver. It is better to offer something small
but be constant in delivery than to go for the grand but unsustainable
gestures. This will keep things manageable. For teachers, there
should be a list of telephone numbers of other professionals such
as psychologists and psychiatrists to whom the teacher can refer for
advice, or suggest to the parents that more expert help is needed.
Be gentle with yourself

Remember your achievements – the simple gift you give to a bereaved
child or adolescent might be giving a safe space to talk openly about
all the difficult things that go through a child’s head at a parental
bereavement which cannot be talked about to a surviving parent, who
is anyway too full of grief to hear what is being said. Listening

is essential: being with a person rather than doing anything. You
do not need to be an expert to provide effective advice and help,
rather you need to be a mature adult who has lived through tough
experience and knows that coming out of the tunnel is possible.
Grief issues take time to process, there is no set time frame

Remind yourself that you, the carer, are an enabler not a magician. We
cannot change what has happened but we can be alongside a bereaved
youngster in their journey. Be aware that this may be painful for you
too, perhaps raising memories of your own losses. You as the carer are
bound to feel helpless at times – admit to it without shame. However,
distancing yourself protects you but can be perceived as not being
supportive to an individual.
Self-knowledge
It is easy to be self-deluded about our own abilities. I cannot know
myself completely. It is only as I reveal myself to another that I can
know more of whom I am. Here the insight of the Johari Window
conceived by Joseph Luft and Harrington Ingham (Luft and Ingham
1955) is helpful. I have adapted it in Figure 8.1.
1 ‘Free or public’ area 2 ‘Blind’ area

The part known to you and to Known to others, but you
others, the area of mutual yourself are unaware of it
sharing and interaction
It includes gestures, tone of
voice, and good traits of which
you are ignorant
3 ‘Hidden’ area 4 ‘Unknown’ area

Known to you but not shared An area where our creative
with others talents and abilities as well as
our fears and limitations lie,
You might wish to keep some
which we do not know about
parts hidden
and others have never seen,
yet a part of all of us
Figure 8.1 Adaptation of the Johari Window

1. The Free or public area: An aim is to enlarge this area.

2. The Blind area: You make this area smaller by getting feedback
from others. Working with a group helps.
3. The Hidden area: It might help relationships if more of you
were known and shared with colleagues with whom you are
working. This can be done by self-disclosure.
4. The Unknown area: Meditation and relaxation may bring some
of these feelings into awareness.
The more your ‘Free self ’ coincides with your ‘Whole self ’ and the
more you share of yourself with the world, the better you communicate
your true self to others and the less tension there is within yourself.
There are ways to do this, for example by going to a counsellor and
sometimes a mentor has the skills to help with this. This is about self-
awareness and self-care.
Support groups
Each profession working with bereaved children and adolescents over
difficult situations is likely to face exhaustion. We need to anticipate that
we may experience an emotional reaction to a situation and realise that
it is perfectly normal and OK to be emotionally affected. However, to
help others we need to feel reasonably strong. Professionals acting as
carers need a supportive management structure and specific colleagues
to talk through any issues that concern them or which have a personal
impact on them. Knowing the carer has a support network lightens
the load and enables clearer thinking about action. There is a stress
factor in ‘holding material’ told by a client in this sensitive area and
within the bounds of confidentiality this could be shared.
Talk with others as the carer and trust in the support group about
your feelings. Using a ‘colleague’ system regularly is a positive method
of learning and growing as a professional. Within this group, as trust
is developed between members of the group, you will be able to reflect
on practice, for example where a colleague was uncertain of what
to do or say, or uncertain of what they actually did. Sharing with
other professionals, and knowing that others in your team are affected
similarly when working with a depressed, bereaved child or a silent
and tight adolescent, helps you to feel less alone and more able to care.
It is important to give one another feedback and support. Give
encouragement to colleagues working with bereaved youngsters;
everyone needs this and it is important to accept it in return. Support

others in the team. If you know someone in your team is going
through a bad time, make time to ask after her or drop a card in her
pigeonhole.
Many professionals today are required to have a mentor or a
supervisor; the former is a trusted advisor and a supervisor refers to
a person who observes and directs the work of an employee. These
relationships built through regular meetings help, support and
encourage self-help through discussion and create ‘epiphany’ moments,
thereby raising professionalism in this difficult and challenging area
of working with children and adolescents. There is a time factor
in working with colleagues and having joint sharing and learning
meetings in addition to individual supervision, but this is outweighed
by the increase in professionalism, which benefits the young person.

Judaism
On several occasions in the Hebrew Scriptures when individuals are
‘stressed’ in their anguish they are met by God. Jacob, fleeing from
his brother Esau’s threat to kill him, stops for rest (Genesis 27.41–3;
28.10–17). He dreams of a ladder stretching from earth to heaven, with
angels ascending and descending and hears, ‘Know that I am with you
wherever you go, and will bring you back to this land: for I will not
leave you until I have done what I have promised you’ (Genesis 28.15).
Years later Jacob decides to return home and be reconciled with his
brother. Nearing home, fearful of the future meeting, he sends his
household ahead (Genesis 32.22–4). Alone at the brook Jabbok, he
wrestles with an unknown assailant (Genesis 28.24–30). At daybreak,
Jacob discovers he has wrestled with God, One who is always present
to bless. Rachel Naomi Remen, an oncologist, suggests a parallel with
her own experience: ‘Perhaps the wisdom lies in engaging the life you
have been given as fully and courageously as possible and not letting
go until you find the unknown blessing that is in everything’ (Remen
2000, pp.25–7).
Elijah flees Queen Jezebel’s anger and threat to kill him after his
defeat of the prophets of Baal (1 Kings 18.20–40; 19.1–20). On his
journey Elijah is fed and nourished. Finally, at Mount Horeb, after
wind, earthquake and fire there is ‘a sound of sheer silence’ (v.12) –
what a wonderful image! – ‘sheer silence’. God’s presence speaks in

reassurance that Elijah is not alone. The Psalmist says, ‘Be still and
know that I am God’ (Psalm 46.10). This is the grace of the present
moment.
Central to Jewish faith is the Shema, ‘Hear O Israel, the Lord our
God, the Lord is one; you shall love the Lord your God with all
your heart, and with all your soul, and with all your mind, and
with all your strength’ (Deuteronomy 6.4f ). These verses are to be
said daily on rising and sleeping and taught diligently to children of
the household. The words we associate with these are, ‘you shall love
your neighbour as yourself ’, which occur in another book of Moses
(Leviticus 19.18). However, the two verses are not found together in
the Hebrew Scriptures of Judaism, nevertheless in the Leviticus passage
there is a command to love the self. This might be called respect and
a self-care.
Christianity
The commandment which is found in the Shema is quoted by Jesus as
the first commandment in answer to the question of a scribe, to which
Jesus’ reply is that the first commandment is, ‘Hear O Israel, the Lord
our God, the Lord is one; you shall love the Lord your God with all
your heart, and with all your soul, and with all your mind, and with
all your strength’ (Mark 12.28–9); and Jesus goes on, ‘The second
commandment is this, “You shall love your neighbour as yourself ”’
(Mark 12.31), thus adding to the Shema. Jesus links directly and
sequentially love of God, with neighbour and self, and adds, ‘No other
commandment is greater than these.’ Taylor comments: ‘(It) brings
together two widely separated commands…while each is warmly
commended by the Rabbis, so far as is known, no one save Jesus has
brought them together as the two regulative principles which sum up
man’s duty’ (Taylor 1963, p.488). This is significant for the argument
here in that Jesus seems to be asserting what we would call ‘self-love’.
In 1965, a Christian scholar who was widely read at the time,
Harry Williams, wrote of how he could only speak of things proved
true in his own experience: ‘Must we not therefore look for God in
what we are, in the whole kaleidoscope of our personal experience?
And in this sense would it be wrong to speak of a theology of the
self ?’ (Williams 1965, pp.8–10). This was important in the 1960s.
However, it is not the final word. Jesus spoke of following him as
denying ourselves: ‘For those who want to save their life will lose
it, and those who lose their life for my sake and for the sake of the
gospel will save it’ (Mark 8.34–7). This seems to indicate that the self,
created in the image of God (Genesis 1.26), is the work of God, and
we find our true selves in God. God is at the centre. Ched Myers in his
commentary on Mark writes:
the argument of this second call to discipleship… Jesus has revealed
that his messiahship means political confrontation with, not
rehabilitation of, the imperial state. Those who wish to ‘come after
him’ will have to identify themselves with his subversive program.
The stated risk is that the disciples will face the test of loyalty under
interrogation by state authorities. If ‘self ’ is denied, the cross will be
taken up, a metaphor for capital punishment on grounds of insurgency.
Through these definitive choices…the disciple will ‘follow Jesus’.
(Myers 1988, 2015, p.247)
Jesus shows his need for ‘taking time out’ for ‘stillness’, at the age of
12 by staying in the temple, listening ‘and asking them questions’
(Luke 2.41–52). When found and questioned by his anxious parents,
his response was ‘Did you not know that I must be in my Father’s
house?’ Through his listening in the temple, Luke says: ‘Jesus increased
in wisdom and in years, and in divine and human favour’ (Luke 2.52).
At the beginning of his public ministry, following his baptism, Jesus is
driven out into the wilderness, ‘and the angels waited on him’ (Mark
1.13). This must have been a period of intense loneliness. Wilderness
is a metaphor in the Scriptures, of the desert experience, of waiting
on God and as the place where God might be found, yet wrestling
with the demons of self-will. In the wilderness, Jesus wrestles with the
calling he believed he received at his baptism.
Throughout Jesus’ ministry, we discover ‘in the morning, while it
was still very dark, he got up and went out to a deserted place, and
there he prayed’. Sometimes the writer states ‘a lonely place’ (Mark
1.35; 6.30; 7.24; Luke 5.16; Matthew 14.23). He taught, ‘Come unto
me, all of you who are tired and bear heavy loads, and I will give you
rest’ (Matthew 11.28). Jesus knew his need for silence. He is our model;
if he knew this need how much more, as professionals working with
bereaved children and adolescents, do we? On one occasion, after the
news of John the Baptist’s cruel death, Jesus says to his friends: ‘Come
away to a deserted place all by yourselves and rest a while’ (Mark
6.31). The disciples too needed silence. Mark adds to this account: ‘for
many were coming and going, and they had no leisure even to eat’.
There are insights in Vanstone’s book, The Stature of Waiting (1982),
of the dignity of Jesus’ waiting while being handing over to those
who arrested and tried him. There is patience, passivity, vulnerability
and powerlessness, which was to become, in the crucifixion, part of
God’s redemptive creative presence in the world. In bereavement care
there are some glimpses of this waiting. Vanstone comments: ‘waiting
can be the most intense and poignant of all human experiences –
the experience which, above all others, strips us of affectation and
self-deception and reveals to us the reality of our needs, our values,
and ourselves’ (Vanstone 1982, p.83). There is a wonderful children’s
book called Jesus’ Day Off, which shows the playful relaxing Jesus
(Nicholas 1998).
Islam
The Qur’an is for the Muslim the eternal Word of God. From childhood,
the first prayer is said as a gift for God. It is recited at the start of the
five prayer periods during the day. It states the submission to the will
of God (the literal meaning of the word ‘Islam’):
The Opening,
In the name of God the Merciful, the Compassionate,
Praise belongs to God the Lord of all Being,
the All-merciful, the All–compassionate, the Master of the Day of
Doom.
Thee only we serve, to Thee alone we pray for succour.
Guide us in the straight path,
the path of those whom Thou hast blessed,
not of those against whom Thou art wrathful,
nor of those who are astray.
(Arberry 1964, p.1)
Prayer is the first of five pillars or principles of Islam; the regularity of

saying the prayer five times a day remembering the presence of God
means that God comes to dominate everything the individual thinks,
does and feels. Islam lays the importance of the self and the self ’s
relationship with God.
In Islam are the Sufi mystics one of which is the work of Rumi
(1207–1273). His poetry and writings have inspired many.
The Guest House

This being human is a guest house
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!
Even if they’re a crowd of sorrows, who violently sweep your house
empty of its furniture,
still, treat each guest honourably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice.
Meet them at the door laughing,
and invite them in
Be grateful for whoever comes,
because each has been sent
as guide from beyond.
(Rumi 2004)
Kahlil Gibran (1883–1931), though not a Muslim, was influenced by

Christianity and Islam’s Sufi tradition. Gibran understood the faiths
of Judaism, Christianity and Islam as coming from a common root
and so brothers of one another through the same Spirit. Kahlil’s work
has a great deal to say on inner stillness and the grace of the present
moment. He thought of the soul walking all paths and unfolding itself
‘like a lotus of countless petals’ (Najjar 2008, pp.74–75).

Henri Nouwen (1932–1996) was a Roman Catholic priest and
theologian eventually working with Jean Vanier in Daybreak, the
L’Arche community in Ontario, Canada. Nouwen had some wise
words to say about being ourselves:
Often we want to be somewhere other than where we are, or

even to be someone other than who we are. We tend to compare
ourselves constantly with others and wonder why we are not as
rich, as intelligent, as simple, as generous or as saintly as they are.
Such comparisons make us feel guilty, ashamed or jealous. It is very
important to realize that our vocation is hidden in where we are,
and who we are. We are unique human beings, each with a call to
realize in our own life what nobody else can, and to realize it in
the concrete context of the here and now. We will never find our
vocations by trying to figure out whether we are better or worse
than others. We are good enough to do what we are called to do…be
yourself ! (Nouwen 1994)
Burn-out comes when, ‘we are always doing something, talking,
reading, listening to the radio, planning what next. The mind is
kept naggingly busy on some easy, unimportant external things all
day’ (Ueland in Cameron 1995, p.87). This burn-out occurs across
the professions. Stress can be a particular challenge to those working
in the area of death, dying and bereavement. It is important to be a
resource to yourself, accept yourself as you are and to love yourself.
As with any mature person it is foolish to be a workaholic; that way
leads to burn-out. Self-care needs to be physical, mental and spiritual.
Physical
Exercise is important. It may be walking with others, with the dog,
on one’s own and taking in the infinite variety of nature. It could
be visiting the gym, Pilates, yoga, Zumba, keep fit or swimming. It
might be seasonal games such as playing football, cricket, tennis or
badminton. With games, there is the added benefit that these are
social occasions.
Mental
This can mean relaxing, reading, visiting the theatre or participation in
music, which can totally absorb a person: singing in a choir or playing
an instrument alone or in a group. Attending a performance by a choir
or orchestra, listening to a concert on a CD, DVD or the radio, and
being so totally absorbed means that the carer can be taken outside
themselves, into another world, an experience of the transcendent or
numinous. For some this comes from reading or writing poetry.
The poet Rainer Maria Rilke (1875–1926) has much to say to

support the carer. Rilke suggests that the carer needs to be patient
with him/herself since there may be unresolved questions, however
one day the answer may become clear. For example, today a stillborn
child causes great distress to the parents leaving many unanswered
questions.
Later the parents find there is research on stillbirths and recognise
how many parents are affected, or parents with such questions find
the organisation which supports bereaved parents called SANDS (Still
and Neonatal Death Support) and find some answers to their tragedy.
The contemporary poet Mary Oliver has much to offer, for example
her thought-provoking poem ‘Wild Geese’, which is full of natural
metaphors (see Astley 2006, p.28).
We are all creative people, created in the image and likeness of
God our Creator. There are a myriad ways to create: improvising a
piece of music, composing, writing poetry/a story, creating a meal,
drawing/painting a picture, making a piece of furniture, making a
tapestry, sailing, designing and creating a garden, decorating a room,
building a boat…try it! The carer can lose herself in creativity. It is a
way of being restored. A useful book is The Artist’s Way: A Course in
Discovering and Recovering Your Creative Self (Cameron 1995).
Play is about becoming so totally engrossed in an activity that time
stands still. Children are experts at play. The American post-Christian
theologian, Mary Daly (1928–2010) said play ‘is the creative potential
itself in human beings that is the image of God’. Remember the ‘mars
bar’ philosophy; the advertisement at one time said ‘a mars bar a day
helps you work, rest and play’.
Spiritual
Parker Palmer, an educator and founder of the Center for Courage and
Renewal, in his older days ponders the resurrection that takes place
under the most destructive circumstances and comments on the ‘vast
web of life in which body and spirit are one’ and asks ‘if flesh and
earth were not infused with spirit, how could we and the natural world
be so full of beauty, healing and grace?’ (Palmer 2015).
Meditation is a way of praying. Christians might use the Jesus
Prayer: ‘Lord Jesus Christ, son of the living God, be merciful to me a
sinner’ and continually repeat it, so that the person becomes part of
the prayer. A breathing meditation is a slow intake of breath counting
up to five and then letting the breath release counting to five and
repeating this. An object such as a seashell, an ear of wheat, a seed can
be felt and experienced by each of the senses in silent contemplation.
It is helpful to have an object such as this in each room of your home.
Walking itself can be an exercise in meditation; if you walk home use one
of your senses to be aware of the environment around you – centering on
a sense, for example sight on one day and hearing the next. This is one of
the techniques in mindfulness which is worth looking at as a resource
in a stressful job (there are many exercises on Google which can also
be found on YouTube).
Find ways to switch off from the day on the way home from the
workplace. One way is to focus on a good thing that happened during
the day and simply reflect on it, letting the positive vibes sink in. Some
carers like to switch on a CD or the car radio on the way home – and
even sing along to it. Another idea is to change into ‘play clothes’, that
is something different from work clothes, when you get home.
George Herbert (1593–1633), a thinker and a hymn writer, wrote
the words below. They can be applied to any household activity,
such as washing up, which can become a ‘de-stresser’ when done
mindfully, as we watch the rainbow bubbles from the washing-up
liquid.
Teach me my God and King
in all things thee to see;
and what I do in anything
to do it as for thee
a servant with this cause
makes drudgery divine;
who sweeps a room, as for thy laws,
makes that and the action fine.
Brother Lawrence (1614–1681) was a Carmelite lay brother in a
monastery near Paris. He worked in the kitchen cleaning pots and
making them shine and mending the sandals of the brothers. His
thoughts were written in a book called The Practice of the Presence of
God. One saying was, ‘we ought not to be weary of doing things for
the love of God who regards not the greatness of the work, but the
love with which it is performed’.
A Life Line
Think back on your life; you may want to choose two decades which for various
reasons were challenging for you, or do a chart of your whole life. With this
information draw a time line of your life showing clearly what were the highs
and the lows for you. It could look something like a temperature chart. When
you have finished, compare the highs and the lows. Which predominate and
why? Later you are invited to share it with someone who is responsible for you
as a carer: your mentor or supervisor.
What resources do you have?

Imagine yourself as a tree. A tree has roots which stretch down and give
nurture to the tree and a trunk which is solid with branches stretching out
to the future. Draw or cut out and stick a picture of a tree on a large sheet
of paper. On the roots write all that nurtures and provides resources for you
as a person and a professional. The trunk is your present moment; on here
you could write your current out-of-work commitments to family members and
friends. The branches stretching out are symbolic of the work that you do; it
may include listening, mentoring, teaching, advising and administrative work.
Look at the finished work and comment on what you have discovered.
Show it to a mentor and invite that person’s comments.
9
Weaving the Threads
Together
A man was travelling alone through the Himalayas. The scenery

was spectacular but isolated. Suddenly he came across a bare
hut surrounded by growing vegetables tendered by an old
man. Each acknowledged the other and conversation began.
The traveller asked, ‘How do you live in such poverty, with so
little?’ The old man responded, ‘But you have so little – just
your back-pack.’ The traveller replied, ‘Oh yes, but I’m only on
a journey.’ ‘So am I,’ replied the old man.
(Traditional)


readers experience
Reflection
Drawing together
implications
Believers’
experiences –
world faiths
188
Weaving the Threads Together 189
Experience
I quote verbatim to illustrate, with permission, a conversation between
a friend and her grandson, Timothy, who is just five.
Granny: Do you know what is special about this Saturday?
Silence.
Granny: It’s my birthday!
Timothy: Oh yes, and you’ll be 61.
Granny: Can you remember my party last year when I was 60?
Timothy: Yes…and next year you’ll be 62, then 63 then…(and he
went on…right up to 100), but most people don’t get to 100 do
they?
Granny: Well, some people don’t.
Timothy: Do you want to die, Granny?
Granny: Well, we all have to die some time, and some people when
they get old, if they can’t talk or walk or go the toilet on their own,
they think it is easier to be dead than to be alive.
Timothy: But will you be able to breathe when you’re dead?
Granny: No, but you won’t need to be able to. It’s only the body that
needs to breathe, and it’s only the body that dies. I think the bit of us
that is deep down in us that makes us all special and different may live
somewhere special when the body has stopped breathing, somewhere
peaceful, maybe like being asleep or being in the best place you can
think of that you’ve ever been to.
Timothy: Oh… So, are we having pasta for tea?
The lively conversation between five-year-old Timothy and his granny
about her birthday, her increasing age and her eventual death arose
because Timothy had tried to talk to his mum about death, which
he had become aware of and wanted to understand, but his mother
silenced him. It was not a suitable subject for a child. At the time,
Granny did not know this. She later explained to her daughter-in-law
what had happened.
Linking adult, child and adolescent

experience: concluding thoughts
Children are fascinated by death; they see a dead bird as did Stephanie
in Chapter 1 and think that they can ‘resurrect’ it. Children want to
know more. They ask questions so that they can relate a new experience
to their existing knowledge. Sometimes they make mistakes and
draw incorrect conclusions but then they try again and ask another
question. Alice Jolly’s son had a considerable number of questions to
ask when his new sister was stillborn: ‘How could she grow in the
ground?’ ‘Can we buy another baby?’ These questions were much to
the consternation of his grieving mother, yet were real issues to him
(see Chapter 3).
Those addressed in this book include a broad group of people
with many life skills in human caring: parents; teachers; children and
youth workers; those in voluntary work with children and adolescents;
the medical profession and nursing; funeral directors; social workers;
and ordained ministry and clergy. The book is also intended for those
training for these professions. As professionals we need to learn to
work alongside one another, to support and help each other. All are
involved in the care of grieving and bereaved children and young
people, yet we also need to be cared for, since this is a sensitive long-
term relationship with the other.
Children have been called ‘our spiritual giants’. Their insights are
amazing. As adults, we can learn from children’s attitudes of being
open, up front, direct, unfazed by tradition or ‘taboos’. They accept
that death is natural and we need to learn to accept our mortality and
live. Yes, we can and should be there beside children and adolescents
who face the death of someone they are close to and love. They grieve
and young children need to be reassured and comforted, adolescents
listened to and sometimes consoled.
We need to recognise that children do grieve, but ‘puddle jump’
in and out of grief. Adolescents grieve but often in silence, needing
their own space but also to know that there can be a listening ear. We
are involved in helping them to learn that life is for living. We should
also help them to ask the big questions in life and learn how to live
Weaving the Threads Together 191
to find the answers; for some these will be found by faith in human
nature and for others through a faith in the love that we can call God.
The aim of this book is to be a theoretical and practical resource.
The objective of the book is to encourage reflective practice arising from
working with children and adolescents in their experiences associated
with dying, bereavement and the afterlife. I have encouraged you, the
reader, to interact with the contents: ‘to enter into a conversation’ with
me, the writer. I have aimed to encourage you to learn more about this
area of experience, to relate it to your own professional experience,
to critically reflect on that experience and become more informed
and confident in your practice of care. Please also use the website
dyingtolive.org.uk to share conversations and comments.
Appendix 1
Creating a School Policy for the
Pastoral Care of Bereaved Pupils
Having a policy in a school helps when a bereavement arises,

particularly with sudden, multiple or traumatic circumstances. (The
Critical Incident Procedure is the prerogative of the head teacher.)
The policy needs to be a framework rather than prescriptive and
agreed by school staff (teaching and non teaching) and the governors
(parent governors are particularly helpful as ‘sounding boards’).
The area of ‘loss’ is particularly emotive and sensitive and therefore
needs a policy statement which is sensitive to each unique situation of
loss. It is likely that a policy may need to be formulated in the same
format as other policies in your school so the information below is a
suggestion only.
It is important that the policy is regularly reviewed in the light of
experience.
The idea of such a policy is included within the Department for
Education and Skills (2005) Common Core of Skills and Knowledge for
the Children’s Workforce. This document sets out the areas of expertise
which anyone whose work brings them into frequent contact with
children should have. The six areas include ‘Supporting transitions’,
which states that ‘some children may have to face very particular and
personal transitions not necessarily shared or understood by all their
peers. These include: family illness or the death of a close relative’
(p.16).
A school policy is likely to include the following:
• aim
• rationale
• clear guidance on procedures
192
Appendices 193
• emphasis on confidentiality
• reference to outside support systems and resources
• review structures.
The ideas below are to encourage discussion and the construction of a
policy reflecting the needs of your particular school.
Aim
A policy on the pastoral care of pupil(s) and the school community in
the event of loss through bereavement.
Rationale
To work as appropriate with pupil(s) with their consent and that of the
family to give ongoing care of pupils following a bereavement.
Guidance on procedures – some considerations

Personnel, defining roles and responsibilities. In a primary school,
everyone will be involved.
• Identify one person to take overall responsibility. This may
well be the head teacher (plus a deputy to cover absence), who
receives news of a death and informs staff; in some schools
this is done using email.
• The accuracy of the information concerning a death should
always be checked (sometimes rumour can abound; it is
necessary to check the facts).
• It is important to consult and follow up with the family and,
if appropriate, the pupil.
• There needs to be a clear set of ground rules of do’s and don’t’s
for all teachers concerning bereavement. Respect for the child
and confidentiality are paramount.
• A policy for consulting the bereaved pupil (and the family)
and one relating to how the information is handled, e.g. for
telling (or not telling) a peer group when a pupil is absent due
to the death of a parent.
• A policy of strategies for coping with pupils who become
distressed in class – e.g. a yellow card (to signal that the pupil
needs to leave the room).
• A policy to ensure communication with parents.
A policy/guidelines should address ‘types’ of death which involve
different responses:
• the death of a parent of a pupil
• a pupil/teacher with a terminal illness on long-term sick leave
and the information given
• a traumatic incident
• the death of a member of staff
• is the policy known, so that pupils/staff know who to talk to
if they need a listening ear?
A policy covers record keeping:
• the necessity of checking sensitively the facts
• keeping records
• place and accessibility of records (for new members of staff; a
child changing class).
A policy needs to recognise the long-term effects of bereavement in
regard to:
• behaviour of pupils
• support services if bereavement issues persist and appear to
becoming ‘pathological’; knowing who to refer to
Appendices 195
• a calendar (or similar) which is marked to show significant

anniversaries of the death, where sensitivity will be needed by
the school.
Materials to support staff and

pupils: books/ videos
Decisions will need to be made on:
• where books (on loss and death) for pupils are kept
• who services materials, keeping them available and up to date
• training and support of staff working with bereavement needs
to be addressed.
Reference to outside support systems

A designated person is useful to take responsibility for the following:
• lists and copies of support agencies
• decisions on where these are kept.
Review structures
• The policy needs to be reviewed regularly
• All staff need to be inducted in the policy.
Appendix 2
Creating a School Policy: Exploring
Loss through the Curriculum
Ofsted inspectors look for Spiritual, Moral, Social and Cultural

development throughout the curriculum.
The educational aspect of this area is likely to include:
• knowledge, e.g. recognition of different losses, rites of passage,
beginnings and endings, cultural differences, funeral practices,
irreversibility of death
• skills, e.g. handling emotions, dealing with anger
• attitudes, e.g. positive – death is natural; life is for living and
enjoying.
Questions for the subject of

‘loss’ in the curriculum
• Is there a clear rationale and aims for the exploration of loss
through the curriculum?
• How do these aims support the overall aims of the schools?
• Are there clear principles for the exploration of loss through
the curriculum?
• How do these principles support the 4 Every Learner principles:
−− access and entitlement
−− curricular balance
−− differentiation and potential
−− preparation for the future?
196
Appendices 197
Planning for the curriculum

• Is a particular teacher identified to coordinate work on loss
within the school?
• Does the policy explain how work on loss is planned in a
systematic way?
• Does the policy make clear how different subjects and other
curricular activities contribute to a growing awareness and
understanding of loss?
• Does the policy make clear how work on loss is linked to
bereavement support?
• Does the policy indicate the range of resources available to
support work on death?
• Does the policy make clear how continuity and progression
are catered for in relation to work on loss?
• Does the policy make clear how work on loss is to be monitored
and evaluated?
Work on loss may feature in informal ways

• circle time – sharing news; pupils discussing something seen
on the TV
• a pupil approaching a pastoral member of staff (who has been
trained in listening/counselling skills)
• incidental conversations, for example in the dinner queue or
before lessons with teaching and non-teaching members of
staff and other pupils
• following something said in assembly
• following a publicised traumatic incident (e.g. a tsunami)
• story time.
Loss may be addressed formally

through the curriculum
This will be academic and intellectually rigorous but will also include
the emotions and the social effects of loss. Death should be seen as
natural and part of life through:
• the changing seasons of the year – the growth of plants, trees
losing leaves in Autumn; pupils planting bulbs
• life cycles in animals – insects such as the butterfly; spawn/
tadpole/ frog; humans from pregnancy – looking at scan
photos and seeing a newborn baby and its growth
• mourning little losses – e.g. a lost tooth; a lost or broken
toy; a cancelled outing. It is important that the different grief
reactions to these losses are respected
• keeping pets – mourning the death of a pet by having a
‘funeral’; talking about it, listening and acknowledging the
sadness
• expressing emotions connected with loss – e.g. losing a friend
when you move house or school, divorce (great care is needed
here – but children will express a range of emotions in school
to such happenings)
• reading stories which use concepts of loss and death (see
Further Reading lists)
• acknowledging deaths of significant people on the TV and in
the media
• teachers and parents being able to show and share their own
feelings with children; being honest; acting as a model for
children when they encounter losses in their own lives
• talking of memories of someone important to our lives
• visiting a local church and looking at the gravestones
• expressing feelings about the death of someone known to all
the children, e.g. a teacher/auxiliary/pupil in a suitable way:
−− making a card for the family
Appendices 199
−− drawing a picture
−− writing their memories down to send to the bereaved
−− preparing a special assembly
−− planting a tree (always plant two in case one dies).
Personal, Health, Social and

Moral Education (PHSME)
• life skills, dealing with emotional effects of loss
• learning skills, memory scrapbook
• relationships including separations
• consideration of and debate on organ donation
• visit to/have a speaker from/support a hospice
• exploration of extending life through a healthy lifestyle.
Appendix 3
The Nature of Childhood
The sociologist Philippe Ariès and the historian Hugh Cunningham

have detailed the developing understanding of childhood noting
historical changes in ideas about concepts of stages of development,
the portrayal of children in pictures, children’s dress, the history of
games and the notion that children were naturally innocent and in
need of protection. Ariès came to the conclusion that the development
of universal education had ‘created’ childhood (Ariès 1979). Change
had come about in many ways. The ancient Greeks saw children
as irrational since they were without speech; children surviving
childhood were incorporated into adult life: everyone had a part to
play and children were not distinctive or treated any differently; they
were simply immature adults, important not for their present but their
future value. The Enlightenment’s emphasis on rationality created a
category of irrational persons, ‘children’, who needed training and
correction; gradually education was seen as significant for all. A pivotal
moment was the Education Act of 1870.
Cunningham (2006) noted the changes in work patterns from
agriculture based around the home in the sixteenth and seventeenth
centuries to the industrialisation in the cities of the eighteenth and
nineteenth centuries with children working in domestic service,
in mines and factories and climbing chimneys. This was seen as
encouraging the habit of work and moral principles. Gradually, child
labour was realised to be exploitative and subsequently regulated.
Later the idea of a ‘natural childhood’ took root. Children came to
be seen as in need of protection and guidance within a family. Thus
in Victorian times, and before, the presence of children at a death was
seen as normal. Changes have continued in what is called the ‘social
construct’ of childhood. The education of children is now a lengthy
commitment with socialisation taking place in the home.
200
Appendix 4
Babies and Infants Dying
A brief history, some case studies and ensuing ethical issues.
History
Throughout history, it is likely that infanticide, the deliberate killing
of newborns with consent of parents and the community, was known,
yet euthanasia meaning ‘a good death’ was a practice of allowing
the patient to die in peace and with dignity. For the physician, it
meant caring for the patient and preventing pain and suffering,
though in ancient times physicians could either heal or cause the
death of a patient by providing a poison. Hippocrates (460–375 bce)
challenged the practice of poisons since they destroyed life, an end
alien to medicine, his professionalism included establishing a set of
ethical principles defining the physician as healer, the Hippocratic
oath, with the principle of primum non nocere (first, do no harm).
Hippocrates is traditionally regarded as the father of Western medicine
(Edelstein 1967).
The Greek city-states and ancient Rome saw infanticide as a way
of ridding themselves of deformed babies by exposing them. Plato
(424–347 bce) was an advocate of infanticide for eugenic purposes.
It served as a form of birth control when food was scarce for the
Eskimos, the Kung in Africa and in eighteenth century Japan.
However, the monotheistic religions of Judaism, Christianity and
Islam condemned infanticide as murder. The commandments taught
that human life is sacred, a gift from God and not to be destroyed,
a teaching reflected in the sixth commandment (Exodus 21.13);
today, particularly in the United States, this belief is central to moral
consciousness. All human life is of equal value, and all humans have a
right to life.
201
However, in the twentieth century, in the Netherlands and

Belgium in the heart of Christian Europe, following lengthy debate
about the suffering of babies and infants, euthanasia was legalised. It
could include a baby born with anencephaly, a condition with most
of the brain missing, which occurs in about one in every 2,000 births;
while biologically human the baby will never ‘develop rudimentary
consciousness, let alone an ability to relate to others or a sense of the
future’ (Holt 2005). The legislation also covered infants and children
suffering uncontrollable pain with a terminal illness.
The viability of babies

Babies born pre-term, whose organs were not totally formed, would
die before or at birth. Gestational age is the primary determinant of
almost all perinatal outcomes; ‘22 weeks is considered to be the cut-
off for human viability and for week 25 onwards there is a general
agreement that active management should be offered’ (Royal College of
Obstetricians and Gynaecologists 2014). Today the charity Bliss (www.
bliss.org.uk) is a source of information and an advocate for babies born
pre-term. It states that one in nine babies born in the UK will spend
at least a few days in a neonatal unit which specialises in the care of
preterm, small and sick babies. Parents, particularly mothers, are supported
on a neonatal unit, since sadly some babies are too small and do not survive.
Babies born with disabilities and abnormalities

Across much of Europe in the 1960s, children were born with
deformities, their condition traced to the thalidomide drug taken in
pregnancy. A BBC TV programme, ‘The Midwives’, based on diaries
of the period, showed the anguish of the GPs who unwittingly
prescribed the drug and the doctors delivering the babies. On
such occasions the baby was fed, kept warm and allowed to die.
Parents were not consulted in the decision. Today, in countries of
the developing world, children with disabilities are more likely to be
abandoned and left to die for lack of adequate facilities.
In developed countries, doctors are convinced that, ‘there is a clear
difference between active and passive euthanasia – killing and letting
die – yet a defendable ethical difference is hard to find’ (Gillert 1998).
Infants are still left for nature to take its course.
Appendices 203
Ethical issues
Care of very sick children
There are children’s hospices in many countries today and these are
places of joy and laughter, caring for babies to young people up to
the age of 18. They support families, children and young people
living with life-threatening conditions from diagnosis to end of life
and throughout bereavement. This is done through a range of services
delivered where the family wishes – in the home, at hospital, in the
community or at the hospice. The help is not simply when death is
imminent, care at the end of life is not the only service provided. Many
children and young people using the service are extremely active but
need additional support and care as their conditions develops. Within
some hospices there are play specialists helping a child to grow in
confidence and aid their physical and mental wellbeing, sensory rooms
providing art and music sessions, places to interact and share. Support
extends to include families, parents and siblings since the hospice staff
recognise the stress of living with a life-threatening illness.
Euthanasia
In the Netherlands and Belgium, where euthanasia is permitted by law,
there is debate about methods, which are varied and controversial. One
method is that of an intravenous sedative to silence the brain, followed
by a morphine injection which is a pain medication. This can trigger
respiratory arrest and death; if it does not neuromuscular blockers are
added causing death in 5-10 minutes. Eduard Verhagen, head of the
Department of Paediatrics at Groningen, in the Netherlands, states, ‘It
happens in a peaceful manner’ (quoted in Nuwer 2014).
An alternative to this proactive method of euthanasia is that of
palliative care such as the withdrawal of food and fluid. In the UK,
this was known in the 1990s as the Liverpool Care Pathway (LCP);
it was used under the supervision of the medical team, in the case of
terminally ill adults. However, families claimed that their relatives were
denied food and drink, leaving them to ‘linger in misery for weeks’.
The Care Minister, Norman Lamb, announced an independent review,
chaired by Baroness Julia Neuberger and published in July 2013.
Accepting the review’s recommendations, the government advised
that NHS hospitals should phase out the use of the LCP over the next
6–12 months. This method has been used with babies and infants
with varying results. A doctor commented that parents and care teams
do not realise the average time from withdrawal of hydration to death,
which can be ten days or more. Nor were parents prepared for the
changes in the infant’s physical appearance – due to dehydration –
‘the unique horror of witnessing a child become smaller and shrunken’
(quoted in Ertelt 2012).
In the UK a judge allowed a mother, Charlotte Wise, to refuse
food or water to her 12-year-old daughter, Nancy, who had been born
blind with hydorcephalus. At birth, she required 24-hour care, and was
fed, watered and medicated by tube at Great Ormond Street Hospital
in London. Since her mother had taken her home Nancy’s health had
begun to deteriorate, and she would scream in agony despite morphine
and ketamine. Her mother ‘knew’ her suffering was too much and that
Nancy deserved to be at peace and had a right to die. When drink was
withdrawn, Nancy’s death took fourteen days, distressing Charlotte.
It is interesting that it was the mother’s decision to go to court and
seek permission based on her assumption that Nancy wanted to die;
however it needs to be recognised that it is possible that Nancy could
neither understand nor show her thoughts. Does the legal verdict
raise a precedent and indicate a need for a change in law to allow
euthanasia?
The arguments for and against euthanasia are given in detail on a BBC
website www.bbc.co.uk/ethics/euthanasia/against/against_1.shtml.
The situation in the USA

The Ohio Pediatrics Ethics Survey of 1993 asked 900 parents about
keeping children alive, who medical science would not previoulsy
have been able to; this was in the light of limited funds for health care.
Parents were asked to respond to scenarios such as: If your child was
seriously injured in an accident and the medical team states that your
child is likely to be severely brain damaged and dependent on you for
the remainder of his/her life would you want:
1. ‘everything’ done
2. a do not ressussitate (DNR) order
3. withdrawal of potentially life sustaining machines
4. withdrawal of all support including nutrition
Appendices 205
5. a lethal injection of a sedative to be given (‘mercy killing’).

The survey ended with the questions:
Do you support physician-supported suicide (voluntary death)? Yes
or No
Do you support ‘mercy killing’ (non-voluntary death)? Yes or No
Although the survey received no attention outside the Cleveland area
it sent a message to those 900 parents: euthanasia for a child is an
option that deserves attention1.
Laws about euthanasia for adults have never reached the statue
books, yet were written in Wisconsin (1975), Iowa (1989) and Illinois
(1997). By 2014, Oregon, Vermont, Washington and Montana
allowed physician assisted suicide under strict and detailed legislation;
California is likely to pass legislation in 2016. Thirty eight states
prohibit assisted suicide. It is not considered for children, although on
occasions the law is challenged by particular cases, for example that of
Natalie in Texas. Natalie, at 19 months, fell into the family swimming
pool. She was rushed into a children’s hospital but when she awoke
Natalie had lost sight, hearing and movement; her organs began to fail.
Brad, her grandfather said he began to ‘think that dreadful thought:
we can’t let her live like this’. Doctors decided to allow the feeding
tube to be removed and sent her home. Brad asked if that wasn’t
starving her to death and wondered why the doctors couldn’t give
her an injection such as morphine – peaceful and quick. Deprived of
food and water, Natalie died after nine days. Brad described the death
as ‘pure torture…just the most cruel, inhumane thing’. The family is
now campaigning for the state to legalise euthanasia (Johnson 2014).
The American College of Pediatricians have produced a useful
and insightful paper ‘Neonatal Euthanasia: the Groningen Protocol’ in
response to the Netherlands. The abstract states:
An examination of the criteria used by the Protocol to justify the
euthanasia of seriously ill neonates reveals the criteria are not based
on firm moral principles. The taking of life of a seriously ill person is
not the solution to pain and suffering of the dying process. It is the
role of the medical profession to care for the ailing patient with love
1 www.patientsrightscouncil.org/site/not-for-adults-only
and compassion, always preserving the person’s dignity. Neonatal

euthanasia is not ethically permissible. (Vizcarrondo 2014)
Summary
The acceptance of infanticide for neonates, infants and young people
and the methods used vary widely across Europe and the United
States. Rachel Nuwer, writing in the New Scientist (2014), concludes:
for most parts of the world, a refusal to even discuss the subject
dominates. As unpleasant as it is, parents, physicians, hospitals and
nations need to confront this issue as a matter of responsibility towards
both infants born into hopeless circumstances and their families.
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Further Reading
Books for children

Under fives
Ailsworth, A. (2008) Remember Me Always: A Handbook to Help Bereaved Families Care for Grieving
Children. Redruth: Penhaligon’s Friends.
Butler, H. (2014) Us Minus Mum. London: Little Brown Young Readers.
Carle, E. (2002) The Very Hungry Caterpillar. London: Puffin Penguin.
Francis, L.J. and Slee, N. (1996) Autumn: Betsy Bear Learns about Death. Birmingham: National Christian
Education Council.
Gray, N. and Cabban, V. (2001) Little Bear’s Grandad. London: Little Tiger Press.
Mellonie, B. and Ingpen, R. (1983) Lifetimes: The Beautiful Way to Explain Death to Children. New York:
Bantam Books.
Rivett, R. (2009) Are you Sad, Little Bear? A Book About Learning to Say Goodbye. Oxford: Lion.
Rock, L. (2004) When Goodbye is Forever. Oxford: Lion Publishing House.
Sendak, M. (2000) Where the Wild Things Are. London: Red Fox Books.
Viorst, J. (1971, 1988) The Tenth Good Thing about Barney. New York: Aladdin Paperbacks, an imprint
of Simon & Schuster.
Key Stage 1 (five to seven years)

Earl, C. (n.d.) My Grandad Plants People: A Simple Guide for Grown-Ups when Children Ask about Death.
Available at www.bereavementadvice.org/topics/the-funeral/taking_children_to_funerals%20
(3).pdf, accessed on 21 March 2016.
Elliott, R. (2015) Missing Jack. Oxford: Lion Children’s Books.
Griffiths, G. and Macleod, L. (2010) Goodbye Baby: Cameron’s Story. Edinburgh: St Andrew Press.
Jay, C. and Thomas, J. (2012) What Does Dead Mean? A Book for Young Children to Help Explain Death
and Dying. London: Jessica Kingsley Publishers.
Jeffs, S. (2005) Rosie: Coming to Terms with the Death of a Sibling. Abingdon: BRF.
Jeffs, S. (2006) Josh: Coming to Terms with the Death of a Friend. Nashville, TN: Abingdon Press.
Kerr, J. (2002) Goodbye Mog. London: Collins.
Leutner, D. and Postgate, D. (2009) Remembering. Saunderton: Child Bereavement Charity. Available
from www.childbereavementuk.org.
Robinson, H. and Straky, M. (2014) The Cooper Tree. London: Strauss House Publishers.
Rosen, M. and Blake, Q. (2004) The Sad Book. London: Walker.
Sanford, D. and Evans, G. (2014) It Must Hurt a Lot: A Child’s Book about Death (Hurts of Childhood).
London: Random House.
211
Stickney, D. (2004) Water Bugs and Dragonflies: Explaining Death to Young Children. Cleveland, OH:
Pilgrim Press.
Thomas, P. (2009) A First Look at Death: I Miss You. London: Wayland.
Viorst, J. (1971, 1988) The Tenth Good Thing about Barney. New York: Aladdin Paperbacks.
Key Stage 2 (seven to eleven years)

Burnett, F.H. (2015) The Secret Garden. London: Puffin.
Butler, H. (2013) Helping Children Think about Bereavement. London and New York: Routledge, Taylor
and Francis.
Erlbruch, W. (2014) Death, Duck and the Tulip. Wellington: Gecko Press.
Hughes, S. (2013) Dealing with Loss: A Workbook for Kids. Raleigh, NC: Lulu Press.
Leutner, D. and Postgate, D. (2009) Remembering, Saunderton: Child Bereavement Charity. Available
from www.childbereavementuk.org.
Ness, P. (2011) A Monster Calls. London: Walker.
Robinson, H. and Straky, M. (2014) The Cooper Tree. London: Strauss House Publishers.
Silverstein, S. (1964) The Giving Tree. London: Harper and Row.
Winston’s Wish (2000) Muddles, Puddles and Sunshine: Your Activity Book to Help when Someone Has Died.
Gloucester: Winston’s Wish.

Boyne, J. (2006) The Boy in the Striped Pyjamas. London: Random House.
Magorian, M. (2004) Goodnight Mister Tom. London: Penguin.
Mood, P. and Whittaker, L. (2001) Finding a Way Through When Someone Close has Died: What it Feels
Like and What You Can Do to Help Yourself: A Workbook by Young People for Young People. London:
Paterson, K. (1977, 2008) Bridge to Terabithia. London: Penguin.

Hughes, S. (2013) Dealing with Loss: A Workbook for Kids. Raleigh, NC: Lulu Press.
Mood, P. and Whittaker, L. (2001) Finding a Way Through When Someone Close has Died: What it Feels
Like and What You Can Do to Help Yourself: A Workbook by Young People for Young People. London:
Pratchett, T. (1991) Reaper Man. London: Corgi.
Books for parents and professionals

Bell, J.L. (2005) The Love Which Heals: A Service of Grieving and Gratitude for those who Have Lost Someone
(2nd ed). Glasgow: Wild Goose Publications.
Cameron, J. (1995) The Artist’s Way: A Course in Discovering and Recovering Your Creative Self. London:
Pan Macmillan.
Collins, M. (2005) ‘It’s OK to be Sad: Activities to Help Children Aged 4–9 Manage Loss, Grief and
Bereavement. London: Sage Publications.
Dignity Caring Funeral Services (n.d.) A Child’s Questions About Death. Sutton Coldfield: Dignity
Funeral Ltd.
Doughty, C. (2015) Smoke Gets in Your Eyes: And Other Lessons from the Crematorium. Edinburgh:
Canongate.
Dougy Center, The: The National Center for Grieving Children and Families (2008) Helping the
Grieving Student: A Guide for Teachers. Portland, OR: The Dougy Center.
Further Reading 213
Holland, J. (2001) Understanding Children’s Experiences of Parental Bereavement. London: Jessica Kingsley
Publishers.
Holland, J., Dance, R., MacManus, N. and Stitt, C. (2005) Lost for Words: Loss and Bereavement Awareness
Training. London: Jessica Kingsley Publishers.
Mundy, M. (2009) What Happens When Someone Dies? A Child’s Guide to Death and Funerals. Meinrad:
Abbey Press.
Nash, P. (2011) Supporting Dying Children and their Families: A Handbook for Christian Ministry. London:
SPCK.
NICE Clinical Guidelines (2015) Depression in Children and Young People: Identification and Management
in Primary Community and Secondary Care. Available at www.nice.org.uk/guidance/cg28, accessed
on 21 March 2016.
Payne, S., Horn, S. and Relf, M. (1999) Loss and Bereavement. Buckingham: Open University Press.
Solomon, S., Greenberg, J. and Pyszczynski, T. (2015) The Worm at the Core: On the Role of Death in Life.
London and New York: Random House.
Stanford, P. (ed.) (2011) The Death of a Child. London: Bloomsbury.
Tallis, R. (2015) The Black Mirror: Fragments of an Obituary for Life. New Haven, CT: Yale University
Press.
Weymont, D. and Rae, T. (2006) Supporting Young People Coping with Grief, Loss and Death. London:
Sage Publications.
Useful Websites and Organisations
Alliance of Hope for Suicide Survivors

www.allianceofhope.org
A US website offering worldwide support for those affected by suicide.
Bereaved Parents of the USA

www.bereavedparentsusa.org
A US organisation that holds monthly support meetings and produces
a newsletter and brochures.
Brake
www.brake.org.uk
A road safety charity for anyone bereaved as a result of a road crash.
Care for the Family

www.careforthefamily.org.uk/family-life/bereavement-support
A faith-based organisation in origin, now offering help to families of
faith and none.
Childhood Bereavement Network

www.childhoodbereavementnetwork.org.uk
A comprehensive list of website providers and articles concerning
bereavement in children and adolescents. Counselling 14 year olds +.
214
Useful Websites and Organisations 215
Child Bereavement UK
www.childbereavement.org.uk
Supports families and professionals when a child dies or when a child
is bereaved of someone important in their lives.
Child Death Helpline

www.childdeathhelpline.org.uk
For anyone affected by the death of a child from pre-birth to the death
of an adult child. Started by experienced and trained bereaved parent
volunteers.
Cruse Bereavement Care

www.cruse.org.uk
Promotes one-to-one support to anyone bereaved and gives information
and contact details of local groups. For adolescents help see http//
hopeagain.org.uk.
Cruse Bereavement Care Scotland

www.crusescotland.org.uk
Provide the UK services (see above) in Scotland.
CRY (Cardiac Risk in the Young)

www.c-f-y.org.uk
Supports those bereaved through young sudden cardiac death (aged
14–35). CRY promotes heart screening and ECG testing programmes
and funds the CRY Centre of Sports Cardiology and Cardiac Pathology.
A downloadble booklet for a father losing a child suddenly can be
found at www.crydadsgrief.org.
Dying Matters
www.dyingmatters.org
Produces resources and advocates for openness about death.
Gingerbread
www.gingerbread.org.uk
Produces fact sheets and information for single parents following a
bereavement.
Grief Encounter
www.griefencounter.com
Grief Encounter is an organisation supporting professionals in helping
bereaved children and adolescents in particular school teachers.
Jigsaw4u
www.jigsaw4u.org.uk
A charity helping children/young people put the pieces back together
following trauma, loss and bereavement.
MindEd Trust
www.minded.org.uk
Provides help and advice around suicide and young people.
Miscarriage Association
www.miscarriageassociation.org.uk
Supports those who have been affected by the loss of a baby in
pregnancy.
Nelsons Journey
www.nelsonsjourney.org.uk
Offers telephone support and guidance, one-to-one therapeutic
support and activity days to children and adolescents in Norfolk
suffering a significant loss.
Useful Websites and Organisations 217
NHS
www.nhs.uk/Livewell/bereavement/Pages/children
A useful website giving references to other sources.
Patient Plus
www.patient.info/patientplus
Articles in Patient Plus are written by UK doctors and are based on
research evidence and UK and European Guidelines.
SAMM (Support after Murder and Manslaughter)

www.samm.org.uk
Supports those who have been bereaved as a result of murder or
manslaughter; information and other activities, including local groups
SANDS (Stillbirth and Neonatal Death Charity)

www.uk-sands.org
Offers support when a baby dies during pregnancy or after birth.
Save the Parents

www.youngminds.org.uk/for_parents/save_the_the_parents_
helpline
A site to help parents concerned about the mental health of their
children and young people.
Saying Goodbye
www.sayinggoodbye.org
Cathedrals organising memorial services for those who have
experienced miscarriage or early loss.
SOBS (Survivors of Bereavement by Suicide)

http://uk-sobs.org.uk
Support for those bereaved by the suicide of a relative or close friend.
Information, activities including local groups and events throughout
the UK.
The Compassionate Friends

www.tcf.org.uk
Organisation of bereaved parents and their families offering
understanding, support and encouragement to others after the death
of a child.
Well at School
www.wellatschool.org
Supports children and young people at school with medical and
mental health conditions such as depression and self-harm. It produces
resources for use in schools.
Winston’s Wish
www.winstonswish.org.uk
The organisation exists to support bereaved children and help them
make sense of death and rebuild their lives. It produces excellent
material for children and adults.
YoungMinds
www.youngminds.org.uk
For parents worried about children/adolescents; improving emotional
wellbeing and mental health of children and young people – also
offers online support to parents and professionals.
Subject Index
absence 156 bullying 78, 117

adjustment 48 see also bullied; cyber bullying
adolescents 25, 53, 94 burial 127
After Death Communication see also buried, bury
Experiences (ADCs) 99 buried 57, 135, 156
afterlife 34, 162 burn-out 173, 184
aggression 50, 160 bury 95
alcoholism 77
candle/s 63, 65, 121, 135,
All Saints 163, 164
139, 143, 144, 162
All Souls Day 67, 163, 164
Catholic Education Service 129–30
anger 44, 54, 68, 71, 94, 117
cardio pulmonary resuscitation
see also angry
(CPR) 19, 22, 23
angry 100, 101, 122
catalyst 38
Anglican Church/Church of
causality 22
England 35, 28–9
celebrant 144
anticipatory grief 68
Celebration/s 70, 103, 148, 120
antisocial behaviour 43
cemetery 150, 155, 156
anxiety 120, 143, 160
Cenotaph 121, 164
assembly 120–1, 132
ceramic poppies 41, 164
atheist 29, 99
ceremony/ies 68, 82
attachment theory 44
chaos 47
attention span 94
chapel of rest 92, 137, 139, 153
babies 23, 49, 67, 69, 79–82 chaplain 40, 67, 68, 174
behaviour 51 see also priest; celebrant
regressive behaviour 60, 124 Child Bereavement Network 88
self-destructive behaviour 161 Child Bereavement UK 96,
bereaved 41, 42, 48 112, 123, 129, 173
bereavement 41, 43, 45, 50 childhood depression 119
Bereavement Advice Centre 88 Children Act 1989 131
bereavement policy 113 children as forgotten mourners 43
body 19, 31, 33, 34, 37, 57, children’s hospices 69, 70, 114, 160
90, 91, 106, 116 Church schools 132
see also embodied voluntary aided 130
breath 16, 31 voluntary controlled 130
see also breathe coffin 91, 135, 136, 137, 139
breathe 18 Cognitive Behavioural Therapy (CBT) 79
British Humanist Association (BHA) 131 colleague/s 178, 179
see also humanists ComRes 41
bullied 110, 120 comfort 56–7, 99, 106, 118, 144
219
comforter 50, 122 Death over Dinner 17

Commission on Religion and Belief death related to experience in children 20
in British Public Life 131–2 death significance 86
see also Living with Difference Department for Education (DfE) 126, 139
Compassionate Friends, The (CF) 161 see also Department for Education
complicated grief 68 and Skills 2005
concept of death Department for Education and
components of 21–2 Skills 2005 192
concept development 18, 58, depression 36, 75, 77, 79, 97
94, 102, 123, 175 destructive 160
see also developmental level; detachment 176
developmental stages; developmental level 18
developmental norms; developmental norms 58
concrete language developmental stages 21, 23, 58, 115, 136
concrete language 50, 52 dicing with death 25
confidentiality 10, 113, 120, 178 disease 55, 95
conspiracy 73 doctor/GP 72, 78, 79, 80
contagious 51, 116 Dougy Center, The 44, 125–6,
continuity 49 157, 168, 169, 173
control 122, 126 drugs 25, 119
cot death/s 67, 174 Dying Matters Coalition 17, 128, 142
counselling 71,79
ecology 144
counsellor/s 64, 113, 120, 175, 178
Education Reform Act 1988 (ERA) 131
see also counselling
education see faith schools; foundation
creative play 50
schools; Church schools; secondary
cremated 135
schools; high school; Madrasah
cremation 57, 134–5, 152
egocentric 23
see also cremated; crematorium
embodied 31, 33, 34
crematorium 144
emotional 90, 97, 174, 178
crisis management 113
emotional development 149
Critical Incident Procedure (CIP) 113
enabler 177
cry 148
eulogy 147
see also crying
euphemisms 23, 36, 51, 99–101, 137
crying 142
euthanasia, infant 79–82
culture/s 30, 43, 57, 67–8,
exit card 122
106, 121, 135, 144
see also time out card
see also multicultural
experience 18, 37, 77, 85, 91
cyber bullying 119
cycles in our lives 47 faith schools 28, 129
family 23, 42, 64, 72, 75, 96, 97,
death
111, 114, 121, 145–6
as an end 37
Father’s Day 110
as a loss 18
fear 17, 24, 44, 51, 53, 71, 76,
as a natural process 53, 125
83, 142, 143,159
as finality for all living things 25
films 16, 17, 18, 20
as inevitable 18
foundation schools 130
as the result of death – internal
friendship 19, 52, 67, 102, 111
and external causes 24
funeral 40, 42, 70
as part of life 113
funeral directors 17, 90, 136, 137, 139, 145
as positive 72
funeral festivals 17
as the ultimate healing 64
death café 17 grave 37, 127, 139, 145
Death Education 126 greenfield site 144, 145
Subject Index 221
Grief Education Institute 46 Key Stage 53

grief Key Stage 1 127
collective grief 42 Key Stage 2 127–8
grief as a process 44, 46, 116 Key Stage 3 128
grief as a social construct 112 Key Stage 4 128
grieve/not limited to adults 125–156 Key Stage 5 129
grieving never ends 157
Lament, Psalms of 82
spiral of grief 48
landscape questions 52
supressed grief 41
library 113
unresolved grief 36
life after death 29, 35, 85, 116
Guild of St Raphael 68
see also life beyond death; life to
guilt/y 43, 33, 51, 55, 68, 69, 71,
come; afterlife; life cycle/s
77, 100, 120, 139, 141, 161
life beyond death 27 104
hallucinations 99 life cycle/s 127, 136
healing 111 life expectancy 20
health professionals 40 life experience 20
see also doctor/GP, hospice see also life is for living; life
doctor, nurse, midwife itself is terminal
healthy coping mechanisms 49, 52, 53 life is for living 125, 190
healthy grief 113 life itself is terminal 174
hearse 145 life to come 149
heaven 22, 23, 39, 40, 63, 89, 101, 171 listening 73, 177
helplines 113 literal/concrete thinkers 23, 24, 100
high school 126 literature 127
holistic growth 56 Living with Difference 132
Holy Innocents Day 165 Lord’s prayer 143
honest/y 51, 52, 95 loss/es 19, 59
hormonal 25, 53, 112
Macmillan 73, 74
hospice 17, 57, 63, 73, 74, 87, 111, 112
Madrasah 130
see also children’s hospices
manipulate 36, 79, 97
hospice doctor 175
Marie Curie nurse 175
hospital 69, 71, 73, 88, 111, 114, 138
media 75, 91, 107, 118
humanists 99
see also social media
identity 25, 26, 53, 95, 114 medical model 20, 123
imaginative play 111 meditation 186
incurable illness 114 memory/ies 44, 45, 47, 52, 73,
innocence 92 92, 97, 99, 115, 117, 121,
see also innocent 140, 146, 155, 157, 167
innocent 111, 121, 136 memory board 115
insecurity 50 memory book 121, 143
intimations of mortality 37 memory boxes 73, 121, 167
intravenous memory garden 168
irreversibility 22 memory holders 117
isolated 92 mental distress 51
isolation see isolated mental health problems 119
mental health professional 160
jigsaw 24, 94
Mental Health Services 119
Johari Window 177–8
see also mental health professional;
journey 85, 147, 188
mental illness; mental distress;
judgement 81
mental health problems; mind/s
mental illness 43
mentor 178, 179 phobic 51, 52

mind/s 46, 87 play 74, 85, 170, 185
midwife 67 see also creative play; imaginative
mindfulness 186 play; playing; playful
mirroring 42 playful 182
miscarriage 67 playing 91
mood swings 25 positive adulthood 159
mortality 20, 24, 57, 91, 93, 94, 100, 190 pray 188
mortuary 137 prayer 64, 65, 67, 121, 143,
mosque 75, 130 145, 147, 148, 150
Mothering Sunday 110 see also praying for the dead;
mourners 54–55, 143, 145 Lord’s prayer; pray
mourning 44, 174 praying for the dead 56–57
see also children as forgotten pre-school children (3–5 years)
mourners; mourners 23, 50–1, 68, 111
multicultural 27, 107 predecease/d 68, 90, 91
murder 76 preschool 23, 50–1, 68, 111
myth 37, 144 priest 20, 71, 131, 135, 136, 144
primary school children (5–9
National Curriculum, 123, 130
years) 24, 51–2, 94
National Health Service (NHS) budget 119
primary school children (9–11
National Institute for Health and
years) 22, 52–3 94
Care Excellence (NICE)
primary socialisation 9, 92
Clinical Guidelines 119
professional/s 72, 92, 98, 101, 172,
National Secular Society 131
176, 179, 181, 184, 190
neonatal 82
see also professional boundaries
New York 16, 75
professional boundaries 176
newborns 81
psychology 47
nightmare 51, 76
clinical psychologist 175
norm 117
developmental psychology 44
see also normal, normality
parapsychology 99
normal 42, 155
psyche 159
normal behaviour 116
psychiatrists 113, 176
normality 49, 54, 159
psycho-somatic symptoms 51
nurse 79, 91, 114
psychological tasks 47
Office for Standards in Education psychologist 79, 99, 176
(Ofsted) 126, 130, 132 puberty 57, 95
organ transplant 19 puddle jump 75, 144, 190
oscillate 42, 158
questions 16, 17, 30, 68, 74, 84, 91, 94,
paediatricians 45, 80 115, 127, 133, 143, 148, 190
pain 71 see also ultimate questions
parent/s 78, 80, 85, 92, 93, 101, 159, 190
reality 16, 92
see also surviving parent; remaining parent
reassurance 24, 49
pastoral care 55, 112, 113, 120, 123
recreation 44
examples of 114–120
red flag 160
pathological 41, 113
re-connect 158
Patient Plus 78
re-establish 92
peek-a-boo 23
re-imaging 97, 157
peer group 95
see also re-visioning; re-
peers 110
establish; re-connect
see also school mate
re-visioning 45
pet 38, 52, 123, 127, 139
Subject Index 223
reincarnation 22, 36, 151 British Social Attitudes

remaining parent 59 Survey (2013) 140
Remembrance Day 76, 127 Office of National Statistics
research 23, 84, 99, 112 71, 78, 130, 136
resilient 43, 112, 142, 159, 166 2011 Census 27
resurrection 33 stillbirths 67, 87
risk-taking behaviour 19, 25 see also stillborn
see also dicing with death stillborn 82, 185
rites of passage 125, 150 strategies 123
ritual/s 24, 52, 54, 57, 127, stress
128, 139, 153, 165 psychological 75
Roman Catholic Church (RC) 34, 35, 148 suffering 55, 83, 86, 104, 105,
see also Catholic Education Service 111, 196, 151
suicide
sadness 44, 117, 135, 114
child/pupil 78–9, 119, 120
safe space 176
known adult 76
school mate 91
supervisor 179
secondary schools 102, 120, 121–6
surviving parent 77, 79, 101, 160, 176
security 19, 53
self image 79 taboo 17, 37, 42, 49, 113, 125, 136, 146
self-blame 77, 161 teacher/s 79, 91, 110, 111, 113,
self-care 178, 184 141, 159, 173, 174, 176
self-esteem 153 terminal illness 20, 26, 42, 65
self-harm 78, 119, 120 of a child 26, 68, 87
self-pity 97 of parent 71, 91, 95, 101, 159
separation anxiety 49 see also incurable illness
sext 119 terrorism 16, 17, 29
sexual abuse 77, 131 terrorist 75
shame 34, 55, 120 Theos Think Tank 131
shock 46, 47 time out card 122
sibling/s 54, 65, 68, 69, 77, 79, 87, 91 toddler/s 23, 49, 50, 94, 97
significant death 112 trust 102, 117, 160, 174
significant life 87 truth 76
see also significant death see also truthful
silence 42, 73, 74, 95, 101, truthful 16
159, 180, 181, 182 tutor group 102, 133
see also silent
ultimate questions 9, 83, 104
silent 159
underachievement 43
sleep 20, 156
undertakers 137
social media 150
universality 21, 58
social networks 118
Social Services 46 wake 146
see also social worker Wellcome Institute 18
social worker 72, 79, 113 Winston’s Wish 42, 48, 59, 68, 74, 76, 77,
soul 19, 22, 31, 57, 152 78, 94, 98, 167–8, 168, 169, 170
see also spirit; spiritual healing withdrawal 124, 161
spiral curriculum 10 withdrawn 159
spirit 31, 95, 138 World Health Organization 77
spiritual healing 99 World Trade Center 16, 29
Spiritual, Moral, Social and Cultural
development (SMSC) 126 Yukon 47
statistics 26, 112, 119
Author Index
Arberry, A. 182 Griffins, C. 68 Rilke, R.A. 185

Ariès, P. 20 Robinson, H. 115
Hafiz, 17
Astley 185 Rogers, S. 131
Hamilton, 18
Rumi, J. 183
Bailey, E. 131 Harnett, I. 131
Barr, J. 32 Hauerwas, S. 105 Schwartz, M. 17
Battersby, 17, 27 Herbert, G, 186 Shapiro, E. 42
Bell, J.L. 99 Hick, J. 36 Shepherd, J. 131
Billings, A. 44 Hilpern, K. 138, 141, Sheppy, P. 153
Bowker, J. 166 142, 146, 147 Silverstein, S. 139
Bowlby, J. 44 Hitchens, C. 17 Slee, N. 137
Brown, D.A. 86, 87, 166 Holland, J. 175 Smid, E. 78
Burgess, R. 146 Smith, S. 43
Ingham, H. 177–8
Butler, H. 59 Spanner, H. 42, 43
Ingpen, R. 139
Butler-Sloss, E. 27 Stokes, J.A.
Jalland, P. 159 Straky, M. 115
Cameron, J. 184, 185
Jolly, A. 67
Carle, E. 68, 143 Templeton, T. 75
Cave, S. 29 4 Kelly, E. 153
Varley, S. 140, 143
Clabburn, P. 71 Kübler-Ross, E. 49
Viorst, J. 135, 139
Collins, M. 98
Cranwell, B. 100 Lawton, T.K. 46, 149–50
Walter, T. 44, 48, 157
Cunningham, H. 20 Luft, J. 177–8
Ward 45
Lumley, T. 75
Weymont, D. 98
Davie, G. 41
Markham, L. 95–6, Wilkinson, A.
Davies, D. 35
96–7, 98–9 Wilson, R. 45
Dawkins, R. 29
McLeod 68 Woodhouse, P. 37
Diamond, 17
Mellonie, B. 139 Worden, J.W. 44, 140,
Drakeford, P. 98
Moltmann, J. 37 160, 175
Draper, A. 71, 73–4,
92, 96, 97, 157 Morpurgo, M. 37, 140–1
Drewes, A. 99 Najjar 183
Duffy, W. 16, 76, Nouwen 184
118–9,139, 141
Oldfield, E. 131
Engel, 44 Oliver, S. 92, 96
Feifel, H. 125 Palmer, P.J. 185–6
Francis, L.J. 137 Porter, M. 98
Freud, S. 44, 97
Rae, T. 98
Goold, 17 Rhodes, B. 68
Graham, J.A. 18, 25, 47–8
224

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How do children understand death?

How do children understand death?

How do children express grief?

How do children express grief?

How can children and adolescents begin to understand death

and cope with bereavement? And how can we, as adults,

about Death, Dying and Bereavement

Marian Carter is an experienced chaplain and educator

Jessica Kingsley Publishers

Cover design: www.ianrossdesigner.com

Carter_HelpingChildren_UKPB_AW.indd 1 09/06/2016 17:49

Talking About Death and Bereavement in School

Great Answers to Difficult Questions about Death

Seeds of Hope Bereavement and Loss Activity Book

What Does Dead Mean?

Jessica Kingsley Publishers

To Jo Roberts, a friend and encourager.

To editors Natalie Watson, Jane Evans and

2. Grief and Bereavement . . . . . . . . . . . . . . . . . . . . . 39

3. Challenging Factors Influencing Grief . . . . . . . . . . . . . 63

4. What Should We Tell Children and Adolescents? . . . . . . . 89

5. Schools Coping with Bereavement and Death . . . . . . . . 109

7. Continuing Care of Children and Adolescents . . . . . . . . 155

8. Care of the Carers Including Ourselves . . . . . . . . . . . . 171

9. Weaving the Threads Together . . . . . . . . . . . . . . . . . 188

Appendix 1: Creating a School Policy for the Pastoral Care

Appendix 2: Creating a School Policy: Exploring Loss through

Appendix 3: The Nature of Childhood . . . . . . . . . . . . . . . . . 200

Appendix 4: Babies and Infants Dying . . . . . . . . . . . . . . . . . . 201

Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211

Useful Websites and Organisations . . . . . . . . . . . . . . . . . . 214

Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219

Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224

Working in schools, hospitals, hospices and a parish I have been

can learn; adolescents are more thought-provoking! The examples in

The experience A child’s

Resources for An adolescent’s

Each chapter also includes activities to elicit the reader’s experience.

a parent, grandparent, favourite teacher or sibling. The development

Chapter 2: Grief and Bereavement

Chapter 3: Challenging Factors Influencing Grief

Chapter 4: What Should We Tell

Chapter 5: Schools Coping with

Models of these two responses are suggested. A large proportion of

Chapter 6: Funerals: The Attendance and

Chapter 7: Continuing Care of

Chapter 8: Care of the Carers Including Ourselves

Chapter 9: Weaving the Threads Together

The methodology used in this book

The experience A child’s

Resources for An adolescent’s

Linking adult, child and adolescent experience

result of road accidents, risk-taking behaviour, poisoning and cancer

nearest definition is, ‘the final cessation of activity in the central

A child or adolescent’s knowledge of death

are more common than adults realise. Understanding death is an

advances in medical technology, but the success of cardiopulmonary

Developmental stages and understanding of death

age and that it is final, permanent, universal and an unavoidable part