Grief responses in pediatric patients are often behavioral, meaning that the grieving child may act out emotionally or physically.
Which of the following is NOT one of the 4 tasks used to help children adapt to loss?
Accept the loss and its permanence
Experience the emotions associated with grief
Adjust to daily life without the lost individual
Come to see the relationship with the deceased person as based on memories
Reconcile the loss with a higher power, if the child believes in a higher power.
Which of the following statements shows that a child is through the first task that helps with adaptation to loss?
"I understand that my grandfather is in Heaven now, which means that he won't be coming back."
"I just know that my grandfather will come back somehow!"
"I feel both angry and sad that God took my grandfather to heaven. Why did He have to do that?"
"I know that Sunday dinners are going to be sad without grandpa there, but mommy says he's there in spirit."
Which of the following statements shows that a child is through the second task that helps with adaptation to loss?
"I feel very, very sad that my mom isn't here anymore. It feels lonely around the house with just my dad, my sister, and I."
"My mom is dead? So what? Why do I need to feel sad about it when it's done and over?"
"I know Christmas this year will be hard on my family, but just because my mom isn't there physically doesn't means she isn't there mentally and emotionally."
"I understand that my mom is dead and not coming back."
What responses to death would you expect to see in a child between the ages of 2-4?
The belief that death is temporary or even reversible.
Changes to sleeping and eating habits.
Regression in toilet training.
Increased craving for attention.
Feelings of guilt or blame.
Concern that other important individuals may die,
Which of the following is the BEST teaching to give to the parents of a 3-year-old child who recently lost his favorite grandmother to breast cancer?
"Children in this age group understand that something in their environment has changed. Try to maintain a normal routine to the best of your abilities, and it may be helpful to provide extra reassurance and attention."
"Children in this age group don't understand death, but they still experience behavioral changes, and may crave more attention and affection. It may be helpful to provide this extra attention."
"Children in this age group may not understand death the same way that adults do, but they understand that something is different. Try maintaining a normal schedule and providing extra attention to your child. These things may help your child through the grieving process."
"Children in this age group understand that death is irreversible. As such, they may crave more attention and affection from people until they're done grieving."
Which of the following statements would you expect a 5 year old to make following the sudden death of a friend?
"I know that my friend has gone to heaven, and that one day I may be able to join him there."
"It's my fault that this happened because I was mad at my friend for cheating during tag at recess."
"Class is not the same anymore since I can't color with my friend."
"My other friend is scared that our teacher will die too, but I'm not that scared about it."
Which of the following statements would you expect to hear from a 6-year-old following the death of her 1st grade teacher?
"It can't be my fault because I was always a good student who never had my card on red."
"I thought Mrs. S went on vacation, but I understand now that she's not on vacation, she's gone forever."
"I wonder what happened to Mrs. S after she died."
"I haven't been able to do my class work as normal since Mrs. S died. She was always so nice and helpful."
Which of the following statements would you expect to hear from a 7-year-old following the death of her father?
"I know that my daddy is gone somewhere and won't be coming back."
"It is my fault that my daddy is dead because I refused to eat my vegetables and go to bed when he told me to."
"I've been trying to help mommy by getting up, going to school and coming home like when daddy was alive."
"Since my daddy is dead, I'm scared that my mommy is going to die next."
"I've been throwing more fits at home because I want attention from mommy."
You are delivering teaching to the parents of a 6-year-old child who is struggling with a family friend's death.
Which of the following is the BEST teaching to give to these parents?
"Your child still doesn't quite understand how pertinent death is, but he may still feel like he caused it and be scared for your well-being. It's best to invite your child to talk about his feelings and answer questions honestly."
"Your child fully understands that death is an irreversible process, and may ask you questions about what happens after people die. Your child may start misbehaving at school or at home."
"Your child doesn't quite understand how permanent death is, which is the reason why he may act as though nothing has changed."
"Your child understands that death is permanent and may even feel like he caused it, creating guilt and fear that another death will happen as punishment for causing the first one."
What statements would you expect a 9-year-old to make following the death of his father?
"My dad is gone and not coming back and it's because God is punishing me for being a bad kid."
"My dad is gone and not coming back and it's because I was arguing with him about doing my homework."
"I wonder where my dad went after he died. I've been told that he went to heaven, but I don't know."
"Since my dad died, I'm scared that my mom is going to die next."
"Although I know that everything has changed, I've been acting like nothing has changed for my mom."
Which of the following is a developmentally inappropriate response to grief in a child between the ages of 8-11?
Increased aggression
Misbehaving in school and at home
Withdrawing and engaging in solitary activities
Directing grief anger at parents
Adolescents between the ages of 12-18 stop believing that they caused death and have grief responses similar to adults.
The grief response in adolescents differs from that of adults in where they aim their anger; it is very common for adolescents to aim their anger at their parents.