Supporting the Grieving Child and Family

Abstract

The death of someone close to a child often has a profound and lifelong effect on the child and results in a range of both short-and long-term reactions. Pediatricians, within a patient-centered medical home, are in an excellent position to provide anticipatory guidance to caregivers and to offer assistance and support to children and families who are grieving. This clinical report offers practical suggestions on how to talk with grieving children to help them better understand what has happened and its implications and to address any misinformation, misinterpretations, or misconceptions. An understanding of guilt, shame, and other common reactions, as well an appreciation of the role of secondary losses and the unique challenges facing children in communities characterized by chronic trauma and cumulative loss, will help the pediatrician to address factors that may impair grieving and children's adjustment and to identify complicated mourning and situations when professional counseling is indicated. Advice on how to support children's participation in funerals and other memorial services and to anticipate and address grief triggers and anniversary reactions is provided so that pediatricians are in a better position to advise caregivers and to offer consultation to schools, early education and child care facilities, and other child congregate care sites. Pediatricians often enter their profession out of a profound desire to minimize the suffering of children and may fi nd it personally challenging when they fi nd themselves in situations in which they are asked to bear witness to the distress of children who are acutely grieving. The importance of professional preparation and self-care is therefore emphasized, and resources are recommended.

Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health

“…The buffering and skill-building roles of responsive relationships are biologically embedded, and they are essential promoters of healthy development. 59 Existing AAP reports on managing perinatal depression, 90 supporting grieving children, 195 fostering male caregiver engagement, 196 partnering with home visiting programs, 142 encouraging developmentally appropriate play, 74,197 discouraging screen time, 125 and promoting sharedbook reading 67,68 include additional recommendations on ways primary care pediatricians might promote SSNRs.…”

Um pedaço de mim virou estrelinha: elaboração do luto infantil

“…Dentro do núcleo familiar, geralmente, os adultos temem abordar o tema da morte com as crianças, pois acreditam que isso pode ocasionar ainda mais problemas, porém a literatura afirma o contrário: falar sobre a temática possibilita que a criança expresse com maior clareza o que está sendo vivenciado por ela naquele momento (Schonfeld & Demaria, 2016). Reafirmando esse pensamento, Emer, Moreira e Haas (2016) declaram que um dos motivos que podem impedir que esse familiar consiga compartilhar essa informação se trata também de uma dificuldade pessoal desse adulto em aceitar a perda.…”

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“…14 Using clear, honest, age-appropriate, and direct words instead of euphemisms like ''sleeping'' or ''gone'' supports a child in their ability to understand the reality and finality of death and in their continued grieving process. 15 When a child has received inaccurate or incomplete information about death, their grieving and coping processes may be hindered. 16 PSWs are able to provide caregivers with age-appropriate language and expectations in understanding how a child may cope with death.…”