Grief Support for Siblings
Children at a young age experience the world mostly through sensory stimulation, rather than through typical ways that older children and adults do - that is, through thinking and asking questions. Such young children do not yet have an understanding of death - but they are aware of separation, the unfamiliar and tension - so it is true that little ones will sense that something is amiss in their world. They don’t have the capacity to understand at a cognitive level, but can be comforted by sensory input (touching, cuddling, rocking, sucking), and familiar people, as well as by her favorite toys, perhaps a cuddly doll or stuffed animal, or a favorite blanket. Whatever is her particular "security blanket" is what she will find most comforting in response to her sense that things may not be right in her world.
My own research has taught me that children do better when they are actively involved or included in family activities during times of duress. So, for little ones, it is important to keep any photos of them with their sibling, of them with mom and dad at the hospital/cemetery or in front of any sort of memorial -- anything that they can look at when they are older that can help them realize that when they were little, and their sibling was sick and died, they were involved with all that was happening. The parents are already keeping photos so it is important for kids to realize they hadn't been left out and shared a great love for their sibling and that the sibling loved them as well.
Kids may not realize or appreciate the involvement now, but will find reassurance in knowing this later. This is an important point because a key concept for bereaved siblings is that, as they grow older, physically and cognitively, reaching and conquering new and challenging developmental tasks, they grieve and re-grieve the death of their brother or sister. At each new developmental level, they have new questions about what happened and they search for a new level of understanding - this is how they grow and learn. So, it's important for parents to expect that questions may be ongoing - as part of the normal process of growing and learning.
Bereaved siblings, as all children do, want to feel as if they are special in their parents' eyes - just for being themselves. And so, it's important to include the sick child in the family's ongoing life but not to the exclusion of the well siblings. This is a critical balance.
All grieving children need safety, security and support. Know that young children may want to keep their parents in view; avoid separation from significant others. Young children may be more anxious or shy than usual, for a time. It's important to maintain their usual routines - young children prefer predictability, and in times of distress, this becomes particularly important. They need to be told what's happening, but simply and clearly in language they can understand. And, the language that such young children understand best is to feel safe and secure because they are with mommy or daddy. Openly communicating with children at levels appropriate to their age and being honest (but not harsh) is important. Be concrete in verbal descriptions, but use puppets and dolls to help communicate - they are wonderful aids to communication, often much more effective than direct questioning. And, listen to the child - let her do the talking and the telling of stories so that you can learn from her what she might want or need to know. Reading books geared to the child's age can be helpful.
One that I have found particularly good is:
A more recent book is also good:
Finally, I would encourage parents to realize that like all children, bereaved siblings are very resilient. With the nurturance and love of their parents to comfort them, help them learn, include them, and make them feel special, children can thrive even in the face of loss and grief.
How Parents Can Support Teens Who are Grieving the Loss of Their Sibling
Supporting grieving teens can be very challenging for parents (who are grieving as well) - but teens are open to new ideas and experiences; grief may trigger opportunities for growth, especially if parents consider some of the special characteristics of teens.
Typically, teenagers are trying to "figure out who they are." That is, teens are preoccupied with two strong drivers: fitting in and searching for their own identity. These years are often a time of confusion, raging hormones and mixed emotions, as teens strive to find their own way in the world. The stress of grief adds even more to the stress of “teenhood.” Depending on their ages, teenagers will express their grief differently.
Younger teens (ages 12-14) are most concerned with fitting in; they do not want to differ from their peers in any way. They may feel embarrassed to express their grief. To avoid this discomfort, they may ignore their grief or work very hard to hide it. Thus, parents should listen to the teen and watch his or her behavior to determine their level of comfort or discomfort. Do not press the teen to talk until he or she is ready. But be attentive and listen when your teen chooses to talk about his or her feelings. Keep in mind that kids of this age sometimes have a very difficult time understanding another person's reaction to loss if it is not the same as theirs, so try to listen to their point of view.
Teens in the middle teen years (ages 14-16) believe they are all-powerful and immune to danger; they often feel invulnerable to risk or having bad things happen to them. They cannot imagine their own death, thinking that they will live forever. The death of a sibling then comes as a great shock and they may interpret death as "unfair." They may feel angry and irritable. If parents acknowledge these feelings and admit to sometimes having similar feelings, this may help open the door to your teen’s own expression. Feeling that they are invulnerable to danger, teens may also subject themselves to unhealthy risks, so watch for an increase in such behaviors, and reach out to local school or community support professionals for help.
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During the late teen years (ages 16 to 18), adolescents are searching for meaningful relationships. They are better able to understand complex relationships and are more interested in another person's point of view. They have a better understanding of others' thoughts and feelings. Teens of this age grieve much as adults do. Providing older teens with an outlet to express themselves, whether with parents or other close adults or support professionals, can be very helpful in the grieving process.
On the whole, teens expect to be involved in family decisions. At the same time, however, they have their own ideas and may be breaking away from parents' beliefs and rejecting family rituals. It helps if parents remember that teens' closeness to the family flows and ebbs - they want to participate in family grief and mourning but they also need their own space. They need their family near so they can push them away! They are often uncomfortable in talking about their feelings with adults; they worry that adults will try to give them answers and not listen to how they feel. And, often, out of an attempt to protect their parents from further sadness and distress, teens avoid talking with their parents. Peer groups are central to teens and often serve as helpful sounding boards, so parents should be supportive of teens spending time with their friends.
Most importantly, when your teen wants to talk, take the time to listen and give him or her your undivided attention. This will let the teen know that he or she is important, and that grieving is natural, and important. Also, there are excellent grief comfort organizations and resources, including therapists who can help your teens (and anyone in your family) cope with and through their grief. Please reach out to your local hospital support social work team, your teen’s school, or call SuperSibs! for resources that can best help your family.
Teens, like all grieving siblings, want to know that they are loved and supported simply for being themselves.
Betty Davies, RN, PhD, FAAN
Professor & SuperSibs! Advisory Board Member
Department of Family Health Care Nursing,
N411Y
University of California San Francisco School of Nursing
2 Koret Way
San Francisco, CA 94143-0606
Phone 415-476-4433
Fax 415-753-2161
Email mailto:betty.davies@nursing.ucsf.edu