Category Archives: Grief

Supporting Children When a Loved One Dies

Hey fam,

Give yourself some kudos for delving into this difficult conversation about end of life (EOL). I first would like to start with a reflection**. Think of a time in your youth when someone you knew and loved died. Ask yourself the following questions:

  • How did you find out? How did adults communicate with you about their death?
  • If it was a death from illness/injury, were you prepared ahead of time?
  • How were you included in the events and rituals around the death?

I invite you to come back to these questions if ever in doubt about how to approach this. The death of a loved one is hard enough, but considering how to navigate that with a child may seem daunting and insurmountable. Adults concerned about having end of life (EOL) conversations with children argue that it may traumatize the child or affect their ability to cope. On the contrary, open, consistent communication and planning around a loved one’s death helps to promote meaningful engagement, strengthen relationships, establish a sense of safety, build trust, and equip children with the emotional regulation tools that they need to cope with life’s challenges. This conversation calls for us to be brave and reckon with our own coping around death.

The Talk

So, where do you even begin? It’s important to tap into how you’re feeling. Center yourself with some deep breaths, debrief with a trusted support person, and get all the accurate information that is available to you in order to have this conversation. Create the conditions for a safe and supportive conversation. Choose a place that is familiar, comfortable, and private. It’s okay to have 1-2 other trusted adults there, especially if they are in a caregiving role to the child(ren). If there are multiple children, it’s a good idea to share the news with them all together, especially if they are close enough in age/developmental level. If there is a vast difference in age (toddler/teen), then it would be okay to separate the children by developmental stages so that you can break down the information in developmentally appropriate language. I’ll give some examples in a bit.

Our role as adults is to model behavior for the children in our lives. So it is absolutely okay to be sad, openly cry, and take breaks during this talk.

  • You can start the conversation by letting your child know that you have something sad and difficult to share.
  • Reassure them that they are not in trouble, that they are safe, and that the adult(s) in the room will be available to care for them and comfort them through this process.
  • Start with what they may already know about the illness or circumstances of injury/death. Children know a lot more than adults give them credit for.
  • As you explain further, it’s important to be clear and direct.
    • With young children especially, avoid coded language and euphemisms. Use the words “died” and “dying” as opposed to some popular phrases like “we lost Grandpa”, “they’re in a better place”, “Aunt Sheila left us”. Young children are quite literal in their comprehension of language. So imagine if they hear these coded phrases and think, “Well if Grandpa is lost, let’s go find him.”, “What’s a better place for mommy than being here with our family?”, or “What did we do to make Aunt Sheila leave?”.
    • Be direct in stating the actual illness, e.g. “She has cancer”, “His brain was hurt in a car accident” instead of just “They were sick and died”. Young children don’t do well with vague and metaphoric language.
    • Young children may need you to define in simple terms what it means to die. For example:
      • “When someone dies, their body stops working. The person no longer talks, walks, breathes, or eats. After someone dies, we don’t get to see them face to face anymore. We can still look at pictures of them, talk about them, and always remember them in our hearts.”
      • Cultural and religious explanations may add an extra layer of comfort to this conversation.
  • Emphasize ways that they can foster continued bonds with the loved one, during the dying process and after their death.
    • Some ways that they can engage meaningfully with their loved one and make memories; Record the love one’s voice, take videos of the child and loved one together, handprint/fingerprint crafts, letters, and a memory box
  • Leave time and room for emotions, questions, and reassurances
    • Children may not emote right away and need time to process the info. You may witness a wide range of emotions. They may seem unfazed, numb, fearful of another loved one dying, distracted, distraught, etc. Just continue to validate and normalize their emotions.
    • Children have this remarkable ability to pick up their grief, and then put it right back down until they’re ready to face it again. Their grieving process is not as continuous as it is for adults. Also, people often underestimate the grieving process of children who are on the spectrum, neurodivergent, or have cognitive delays. They absolutely grieve in their own way and I’ve included some resources on how to support them.
    • Encourage an open-door policy where they can come back to you to revisit the conversation and ask questions as you all move forward.

Choices

Consider giving the child a choice in HOW they want to engage after they’ve been informed about a loved one’s end of life. Some children may want to visit with the loved one as they are dying, some children may not. Some children may want to attend the funeral service and burial, others may not. Helping children to make informed choices during this time can help to bolster their sense of autonomy at a time when so many things are beyond their control. Also, children may be less likely to experience regrets and resentment when they are invited to make choices about their own participation in a loved one’s end of life, as opposed to when adults have made decisions for them without seeking their input. Giving the child a choice will impact how they reflect on their relationship with grief for years to come.

Community

It’ll be helpful to discuss with the child any potential changes in their daily routine, how the family will navigate around the dying process, and what to expect after the death. Help them identify support people within their community (school staff, spiritual leaders, coaches, neighbors). Speak to their school’s counselor about providing extra support in school. Seek the support of a professional experienced with end of life.

Part of my role as an end of life doula/consultant is to help families facilitate these difficult conversations, prepare for the death of a loved one, help them with planning and making funeral arrangements, linking families to community resources that can help with reduced funeral costs, and educate folks on how to financially and legally protect their families after their death. I’m especially passionate about helping families who have the unfortunate circumstance of navigating the death of a child. Please feel free to schedule a consultation if you’d like to learn more, or if you’d like to refer me to someone who is in need of these services.

Check out the links below for some additional book and video resources to help support children through grief. Should I do a Part 2 about how to help children cope after the death of a loved one? As always, I love hearing from you and am looking forward to the conversations that this will inspire.

 

Warmly,

Doula Jo

Resources:

Sesame Street Grief Videos

Children with Special Needs Grieve

Book: The Invisible String

Book: When Dinosaurs Die

Teen Grief Toolkit

Children’s Grief Support

**Information adapted from a presentation I co-created with Certified Child Life Specialist Polly Hurlburt, M.Ed, CCLS

Disenfranchised Grief Part 3

Hey Fam,

Welcome back to the final installment of our disenfranchised grief series. In my previous two newsletters, I talked about a few examples of ambiguous loss and how isolating it can be to experience grief in a silo. I also talked about what informs our expectations of grief, how long we allow ourselves to grieve, and validating all kinds of loss. So, as you navigate a loss that is not often acknowledged by your community, it’s important to ask yourself, what is the story of grief that you know? What have you been told what it’s supposed to look like? What are the words that come to you? I think we don’t even realize how often we are carrying these external stories of grief. First step in working through disenfranchised grief is acknowledging the feelings and affirming that they are true and deserving of you expressing them fully and authentically. You have the power to decide what you want your grief to look like and what coping strategies help you move through it.

  • Loss of Support– support from significant figures/changes in relationships/friendships, etc.; this type of loss can show up at any point in the family planning journey, from fertility treatments to postpartum. The nature of friendships change, partners separate, family conflict happens. The grief of losing a relationship or a changed relationship in your life during one of the most important times in your life is a valid and heartbreaking loss. Allow yourself the grace and time to honor that feeling.
  • Adoption– Adoption is a beautiful, joyous gift, and it is important to discuss the ways in which grief & loss show up for all involved. One aspect of ambiguous loss is when something or someone is lost physically but still remains ever-present psychologically. So for example, birth parents experience this when they place their baby for adoption, are physically separated from them, and yet the memory of their existence and the experience of birthing them remains. Many people don’t understand that even though some birth parents choose adoption and are confident in that choice, there is still loss involved. Adoptees also experience something similar. Even if placed with the most loving of families, some wonder what life could have been like with their birth family, the psychological presence of their birth parent(s) remain. They experience loss of not knowing pertinent genetic or medical information and there can also be secondary loss of identity when adopted into families of a different culture, race, ethnicity. For adoptive parents, some choose to adopt because they have experienced the heartbreaking journey of infertility, which comes with its many layers of grief and loss. However after adopting, that loss is not often recognized or validated because of the benefits gained from adoption. Joy and pain can co-exist.
  • Traumatic Birth– While people acknowledge how difficult coping from a traumatic birthing experience is, most don’t often recognize that there is a real grief and mourning that occurs following such an experience. One is left with grieving the loss of autonomy and grieving the expectation of a certain labor outcome. Having a traumatic birthing experience comes with very nuanced layers of grief, guilt, shame, anxiety, fear, regret. Folks feel pressured or put pressure on themselves to put a time limit on their grieving period. I want to also acknowledge traumatic births that result in partial or full hysterectomies. The unexpected loss of reproductive organs is something that feels taboo to discuss and seek support for. There are many skilled psychotherapists who specialize in pregnancy related traumas and I encourage you to seek their supportive services. Don’t know where to start? Ask your PCP/OBGYN for recommendations.
  • Returning to work– grieving the loss of family bonding time, time spent with your baby, flexible schedule, and a routine that you worked really hard to create. Take things slow as you reintegrate back to work, create a transition plan with your employer/colleagues, and give yourself the grace to feel the myriad of emotions that come up for you, most importantly I encourage you to talk about it with trusted and supportive people in your life.

This is by no means a complete list of the ways that disenfranchised grief and ambiguous loss show up in the family planning journey. There is so much more to discuss, but hopefully after sharing this information, you can continue those conversations. Acknowledge the loss, validate the grief, give yourself time and permission, and seek support. Wishing you all a beautiful end to Pride Month and Black Music Appreciation Month.

With Love & Gratitude,

Doula Jo

For more information about the lived experiences of adoptees, check out Denise Defoe, LMSW and her book They Chose Me: An Adoption Story, Saara McEachnie’s article on Legacy and Adoption, and resources offered by The Barker Adoption Foundation.

Disenfranchised Grief Part 2

Hey Fam!

This is the second installment of our Disenfranchised Grief series, so let’s do a recap. I talked about how grief shows up when parents mourn their ease of pre-parenthood lifestyle, grief after a first trimester pregnancy loss, and the ambiguous loss experienced by the non gestational parent. Disenfranchised grief is so hard to recognize and validate, partly because we don’t allow ourselves to fully grieve major losses. We carry stories of what grief looks like, sometimes based on the grief that we’ve already experienced. If we have never been through grief, we base our perception on movies we’ve seen, books we’ve read, or from witnessing someone else going through grief.

We internalize so many messages from our culture about how long we are allowed to grieve. Think of the 2-5 day bereavement policies in our workplaces, which is in itself a message on how long we get to grieve. And even with those policies there are stipulations on what a legitimate loss is. Any loss other than the death of an immediate family member doesn’t qualify most of us for bereavement leave. And that is not realistic for most of us. So there are these implicit and explicit things that inform a story of what grief should look like. Below are a few more examples of how disenfranchised grief and ambiguous loss show up in the family planning journey.

  • Complications after birth– anything that causes one to be separated from baby and family: NICU stay, postpartum pre-eclampsia, postpartum hemorrhage, even difficulty with breastfeeding. That ambiguous loss of time, grieving the bonding experience, the expectations of returning home, and the expectations of the ease in feeding your baby.
  • Abortion– I want to acknowledge that terminating a pregnancy may bring relief, safety, and opportunity for some. However, there are folks who grieve the conscious decision to terminate a pregnancy, for many reasons. Because of the polarized and politicized conversations about abortion, many do not feel free to express their grief. There are few spaces where people can go to seek support for their grief after a pregnancy termination. Full spectrum doulas are an excellent source of support and can help to link you to resources in your community. Your medical provider may also have recommendations.
  • Difficult Pregnancy– celebrities make pregnancy look easy don’t they? This is, of course, not everyone’s experience. Some people just don’t enjoy their pregnancy. As a pregnant person, it is stigmatized to express regret or disdain for your pregnancy experience. Whether it’s hyperemesis gravidarum, persistent and debilitating swelling and joint pain, frequent monitoring and tests, feeling disconnected from one’s body, it’s okay to grieve the experience that you wanted or thought you’d have.
  • Gender Disappointment & Disability Diagnosis- I wasn’t sure about including these two experiences of disenfranchised grief because while one’s feelings are valid, these instances of grief and loss are rooted in ableism, sexism, and the chokehold that gender constructs have on us. I think talking about it provides us the opportunity to assess what we value as a society and why. And if you’re thinking “Pfffff eye roll!”, that’s exactly why I included it under disenfranchised grief. Now, when I talk about a disability diagnosis, I’m not talking about a life limiting or terminal diagnosis. I’m talking about a chronic condition that may affect the baby’s care, appearance, functioning, and quality of life. There’s an emotional suffering that happens when some parents learn that their baby has a disability. They feel grief for themselves, the loss of the parenting journey they expected, grief for their child, for their siblings, because of how hard life will be in this ableist and unaccommodating society. There’s not really a safe space to have these discussions and process these feelings. Some people have a deep expectation for their baby’s biological sex and go through a grieving period, thinking of all the future losses when they find out their baby’s sex is not what they wanted. The pressure we put on ourselves and our children based on their sex and gender expression is something to further investigate, and processing those feelings may help to release the deep sadness associated with the loss.

Our last newsletter in this series comes out in two weeks! And as always, I love hearing your feedback. I’m so glad that this resonates for so many of you.

With love,

Doula Jo

Disenfranchised Grief

Hey fam!

I want to talk with you about disenfranchised grief. Many of you know, as a doula AND hospice social worker, I work with families who welcome new life into this world as well as families who are preparing to say to goodbye to their loved ones. What a gift this work has been. I’m in the unique position to witness some common threads in the areas of birth and death. Grief and loss show up in many ways. Joy and peace also show up in death work, but that’s another story that I’d love to share with you for another day.

What is grief? Grief is a natural response to loss. It can make you feel confused, forgetful, anxious, angry, profoundly sad, and scared. It can also have physical symptoms. Grief asks a lot of us; it can be beautiful and transformative and is a healthy part of our life cycle. We grieve throughout our lifetimes for many things.

Disenfranchised grief is the experience of loss that is not often recognized or validated by society at large. One feels isolated, shamed, and undeserving of grieving these kinds of losses. Below is a list of some of the most common ways disenfranchised grief shows up in the family planning, pregnancy, birth, and postpartum journey. Because there’s so much to say about this experience, I’m actually splitting this up into a three-part series. Would you like to submit a question? I’d be sure to answer it in the upcoming newsletters.

  • Exclusion of Non-gestational Parent– often times, the experiences of loss, grief, and postpartum adjustment for the non-gestational parent are invalidated, minimized, or ignored.
  • First Trimester Pregnancy Loss– because folks are advised to wait (typically 3 months) to share news of their pregnancy, if a loss happens before that time period, individuals and couples are left to grieve in silence. If others do know of the loss, it’s unclear how to proceed.
  • Loss of Support– support from significant figures/changes in relationships/friendships, etc.; this type of disenfranchised grief can show up at any point on the family planning journey, from fertility treatments to postpartum.
  • Difficult Pregnancy– celebrities make pregnancy look easy don’t they? This is, of course, not everyone’s experience. Some people just don’t enjoy their pregnancy. As a pregnant person, it is stigmatized to express regret or disdain for your pregnancy experience.
  • Traumatic Birth– While people acknowledge how difficult coping from a traumatic birthing experience is, most don’t often recognize that there is a real grief and mourning that occurs following such an experience. One is left with grieving the loss of autonomy and grieving the expectation of a certain labor outcome.
  • Ease of lifestyle– As a parent, it is absolutely ok to mourn the ease and freedom of your pre-parent life. You are human. There is a loss of identity, in trying to find and acclimate to a new identity.

Stay tuned as we continue this conversation on how to deal/cope with each of the disenfranchise grief mentioned above. I hope you feel seen. Feel free to share with others in your community.