Death of a Friend

Dear Lisa,

My 5 year old daughter has had a friend die. She did not know her very well, only has played with her a few times. They attended the same school but were in different classes. But, the school became quite involved having fundraising activities. Her teacher had the class make several crafts for her during her illness (inoperable brain tumor) and her Daisy Troop also has made things for her. They have had discussions in class that were general and have hospice and counselors on hand for them if needed.

Here is my question. If my daughter does not understand what happened (death), and is not showing any signs of sadness or grief, should I take her to the funeral? Many of the families in my situation are contemplating taking their children. I'm not sure and do not want to cause any unnecessary stress for her or the family that has suffered this terrible loss(seeing a child that may be smiling or laughing or seeking out a playmate at the funeral). Hospice says let your child take the lead, should I ask her if she wants to go? This has been tough, her first exposure to sickness and death. The family of this child has welcomed the community to the interment. I have read the book, What’s Heaven to my daughter and she does not really understand or seem phased. What are your thoughts?

Thank you,

“Sad Situation”

Dear “Sad Situation”,

I am sorry to hear about the loss in your life. Understanding and coping with the concept of death is very difficult for a family, especially when a young child is involved. Children at different ages deal with death differently. The way a child handles death depends upon their developmental stage, psychological development, previous experience with death, emotional maturity, coping abilities, environment, culture and parental attitudes.(1) The way that your daughter is responding to her friend’s death is quite normal.

In order to help a young child cope with death it is important to understand their thinking processes. Because of your daughter’s young age and developmental stage, she does not fully comprehend the meaning of death. This is especially true because she has had no previous experience with death in her life. Young children may use the word “die” or “death” in conversation but this does not mean that they truly understand what the word means.

Naturally a young child will handle death much differently than a teenager or an adult would. This is because specific patterns of behavior and understanding are expected at different ages. Developmentally speaking, a pre-school child, or a child between 3 and 6 years old, views the world from the perspective of their own experience. In other words, they see themselves as the "center" of the world. Young children interpret experiences depending upon how they relate to them directly. Young children can not relate to the feelings of others or to situations that occur to families outside of their “world”. Therefore it is normal for a young child not to display sympathy for others or not to seem phased by something bad that happens to someone else. A death occurring to a person outside of their immediate circle may not seem to affect them.

Children at a young age also cannot comprehend the finality of death. It is hard for them to believe that death is a “permanent” separation. Very often children view death as a temporary situation. Most young children believe that death is reversible.(2) This may be due to their exposure to death from the media through the shows that they watch on television.(1) While watching a cartoon a child sees a character die only to see them come right back to life again, usually unharmed. A child can watch a television show one day where a character dies and the next day the same character is on the television appearing very alive and healthy. This only confuses their perception of death and reinforces their belief that death is reversible.

Since your daughter’s friend was a casual acquaintance that only played with her a few times, her death probably will not directly affect your daughter's everyday life or seem to bother her. Most likely she will not need the funeral ceremony to help her cope with this young girl’s death. Since her friend was not a close family member, your daughter’s attendance at the funeral would not likely be a necessary step in her coping processes and understanding of death.

Ultimately it is a parent’s decision if a young child should attend a funeral. When making this decision it is important to know that children under seven years old and girls are particularly sensitive to funeral activities. (2) Therefore having your daughter attend the funeral may not be beneficial in this particular situation. If a parent decides that their child should go to a funeral, it is a good idea to discuss it with the child first. A young child needs preparation and an explanation of what to expect; what it will look like and how others will be acting.

If you ask a young child if she wants to go to a funeral, chances are she will not have the ability to make that decision because she doesn’t have any experience with death and never has been to a funeral. When you explain to a child that a funeral is not a place for playing with friends or make noise, but a place to be quiet, most children will not want to attend.

If a child does not attend a funeral it is still important that you answer any questions that she may have about the funeral and death. Young children experience magical thinking and it is often necessary to clarify any misconceptions that they may have. Young children tend to believe that their thoughts can control what happens to others.(1) Therefore, if a young child had a disagreement with a friend and wished bad thoughts for that friend and then their friend died, the child may believe that they caused the death. This is why it is important to talk to a child about their understanding of a death that occurs in their life.

Children also lack the reasoning power that adults have. They cannot make appropriate connections between events or the sequence of events.(1) Young children do not have the cognitive ability to think through the beginning, the middle and the end of a story. Instead, young children tend to connect events that do not belong together. As a result they commonly fill in the blanks with their imagination. Many times the images that they conjure up are scarier then the truth itself. For example, if your daughter was playing with dolls the last time she played with her friend, she may come to the conclusion that the dolls caused her friend to die. This is why it is better to tell a young child the truth about the circumstnces surrounding a death experienced in their life. Specific details are not necessary, but the proper order of events is.

It is wonderful that you read your daughter the book that you did. She may not have seemed to understand the concepts that you were trying to teach her but spending time with her reading this book let her know that you are there to love and support her. I suggest that you sit down and talk to your daughter about her feelings about her friend’s death. Let her know that it is okay to ask questions. Answer any questions that she may have very simply and at a level that she can understand.

It is likely that you will need more emotional support than she does at this time. Seeking comfort and counseling from support systems for yourself will help you cope with this tragic loss and in the end benefit your family as a whole.

I wish your family peace during this sad time.

References:
(1)Huntley T. Helping Children Grieve. When Someone They Love Dies. Minneapolis, MN: Augsburg Fortress. 1991:9-42.
(2) Betz C, Hunsberger M, Wright S. Family-Centered Nursing Care of Children. 2nd ed. Philadelphia, PA: W.B.Saunders Company. 1994:689-709.

Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Advice For Parents of Young Children