Even though this information is directed mainly toward adults who are helping children who have lost a parent, it can also apply to the loss of any adult who was an important part of the child's life.

Grief can look different in a child

Children of all ages go through grief, sadness, and despair after the loss of a parent to cancer even though the process might look different from that in adults Children often will feel sad or show other emotions for a short time, then go back to their usual activities or go play with friends. Adults might mistakenly think that the child has already gotten over it, or that the child doesn't fully understand the loss. But children grieve in their own ways, often showing emotion for awhile then going back to more everyday things. This can go on for a long time.

If the parent had a long and difficult battle with cancer, sometimes the child may seem less anxious after the death than before. It is hard having a very sick parent, and the child may be able to settle into a quieter routine while handling their grief. But caregivers need to keep checking in with the child to listen to concerns and find out if the child has questions. This can be a challenge at times, since children often respond in ways that may seem to be unconcerned, callous, or indifferent. It helps to remember that children feel the pain of loss, but are not able to express it the same way that adults do. It can take a long time to adapt to the loss of a parent.

Sometimes emotional symptoms can become more severe and interfere with the child's or the family's life. About 1 in 5 children have serious emotional symptoms a year or more after the parent's death. And one study suggested that some children have a delayed response to the death, and have an increase in emotional problems 2 years after the death. How long this period of adjustment might last after the loss of a parent is uncertain, and it varies from child to child.

Helping a child adapt after a parent's death

The surviving parent or caregiver is a key part of helping a child adapt to the death of a parent. Studies have shown that the quality of the relationship with the child and how well they are able to parent are the best predictors of how well the child adapts. Things to do that might help a child include:

• keep an open channel of communication with the child
• continue to talk about and share information about the parent's life and death with the child
• as the caregiver, try to remain emotionally healthy--if you need extra help, get it
• work to be a loving family that sticks together and supports one another

As the child matures, their understanding of what happened to their parent may change. They may have more questions, or ask questions that you've answered before. Keep answering the questions honestly, and check to find out how much the child understands. They may need more support from you to correct misperceptions from their younger years, and integrate this extra information at their new level of understanding.

Some pointers about dealing with children just before and right after the parent's death are given in Helping Children When a Family Member Has Cancer: Dealing with a Parent's Terminal Illness. It includes information on how children of different ages cope and how to help them.

Signs that a child may need extra help after a parent's death

Depression and complicated grief in children can look different from an adult's. For instance, a common sign of depression in a child is a change in behavior, like sudden changes in grades at school, withdrawal, or losing friends. Some children seem more angry and irritable than depressed.

Complicated grief is different from the usual grieving process. It is marked by how long it lasts, how much it interferes with the child's life, or by how severe it is. Sometimes, a child will seem to be "stuck" in the process of grieving. Grief reactions or mourning processes like this are not only unusual, but are also unhealthy. If it is severe and lingers, the child might need therapy to help them get through the grieving process.

These problems can show up months or even years after the parent's death. If a child seems to be having trouble, it may mean a more serious problem than the usual grief response to losing a parent. Extra help is needed if a child:

• is unable to handle the feelings of sadness
• feels sad all the time
• cannot be comforted
• admits to thinking of suicide
• feels extra irritable
• becomes very angry very quickly
• has changing grades
• withdraws or isolates himself or herself
• acts very different from usual
• has appetite changes
• has low energy
• shows less interest in activities
• has trouble concentrating
• cries a lot
• has trouble sleeping

When a child shows 1 or 2 of these symptoms, it may help to offer more support. But if the usual ways of handling these problems are not working, or if the problem goes on for more than 1 or 2 weeks, the child may need special help. (For more serious problems, such as if the child is thinking about hurting himself or herself, urgent help is needed.) It may be useful to talk with the child's pediatrician, school counselor, or with the social worker or counseling staff at the hospital where the parent was treated. Since these experts know how other children have responded to similar situations, they may be able to offer ways to help with the problem. They can evaluate the child and make sure that any needed help is given. They may also be able to suggest books, videos, and children's support groups that may help. Rarely, a child may need to see a psychiatrist for medicines or counseling.

How do I find out more?

This short introduction is offered mainly to get you started looking into deeper and ongoing resources to help a child who has lost a parent. We have included a list of books and other resources that you can use to help your child.

As the surviving parent, you have also had a major loss with this death. You may want to learn more to better cope with your own grief as well. Remember that children cope better when their caregiver is emotionally healthy, so don't hesitate to ask for help for yourself if you think you need it. For more information on dealing with adult grief, see Coping with the Loss of a Loved One. Some of the resources below also deal with adult grief. If you need information for families who have lost a child, please contact us for Resources for Those Who Have Lost a Child..

Additional resources

The following list of books, Web sites, and organizations may provide useful information for people who are going through a loss or discussing death with children.

National organizations and Web sites*

Along with the American Cancer Society, other sources of information and support include:

GriefNet (online groups for grief support, with a subsite for children only)
Rivendell Resources, Inc.
Telephone: 734-761-1960
Web site for adults: www.griefnet.org
Web site for children: http://kidsaid.com

The Centering Corporation (information and resources for children who have lost parents, adult grief, and more)
Toll-free number: 1-866-218-0101
Web site: www.centering.org

Kids Connected (for children and teens who have a parent with cancer and for those who have lost a parent to cancer)
Toll-free number: 1-800-899-2866
Web site: www.kidskonnected.org

The Dougy Center (information on grieving, and referrals to programs across the country and internationally that serve grieving children, teens and their families)
Toll-free number: 1-866-775-5683
Web site: www.dougy.org

Books for Adults*

Bereaved Children and Teens: A Support Guide for Parents and Professionals by Earl A. Grollman. Published by Beacon Press, 1996.

The Bereaved Parent by Harriet Sarnoff Schiff. Published by Penguin, 1977.

The Bereaved Parents' Survival Guide by Juliet Cassuto Rothman. Published by Continuum International Publishing Group, 1997.

Beyond the Innocence of Childhood: Helping Children and Adolescents Cope With Death and Bereavement. (Professional Practices in Adult Education and Human Resource) by David W. Adams and Eleanor J. Deveau. Published by Baywood Publishing Company, 1995.

The Child and Family Facing Life-Threatening Illness: A Tribute to Eugenia Waechter by Tamar Krulik, Bonnie Holaday, and Ida S. Martinson. Published by Lippincott Williams & Wilkins, 1987.

Children's Conceptions of Death by Richard Lonetto. Published by Springer, 1980.

Children and Grief: When a Parent Dies by William J. Worden. Published by Guilford Press, 1996.

Explaining Death to Children by Earl Grollman. Published by Beacon Press,1987.

Gili’s Book: A Journey Into Bereavement for Parents and Counselors by Henya Kagan Klein. Published by Teachers College Press, 1998.

Grieving: How to Go on Living When Someone You Love Dies by Theresa A. Rando. Published by Lexington Books: 1995.

Guiding Your Child Through Grief by James P. and Mary Ann Emswiler. Published by Bantam, 2000.

Helping Children Cope with Death by Donna L. Schuurman. Published by the Dougy Center, 1997. Also available in Spanish.

Helping Children Cope With the Loss of a Loved One: A Guide for Grownups by William C. Kroen and Pamela Espeland. Published by Free Spirit Publishing, 1996.

Healing Children's Grief: Surviving a Parent’s Death From Cancer by Grace Christ. Published by Oxford University Press, 2000.

Helping Children Cope With the Death of a Parent: A Guide for the First Year by Paddy Greenwall Lewis and Jessica G. Lippman. Published by Praeger Publishers, 2004.

Helping Teens Cope with Death, published by the Dougy Center, 1999.

It's Okay to Cry: A Parent's Guide to Helping Children Through the Losses of Life (Workbook) by Norman Wright. Published by Waterbrook Press, 2004.

Never the Same: Coming to Terms With the Death of a Parent by Donna Schuuman. Published by St. Martin's Press, 2003.

On Children and Death by Elisabeth Kubler-Ross. Published by Touchstone, 1997.

Relative Grief: Parents And Children, Sisters And Brothers, Husbands, Wives And Partners, Grandparents And Grandchildren talk about their experience of death and grief by Dorothy Rowe, Judy Merry, and Clare Jenkins. Published by Jessica Kingsley Publishers, 2005.

Talking with Children About Loss: Words, Strategies, and Wisdom To Help Children Cope With Death, Divorce, and Other Difficult Times by Maria Trozzie. Published by Childhood Education, 2000.

Children and Grief: When a Parent Dies by William J. Worden. Published by Guilford Press, 1996

35 Ways to Help a Grieving Child, by the Dougy Center Staff. Published by The Dougy Center, 1999.

Understanding Children's Experiences of Parental Bereavement by Jessica John Holland. Published by Kingsley Publishers, 2001.

What About the Kids? Understanding Their Needs in Funeral Planning and Services by The Dougy Center for Grieving Children. Published by the Dougy Center, 1999.

When a Parent Has Cancer: A Guide to Caring for Your Children by Wendy S. Harpham. Published by HarperCollins, 2004.

When Children Grieve: For Adults to Help Children Deal With Death, Divorce, Pet Loss, Moving, and Other Losses by John W James, Russell Friedman, and Dr. Leslie Landon Matthews. Published by HarperCollins Publishers, 2001.

Books for children*

A Candle for Grandpa: A Guide to the Jewish Funeral for Children and Parents by David Techner, Judith Hirt-Manheimer, and Joel Iskowitz. Published by Urg Press, 1993. Ages 4 to 8.

A Child's Book About Burial and Cremation by Earl Grollman. Published by the Centering Corporation, 2001.

A Child's Book About Death by Earl Grollman. Published by the Centering Corporation. 2001. Ages 6 and up.

A Pillow for My Mom by Clarissa Sgourous and Christine Ross. Published by Houghton Mifflin/Walter Lorraine Books, 1998. Ages 5 to 9.

A Quilt for Elizabeth by Bennette W Tiffault. Published by Centering Corporation, 1992. Ages 6 to 11.

After Charlotte's Mom Died by Cornelia Spelman and Judith Friedman. Published by Albert Whitman & Co., 1996. Ages 5 to 7.

After the Funeral by Jane Loretta Winsch. Published by Paulist Press, 1995. Ages 4 to 8.

Always and Forever by Alan Durant and Debi Gliori. Published by Harcourt Children’s Books, 2004. Preschool to Grade 3.

Anna's Corn by Barbara Santucci and Lloyd Bloom. Published by Eerdmans Books for Young Readers, 2002. Ages 4 to 8.

Barklay and Eve: Sitting Shiva by Karen L Carney. Published by Dragonfly Publishing, 1997. Ages 4 to 8.

Bluebird Summer by Deborah Hopkinson and Bethanne Andersen. Published by Greenwillow, 2001. Ages 4 to 8.

Don't Despair on Thursdays!: The Children’s Grief-Management Book (The Emotional Impact Series) by Adolph Moser and David Melton. Published by Landmark Editions, 1996.

Dusty Was My Friend: Coming to Terms With Loss by Andrea Fleck Clardy. Published by Human Sciences Press, 1985. Baby-preschool.

Facing change: Coming Together & Falling Apart in the Teen Years. Compassion Press, 2004. Best for teens.

Fire in My Heart: Ice in My Veins by Enid Samuel-Traisman. Published by Centering Corporation, 2003. Best for teens.

Goodbye Mousie by Robie H. Harris and Jan Omerod. Published by Margaret K. McElderry, 2001. Preschool to Grade 2.

Grandma's Purple Flowers by Adjoa J. Burrowes. Published by Lee & Low Books, 2000. Ages 4 to 8.

Grandma's Scrapbook by Josephine Nobisso and Maureen Hyde. Published by Gingerbread House, 2000 (Revised edition). Ages 4 to 8.

Grandpa Loved by Josephine Nobisso and Maureen Hyde. Published by Gingerbread House, 2000 (Revised edition).

Help Me Say Goodbye: Activities for Helping Kids Cope When a Special Person Dies by Janis Silverman. Published by Fairview Press, 1999.

How It Feels When a Parent Dies by Jill Krementz. Published by Knopf, 1988. Ages 7 to 17.

I Know I Made It Happen by Lynn Bennett Blackburn. 2003. Published by Centering Corporation. Best for ages 6 to 12.

I Miss You: A First Look At Death by Pat Thomas and Lesley Harker. Published by Barron’s Educational Series, 2001.

Lifetimes: The Beautiful Way To Explain Death To Children by Bryan Mellonie and Robert Ingpen. Published by Bantam, 1983. Ages 6 to 11.

My Grieving Journey Book by Donna Shavatt and Eve Shavatt. Published by Paulist Press, 2002. Ages 4 to 8.

Sad Isn’t Bad: A Good-Grief Guidebook for Kids Dealing With Loss (Elf-Help Books for Kids) by Michaelene Mundy and R. W. Alley. Published by Abbey Press, 1998.

Tear Soup by Pat Schweibert and Chuck DeKlyen. Published by Grief Watch, 2nd Revised Edition, 2001.

The Dying and Bereaved Teenager edited by John D. Morgan. Published by the Charles Press Publishers, 1990. Ages 12 and up.

The Empty Window by Eve Bunting. Published by Frederick Warne, 1980. Ages 7 and up.

The Fall of Freddie the Leaf: A Story of Life for All Ages by Leo Buscaglia. Published by Henry Holt & Co, 1982. Ages 4 to 8.

The Saddest Time (An Albert Whitman Prairie Book) by Norma Simon and Jacqueline Rogers. Published by Albert Whitman & Company, reprinted 1992. Ages 4 to 8.

The Tenth Good Thing About Barnie by Judith Viorst. Published by MacMillan Publishing, 1987. Ages 5 and up.

Thumpy's Story: A Story of Love & Grief Shared by Thumpy the Bunny by Nancy C. Dodge. Published by Prairie Lark Press, 1985. Ages 6 and up.

Transitions Along the Way: A Guide to the Dying Process for Children and Young Adults by Stephanie Jonah. Published by Visions, 1999. Ages 9 to 12.

When Bad Things Happen: A guide to Help Kids Cope (Elf-Help Books for Kids) by Ted O’Neal and Robert W. Alley. Published by On-Caring Place, 2003.

When Dinosaurs Die: A Guide to Understanding Death by Laurie Krasny Brown. Published by Little, Brown, and Company, 1996. Ages 4 to 8.

When a Grandparent Dies: A Kid’s Own Remembering Workbook for Dealing with Shiva and the Year Beyond by Nechama Liss-Levenson and Karen Savary. Published by Jewish Lights Publishing, 1995. Ages 4 to 8.

When Your Grandparent Dies: A Child’s Guide to Good Grief (Elf-Help Books for Kids) by Victoria Ryan and Robert W. Alley. Published by Abbey Press, 2002. Ages 4 to 8.

*Inclusion on this list does not imply endorsement by the American Cancer Society

References

Christ GH, Christ AE. Current approaches to helping children cope with a parent's terminal illness. CA Cancer J Clin. 2006 Jul-Aug;56(4):197-212. Full text available at: http://caonline.amcancersoc.org/cgi/content/full/56/4/197

Harpham WS. When a Parent Has Cancer: A guide to caring for your children. New York: HarperCollins 2004.

National Cancer Institute. Pediatric supportive care (PDQ^®). Accessed at www.cancer.gov/cancertopics/pdq/supportivecare/pediatric/HealthProfessional on April 2, 2009.

National Cancer Institute: When Someone In Your Family Has Cancer. Accessed at: www.cancer.gov/cancertopics/when-someone-in-your-family/page1 on April 2, 2009.

Welch AS, Wadsworth ME, Compas BE. Adjustment of children and adolescents to parental cancer. Parents' and children's perspectives. Cancer. 1996 Apr 1;77(7):1409-1418.

Last Medical Review: 05/26/2009
Last Revised: 05/26/2009