Children of different ages have varied understandings of death. The concept of death consists of three main components: irreversibility, nonfunctionality and universality. Children have to grasp each idea before they can fully comprehend the notion of death. The majority of children understand all three components by age 7.
Irreversibility means that a dead person cannot become alive again. This perception is distinct from religious or spiritual ideas of an afterlife or of a soul continuing to survive. Nonfunctionality means that all life functions stop with death. Universality refers to the inevitability of death for all living creatures.
Before young children accept the irreversibility of death, they often view death as reversible. They express the belief that medical intervention, eating, magic, praying or wishful thinking can bring people back to life. In their minds, death is like sleep or sickness, from which one can awaken or recover. In the stage before they acknowledge the nonfunctionality of death, many young children think that dead people can feel or breathe. They recognize that the dead lack some functional capacities but think they retain other functions. Prior to understanding the universality of death, young children believe that special classes of people are exempt from death, or that they can take actions to prevent death. They appear to believe that others will die before they accept that they themselves will die.
Parents and caregivers of children who have experienced a family death can take steps to help the children cope. At each stage, children react differently to death, and different methods of support are called for.
From newborn to age 3, children cannot understand death. However, they can sense that someone important is missing and are aware of emotions such as sadness or anxiety within the home. Babies absorb the emotions of others around them. They may respond with signs of irritability, as well as changes in eating, crying and elimination. Caregivers should provide verbal and physical affection and reassurance and maintain everyday routines and structure.
Preschool-aged children, from ages 3 to 6, think death is reversible or temporary. They think the dead person has gone to the store or to work and will soon return. Magical thinking is common at this age, and preschool-aged children might think their words, actions or thoughts have caused the death or can bring back the dead. They are emotional creatures who are affected by a parent's emotional state and act out feelings that they have trouble verbalizing.
Preschoolers who have lost loved ones might display regressive behaviors such as bed-wetting and thumb-sucking. They might have increased aggression in their play, or they might simply escape into play. They can have somatic symptoms, complaining of stomachaches and headaches. Asking the same questions repeatedly is a common method of trying to comprehend the loss.
To help preschoolers cope with death, parents and caregivers should maintain normal routines, while helping the child identify and verbalize feelings. They should explain the death in concrete terms without using euphemisms, making sure that the child does not feel responsible for the death. As much as possible, a parent should model healthy coping behaviors.
From ages 6 to 9, children understand the finality of death but often fear that death is contagious, worrying that other loved ones will die too. They ask concrete questions but have difficulty expressing feelings in a verbal manner. They might feel guilty, blaming themselves for the death. They can react with increased aggression, somatic symptoms and school phobia. Children at this age need verbal support. Talk with them, ask questions, and help them develop positive memories of the deceased. Avoid clichés and euphemisms, and make sure they do not feel guilty or responsible for the death.
At ages 9 to 13, a child's understanding of death is more mature. They are concerned about how they will be affected by the loss in their daily life. They will ask fewer questions but will also be more reluctant to express their feelings. Results might be poor peer relationships, increased anger and guilt, somatic symptoms and self-consciousness about their fears. Parents can help children of this age group by encouraging discussion and artistic expression of their experiences.
At any age, children who have experienced the death of a loved one are likely to be plagued by fears and worries. A listening ear and calm support can diminish fears and allow the healing process to begin.