Bereavement Program

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The Bereavement Program at Boston Children’s Hospital provides support and guidance to bereaved parents and family members following the death of a child.

While grief is a normal response to loss, it can at times feel isolating and overwhelming.

The program, located within the Center for Families, provides the following services:

  • information about grief
  • seminars about what to expect when dealing with loss
  • support groups
  • memorial services and workshops
  • referral information

If you would like more information, please contact the Center for Families at 617-355-6279 or email bereavement.program@childrens.harvard.edu.

What is grief?

Grief is characterized by a deep sadness and an intense yearning to be with the person who has died. It’s a normal response to loss that follows a wave-like pattern, where the waves tend to lessen in frequency and intensity as time goes on.

Grief is a very individual process and there is no “right” or one way to grieve. No two people will grieve in the same way, even parents who are grieving the death of the same child.

If your child has recently died, you’re likely to experience strong emotions and physical reactions especially during the first few months, which at times might seem unbearable. Many of these emotions will come and go and change over time. You may feel desperately sad, overwhelmed or completely alone. Some parents also experience anger, guilt or regret and replay over and over, the events of their child’s last few days or weeks.

Common emotional and physical reactions

It is common to experience a number of different emotional and physical reactions soon after the death of your child. You may experience many of these reactions or just a few – everyone’s experience is different. Some reactions ease in the first few weeks, while others can linger for many months and even re-appear, in years to come.

Early on, parents often report that they feel as though they’re on "automatic pilot", where they are just going through the motions. You may not remember who called to express their condolences or stopped by to visit. You may be totally consumed by caring for other children - trying to keep their lives as normal as possible. You might feel numb or "on edge" and find that the days tend to blur into one.

Even though these feelings can be difficult to tolerate, they are all normal responses as you attempt to take in the reality of your child's death. It's important to tell yourself that eventually these reactions will lessen as time goes on.

Physical reactions

  • Crying/sobbing
  • Muscle tension
  • Panicky sensations
  • Fear
  • Restlessness
  • Agitation
  • Difficulty sleeping
  • Difficulty eating
  • Stomach upset

Emotional reactions

  • Intense sadness
  • Yearning
  • Disbelief
  • Despair
  • Worry
  • Anguish
  • Guilt
  • Remorse
  • Emptiness
  • Anger
  • Numbness
  • Relief

What to expect when grief is new?

One of the first questions that parents ask is: "How long will I feel this way?"

The answer to this question is that it depends. How you grieve and how long it takes are influenced by many factors including your personality, the way you deal with other challenges or difficulties in your life and the circumstances surrounding your child’s death.

Our society isn't very good at dealing with grief. We live in a fast-paced world with a "fix-it" mentality, and when a child dies, people often don’t know what to say or how best to support bereaved parents. This “not-knowing” can create a sense of awkwardness and distance.  Also, there's often an unrealistic expectation that the bereaved should "get back to normal" as quickly as possible.

Grief, however, is not that simple because there’s no quick “fix” and the “normal” as you knew it, no longer exists. When someone dies – especially a child, your life changes forever and the direction your life was heading, alters course.

If your child was sick for some time you may also miss your role as caregiver and the relationship you shared with the health professionals who were involved in his or her treatment.

When your grief is new, you may find yourself:

  • Crying easily
  • Yearning for your child
  • Feeling overwhelmed
  • Feeling out of control
  • Having difficulty concentrating
  • Feeling tired
  • Thinking you're going crazy
  • Feeling less tolerant of other people
  • Feeling anxious or panicky
  • Feeling alone and disconnected from others
  • Having difficulty making decisions
  • Having difficulty reading
  • Dreaming about your child
  • Having thoughts of dying to be with them again

The wave-like pattern of grief

It's helpful to think of grief as following a wave-like pattern, where the strength and frequency of the waves lessens over time. Occasionally, larger waves or "trigger waves," which are usually accompanied by strong emotions, can catch you off guard when you least expect them. These triggers can include anything from seeing a child who reminds you of your son or daughter or hearing a song on the radio. Other significant events such as birthdays and holidays can also produce an increase in emotion – even though you can anticipate and plan for them.

Knowing that your grief will follow a wave-like pattern may help you understand why you have good and bad days. If you expect your grief to follow this pattern, you won't be surprised or think that you are getting worse when you have a bad day or experience a difficult period.

What do grieving parents need?

Dealing with the death of a child can be a very lonely and isolating experience. Working out what you need to do to help yourself at this difficult time is crucial. Parents who are grieving need to be able to:

  • Tell their story  
  • Give themselves permission to grieve
  • Gain support within their community

Tell their story

Everyone has a different story to tell about how their child died and the impact that his or her death has had on their life. Being able to tell your story – whether verbally or through writing – can help you make sense of what has happened and how your life has changed. Seek opportunities where you can talk about your child, including: empathic friends, a grief counselor or by joining a support group.

Permission to grieve

One of the hardest things about grieving is that no one else can do it for you. There's no "off" switch or easy way around grief; it's something only you can do for yourself.

How much your life changes following the death of your child relates to the degree of adjustment that you have to make. You may have to return to work, or you may have to find ways to fill your days that had previously been consumed by care giving and medical appointments. If your only child died or your child died suddenly and unexpectedly, the more changes you are likely to have to make. So, it’s important to be patient with yourself and carve out the time you need.

Even though grieving can be particularly painful, it is in fact good, as it gives you the time to adjust to life without your child and the many changes that follow. Giving yourself permission to grieve doesn't mean "getting over" the death of your son or daughter, but rather it involves acknowledging to yourself that it's normal to feel sad and to express your concerns about your future.

In the beginning, the best advice is to takes things slowly. Set aside some regular time to grieve. Healthy grieving involves getting through all the firsts: holidays, significant dates, birthdays and the first anniversary of your child’s death. Planning for these dates ahead of time is important as it increases your sense of control over your grief.

Gain support within their community

Even though grief can be a lonely and isolating experience, it’s important to seek support including help from family and friends, spiritual or religious organizations, counseling, support groups (including online groups) and self-help books. Also, being able to share your experiences with other bereaved parents who have a sense of what you are going through can help you feel less alone. Check in with your doctor who might be able to refer you to local community groups and organizations.

If, however, you feel that you are becoming increasingly depressed or anxious and have thoughts of hurting yourself, seek help immediately from a doctor, grief counselor, social worker or psychologist.

Helpful strategies when grief is new

Staying healthy while grieving

The death of any loved one, especially a child, is an extremely stressful event that affects both your emotional and physical well-being. If you are physically healthy, you will have more resources to deal with your grief.

The following tips can help:

1. Maintain a simple routine

  • Try to go to bed and wake-up about the same time as you usually would
  • Eat at regular meal times, even if you don't feel like it
  • Plan to do a task or activity each day
  • Write a to-do list and aim to check off one or two things each day

2. Focus on your health and well-being

  • Walk wherever you can
  • Try to do something outdoors each day
  • Limit your alcohol intake
  • Eat fresh food
  • Practice good self-care – do something regularly that is nurturing
  • Make an appointment to see your doctor

3. Connect socially with others

  • Seek opportunities to be with others, especially those who are good listeners and who are supportive
  • Seek counseling if you feel overwhelmed or have little support

Set aside "grief time"

In the early months, it's important to carve out time to grieve where you can intentionally focus on your child. Even though you may not want to do this, scheduling grief time can help you feel more in control of your grief and less overwhelmed. One suggestion is to start with 20 or 30 minutes every few days when you won't be disturbed. Plan a time of day when you can be alone. If you have other children, maybe you can find time when they are at school.

The following tips may give you some ideas about what to do in your "grief time":

  • Sit quietly and think about your child
  • Talk to him or her
  • Allow yourself to cry
  • Write him or her a letter
  • Look through photos
  • Start a journal, a memory book or a photo book
  • Write their story
  • List any questions you have

Dealing with the “firsts”

There will be many firsts that you and your family will face in the year following the death of your child. Some of these you will be able to prepare for such as Mother’s and Father’s Day or your child’s birthday. Others may take you by surprise and catch you unaware. There will also be firsts in years to come such as the time when your child would have graduated from school or other significant events such as family weddings.

The firsts that come out of the blue are often harder to deal with because you can’t predict when they will occur. But it is helpful to remind yourself that both of these types of firsts are a normal part of grief.

The best way to deal with the known firsts is to make a plan, even if it is a plan to do nothing and stay home.

Think about the following questions ahead of time:

  • How do you want to acknowledge the date?
  • Whom do you want to spend it with?
  • Whom don’t you want to spend it with?
  • Do you want to create a new tradition to acknowledge this date?
  • Remind yourself that it is okay to feel sad and that your needs may be different from other family members.

Maintaining a connection with your child

The process of grieving gives you the time and space to think about how you will maintain a connection with your child that is now based on memory. It is a process that will evolve over time and most people find it helps to take an active role. 

Some suggestions that other parents have found helpful include:

  • Making an online photo or picture book using a commercial application
  • Celebrating your child’s birthday by creating a new tradition
  • Supporting a cause in his or her memory
  • Writing your child’s story
  • Maintaining contact with his or her friends
  • Reminiscing about your child with others
  • Asking friends and family to write down their memories of your child that can be collated into a book or blog

Helping siblings

Like adults, children grieve. The way they express their grief will depend on their developmental level and the nature of the relationship they had with their sister or brother. It’s important to keep children involved with the family, especially in the early days, even though your natural instinct might be to shield them from what is going on.

Some helpful tips include:

  • Tell children the truth about death in terms that they can understand
  • Answer their questions simply and honestly
  • Use accurate terms to explain the physical facts of death
  • Allow them to participate as much as possible in services and memorial events
  • Give them an opportunity to say goodbye
  • Ask them what they would like to do to remember their sibling
  • Children need adults to take the lead and initiate conversations about their brother or sister’s death, even at a later date
  • Find a support group or camp for children

Helping Grandparents

Grandparents need support too because not only are they dealing with the death of their grandson or granddaughter, but they are also in the difficult position of trying to support their own child.

If your grandchild has recently died, it can help to separate these two aspects of your grieving experience – your own grief and how best to support your child. In dealing with your own grief, you might want to speak to a counselor or talk to friends. Some people also find it helpful to attend a support group or to write about their grandchild and the memories they shared.

When it comes to supporting your child as they grieve, some suggestions include:

  • Being able to listen to your son or daughter’s story over and over
  • Being able to sit with their intense emotions
  • Helping with practical roles especially if there are other children in the family
  • Providing opportunities to reminisce about their child
  • Remembering and acknowledging special dates and helping to create new traditions.

Links

When grief is new - PDF

Resource sheet - PDF

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