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Military Health System

Helping Your Child to Cope with Grief and Losses Related to COVID-19

Image of Shirley Lanham Elementary School students perform Taiko drumming during a Month of the Military Child celebration aboard the Naval Air Facility Atsugi, Japan, April 6, 2022. (Photo: Petty Officer 2nd Class Ange-Olivier Clement, Naval Air Facility Atsugi). Shirley Lanham Elementary School students perform Taiko drumming during a Month of the Military Child celebration aboard the Naval Air Facility Atsugi, Japan, April 6, 2022. (Photo: Petty Officer 2nd Class Ange-Olivier Clement, Naval Air Facility Atsugi)

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More than 140,000 American children have suffered the loss of a parent or caregiver due to COVID-19, according to a recent study.

COVID-19 was the third leading cause of death among Americans last year, according to the Centers for Disease Control and Prevention, so many children have also lost extended family members or close family friends.

And death is not the only form of loss that children have faced. Children of all ages have experienced the loss of friendships through physical separation. They've missed out on social experiences and milestones like in-person schooling, sports seasons, proms, or even graduations.

How can parents help their children through the grieving process?

"Children of different ages react to death differently," said Army Capt. (Dr.) Christin Folker, a pediatrician at Weed Army Community Hospital at Fort Irwin, California.

"Infants and toddlers will notice the absence of a caregiver or sense that something is wrong and that others are upset," she said. "Even without understanding the concept of death, their brain development is influenced by these stressful experiences, promoting a stronger 'fight-or-flight' response to future stressors."

In preschool and early school-age years, "children may believe that death is temporary and that their loved one will come back," said Army Capt. (Dr.) Cory McFadden, a staff pediatrician at the Carl R. Darnall Army Medical Center, Fort Hood, Texas.

"The younger that a child is when he or she experiences the loss of a loved one, the more they will struggle with the finality of death. It will take time for them to understand that the person is no longer alive," he said.

"Because of this difficulty with understanding, they will in general grieve a little quicker and bounce back," he suggested.

Folker explained how younger children may struggle with a wide range of emotions.

"They also may believe that they are in some way to blame for the death if they misbehaved or got angry with that loved one," Folker said.

"A more concrete understanding of the causes and absolute nature of death begins in school age years," she explained.

"Adolescents will process losses more similarly to adults, but many are processing these experiences and their accompanying strong emotions for the first time."

Air Force Tech. Sgt. Moses J. Villagomez, 60th Maintenance Group quality assurance inspector, poses with his wife and children April 22, 2021, at Travis Air Force Base, California. April is the Month of the Military Child, providing Travis with an opportunity to highlight the resilience of children in the military community. (Photo: Hun Chustine Minoda, 60th Air Mobility Wing Public Affairs)
Air Force Tech. Sgt. Moses J. Villagomez, 60th Maintenance Group quality assurance inspector, poses with his wife and children April 22, 2021, at Travis Air Force Base, California. April is the Month of the Military Child, providing Travis with an opportunity to highlight the resilience of children in the military community. (Photo: Hun Chustine Minoda, 60th Air Mobility Wing Public Affairs)

Re-grieving

"Many children will 're-grieve' the absence of a significant person as they go through different developmental stages and milestones," Folker said.

"For example, a child who lost a close grandparent at the age of 6 may re-experience the sadness of their absence at their next birthday party or elementary school graduation," she said.

"Children who are less likely to talk about their feelings, especially adolescents, should be offered open-ended opportunities to talk about how they're feeling," she suggested.

Some ways to approach that are to say: "I know we talked about your aunt's death a few days ago – how are you feeling? What are you thinking about? Do you have any questions about what happened, or what it means for our family?" Folker said.

"Even children who seem 'OK' may benefit from discussing their feelings with a counselor or participating in play therapy," she added.

Ways to Cope

Signs of grief can be individual for each child. Folker and other child experts from the Defense Health Agency's Psychological Health Center of Excellence offer these tips.

  • Refer to "death" directly. Avoid using confusing phrases such as "went to sleep."
  • Explain that the loved one is not living on Earth anymore and cannot come back. If it fits with your family's beliefs, explain that their loved one is in Heaven or the afterlife.
  • Get back to normal routines at home.
  • Maintain a consistent schedule for school activities and bedtimes to help kids establish a sense of security after a loss.
  • Be ready and accessible. Avoid pushing your child to talk. Instead, follow your child's lead and stay open to talking over time as needed.
  • Allow your child to ask questions, and provide honest answers.
  • Talk about how to express anger in appropriate ways, such as through drawing or writing.
  • Remind your child they are safe and surrounded by supportive people.
  • Model your grieving. Say, "'I'm feeling really sad today' or 'I'm feeling frustrated today'" about your loss and explain why you are feeling that way.
  • Teach calming techniques like deep breathing, yoga, and meditation. These can help reduce the effects of stress and build your child's capacity for coping with adverse events.

"Sometimes parents are so overwhelmed with grief that they can't be there for their kids, and in the short term that is OK," McFadden said.

"It is also OK for the parents to share with kids how they are dealing with the loss," he said.

"Another way that parents can help children to overcome the pandemic's developmental challenges is to engage in activities,' Folker said.

For example, "reading together and talking about the story gives children a chance to practice language. Age-appropriate crafts allow children to work on fine-motor hand skills. Parents can let their children 'help' with activities around the house to keep them active and developing gross motor skills," Folker said.

Reach Out for Help

Mourning the loss of a loved one is painful, but you do not have to do it alone. "Check in with other families facing similar experiences. Ask about their religious background and practices, and always recommend meeting with a priest/rabbi/imam for support," or to military chaplains, McFadden suggested.

"In addition to reaching out to a psychological health professional, try building a nurturing support network," Folker said. This may include other families with similar experiences, school officials, and places of worship.

Some of Folker's favorite resources include:

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