Questions and Answers

Children and Adolescents

HFA’s teleconference features some of the best-known experts in the field of grief and loss. While the goal of the program is to share new insights and tangible ideas that can be put to use to help grieving children and adolescents, HFA strives to hear from professionals who are working with children every day. Prior to the broadcast, HFA solicited questions from Site Coordinators. Many of these questions were worked into the program, but as a follow-up we have included a few more here, with answers from Dr. Kenneth J. Doka.

Question: In my experience, children are "natural" grievers if the adults around them don't constrict them. But what about children's spirituality? How can hospice staff and others facilitate children's experience and expression of spirituality?

Dr. Doka: It is important to just listen carefully for the child’s questions. I would want to be careful of hospice staff treading here without a real knowledge of the parent’s beliefs and values. I would assess spirituality with the parent, and encourage hospice staff and others to ask the child who he she gets support from, who was at the funeral, what they heard there, etc.

Question: What is the best way to tell a child that a loved one has died when it happens suddenly, or if there has been no discussion about death before the death occurred?

Dr. Doka: Simply, honestly without euphemisms. I would want to find a quiet area and make sure the child had a lot of support around. One book that can be useful in explaining death is What Does that Mean? A Dictionary of Death, Dying and Grief Terms for Grieving Children and Those Who Love Them by Smith and Johnson. This book identifies more than 70 important words, explains how to pronounce them and what they mean, and offers guidance about how to use these words and discuss these subjects with children.

Question: Do you have suggestions for other books that can be used to help children deal with grief?

Dr. Doka: Books can be very effective resources in helping children and adolescents learn more about grief. Bibliotherapy can be very useful but I always treat it as a prescriptive. Books have to be “prescribed” for a particular concern -- if not they can sometimes do as much harm as good. Also remember that the books used should be developmentally appropriate for the particular child. I think it is also important that the books are used in conjunction with counseling or other support.

Listed below are a few suggestions for books divided by reader level. These books are part of a more comprehensive list found in “Bibliographical Resources—Children, Adolescents, and Grief” by Charles Corr, in Living With Grief: Children and Adolescents, Kenneth J. Doka and Amy S. Tucci, Eds., published by Hospice Foundation of America, 2008.

Picture and Activity Books for Preschoolers and Beginning Readers

Carney, K. L. (1997-2001). Barklay and Eve Activity and Coloring Book Series. Dragonfly Publishing Company, Wethersfield, CT. This series currently has eight titles. Each book tells a story and offers drawings to color or blank spaces to draw pictures about a loss-related topic that adults may find difficult to discuss with children. In each book, two curious Portuguese water dogs learn lessons like: loss and sadness do happen; those events are not their fault; it is OK to have strong feelings as long as they are expressed in constructive ways; and “we can get through anything with the love and support of family and friends” (Book 1, p. 5).

De Paola, T. (1973; 1998). Nana Upstairs and Nana Downstairs. New York: Putnam. Tommy likes visiting “Nana Upstairs” (his great-grandmother). When told that she has died, he does not believe it until he sees her empty bed. A few nights later when Tommy sees a falling star, his mother suggests that perhaps it represents a kiss from Nana who is now “upstairs” in a new way. Later, an older Tommy repeats the experience and interpretation after the death of “Nana Downstairs” (his grandmother).

Storybooks and Other Texts for Primary School Readers

Alexander, A. K. (2002). A Mural for Mamita/Un Mural Para Mamita. Omaha, NE: Centering Corporation. A young girl, her family, and the whole neighborhood plan a fiesta to celebrate the life of her grandmother who has recently died after a long illness. Mamita was well known and greatly loved in the neighborhood as the proprietor of the local bodega or store. The girl’s special contribution to the celebration is a brilliant mural painted on the side of Mamita’s store. The text of this book appears in both English and Spanish.

Bunting, E. (1999). Rudi’s Pond. New York: Clarion. While Rudi is sick, his classmates send cards and make a big “GET WELL RUDI” banner for his hospital room. After Rudi dies, the children write poems and make a memorial pond in the schoolyard that attracts a beautiful hummingbird.

Literature for Adolescent Readers

Gignoux, J. H. (1998). Some Folk Say: Stories of Life, Death, and Beyond. New York: FoulkeTale Publishing. Here are 38 legends, retold in prose and poetry, that different cultures have used to come to terms with the reality of death and hopes for life beyond the grave. Brief comments from the author introduce each section and follow each story. The book is also enlivened by 8 dramatic illustrations. A treasury of global culture to stimulate the imagination and to use in working with children.

O’Toole, D. (1995). Facing Change: Falling Apart and Coming Together Again in the Teen Years. Burnsville, NC: Compassion Books. This little book is intended to help adolescents understand loss, grief, and change, and to think about how they might respond to those experiences.

Traisman, E. S. (1992). Fire in My Heart, Ice in My Veins: A Journal for Teenagers Experiencing a Loss. Omaha, NE: Centering Corporation. This book offers a journal framework for teenagers who have had a loss. A line or two of text on each page and many small drawings offer age-appropriate prompts for this purpose.