Professional Resources

Whatever age we are the death of a significant loved one is a life changing event.

•  Every 22 minutes a parent of dependent children dies in the UK.
•  Up to 70% of settings have a bereaved pupil on their roll at any given time.
•  92% of young people will experience a significant bereavement before the age of 16 years (Child Bereavement UK).

When a loved one dies during childhood grief may be complicated by;

• The relationship between person and the child.
• The nature of the death; was the death expected/unexpected?
• The impact of the death on the people they rely on; for example the mental health of a surviving parent.
• The age and stage of the child/young person and it’s implication on their understanding of what has happened.
• People trying to ‘protect’ the child from the reality of the loss.

When you are bereaved as a child your understanding of what you have lost changes as you grow and develop. What you miss about your Dad aged five will be different from what you miss at 17. Children need to revisit and reconnect with the person who died throughout their lives and make sense of their loss. Their grief tends to ‘ebb and flow’ particularly at points of transition like changing class or starting new schools.

One of the most important things those working with bereaved children need to understand is the longitudinal nature of grief for children and young people.

You may see the fallout of grief many years after the loss. It is important that information about a child’s significant loss is passed on throughout their school life. Children and young people may need to access help to make sense of their grief on and off throughout the years.

Children tend to ‘puddle jump’ their grief; this describes how children may be distraught one minute and the next be playing happily with friends. Children and young people cannot stay with such strong emotions for long and will ‘take a break’ from them when they can. It does not mean that they are ‘using’ their sadness or are ‘over’ their loss Parents and friends may need help to understand this. There is no right or wrong way to grieve.

Children’s understanding of death, particularly its permanence, evolves over time. You can find out more about the ages and stages of grief.

For many years Elisabeth Kubler-Ross’s work on the ‘5 stages of grief’ was thought to explain the grieving process. It suggested that the grieving process moved smoothly through the stages beginning with denial and ending in acceptance. As anyone who has suffered a loss will tell you can do all the stages in a day and back again because grief is not orderly.

In 2008 William Worden described the 4 tasks of mourning – which he described as the ‘work of grief’ and was a more dynamic, changeable description. The tasks are;

• Accept the reality of a loss
• Feel the pain of the loss
• Adjust to a world without your loved one

Find an ongoing connection with the deceased whilst moving forward in life. Worden’s work took away the pressure to ‘accept’ and ‘move on’ focussing instead on moving forward and carrying an ongoing connection with you.

Death and dying has been described as the ‘last taboo.’

Professionals can help by being open to discussing death and dying when the opportunity arises. This can be as simple as helping small children notice the differences between ‘dead and alive’. For example a dead bird in the playground is an opportunity for children to see that dead means your body stops working – not breathing, not flying, not asleep.

Use the words ‘dead’ and ‘dying.’ Words such as ‘lost’, ‘passed on’ ‘gone to sleep’ etc. (there are many euphemisms for death!) are unhelpful to children. 

Small children particularly struggle to make sense of these words – In their experience if something is ‘lost’ it can also be ‘found’. They may become worried about going to sleep if it has been used as a way to describe ‘dead’. Children can manage the words death and dead from very young ages if they are given an age appropriate explanation of what it means.

Home-Setting Communication

Keep in touch with the family. Creating good communication between home and setting from the outset can make a big difference. Signpost the family to the organisations and resources below so that they can better understand the needs of their children. Check in with the family from time to time; how the wider family are coping impacts on how a child will cope. Encourage other family members to seek support for themselves if this seems appropriate.

Consider what other pupils need to know. It can be helpful to give peers the chance to talk about what has happened to their friend and understand how their friend might be feeling.

Space to Talk

Talk to the child about what has happened. When a child returns to their setting after bereavement find some moments to tell them you are thinking about them. Ask them what they think might help them. Bereaved children and young people tell us that people avoid talking about what has happened to them. A sad thing has already happened - mentioning it will not make it worse. Children & young people vary in how much or how little they want to talk their loss; be led by the individual.

Be sensitive to ‘hard days.’ The build up to individual special days like birthdays and anniversaries can be hard. There are also mother’s / father’s day or Christmas to manage. It could also be days like sports day or school reports day. Ask the individual what they think would help them with this. Winston’s Wish has some helpful suggestions.

Many children and families will cope with the sadness of the death of a loved one without specialist support. If they are displaying signs of emerging mental health problems that are concerning their family and / or school staff further assessment may become necessary. They may be displaying risky behaviours or be struggling with school attendance.

Children and young people may continue to be overwhelmed by their feelings such as intense distress, anxiety or anger and they may benefit from more specialist intervention. Concerns may emerge around the time of the loss or it can be some time afterwards.

You might signpost the family to the GP. The family or settings can call our services on the number below for advice. You could also refer to a local service like Nelson’s Journey or CRUSE bereavement care.

Call Just One Number to speak to a health professional by phoning 0300 300 0123. They will be able to provide initial advice and support, guide next steps with us or signpost you to other more relevant agencies and professionals.

Just One Number is available 08.00 to 18.00 Monday to Friday and 09.00 to 13.00 on Saturdays.

All referrals are made by contacting Just One Number on 0300 300 0123. Please make sure you have the consent of the parent and / or young person before you make a referral to us. You do not need to fill out any paperwork prior to this call.

Referrals are made via the telephone to enable us to have an informative conversation with you at the point of referral so we can ensure we have all the required information for early triage and assessment of the child, young person or family. This will ensure the referral gets managed by the appropriate team in a more timely way or we can signpost you to a more appropriate service.

Children and Young people aged 11-19 can access us through our text messaging service on 07480 635060. They will be able to discuss any health concerns with one of our Practitioners and also be able to request an appointment if they would prefer to meet with us.

If you are worried that a child or young person's speech or communication will impact on their ability to tell you when they feel unwell or need assistance, you can find information, advice and guidance and details of how to refer to the Speech and Language Therapy service here.

Speech & Language Therapy (SALT)

Parents can access our services by calling 0300 300 0123 or texting  07520 631590. This allows them to access the advice and support from a clinician about any health issues affecting their children aged 0-19.

Young people aged between 11-25 can find self-service healthcare advice and guidance over at FYI Norfolk.

It signposts to services and promotes self-care. Aiming to increase resilience and wellbeing, and to find out how to access health services.

Go to FYI Norfolk

Parents can be signposted to this. It is a carefully monitored online community forum which allows local parents and carers to talk with each other regarding issues affecting their children. This can be accessed through our Just One Norfolk website.

All Norfolk parents, carers and professionals can access this free of charge. It supports parents and carers to feel more confident in understanding their children and young people via 9 online modules.

Staff working with children and families will also benefit from this – or they can book to do the two day Solihull Training provided by our service by contacting karin.bibby@nhs.net.