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Grief and Developmental Stages

Age Understanding of Death Expressions of Grief
Infancy to 2 years Is not yet able to understand death. Quietness, crankiness, decreased activity, poor sleep, and weight loss.
Separation from mother causes changes.
2-6 years Death is like sleeping. Asks many questions (How does she go to the bathroom? How does she eat?).
Problems in eating, sleeping, and bladder and bowel control.
Fear of abandonment.
Tantrums.
Dead person continues to live and function in some ways. Magical thinking (Did I think something or do something that caused the death? Like when I said I hate you and I wish you would die?).
Death is temporary, not final.
Dead person can come back to life.
6-9 years Death is thought of as a person or spirit (skeleton, ghost, bogeyman). Curious about death.
Asks specific questions.
May have exaggerated fears about school.
Death is final and frightening. May have aggressive behaviors (especially boys).
Some concerns about imaginary illnesses.
Death happens to others, it won’t happen to ME. May feel abandoned.
9 and older Everyone will die. Heightened emotions, guilt, anger, shame.
Increased anxiety over own death.
Mood swings.
Death is final and cannot be changed. Fear of rejection; not wanting to be different from peers.
Even I will die. Changes in eating habits.
Sleeping problems.
Regressive behaviors (loss of interest in outside activities).
Impulsive behaviors.
Feels guilty about being alive (especially related to death of a brother, sister, or peer).

Source: National Cancer Institute, U.S. National Institutes of Health

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