Over the last year, so much has been lost during the pandemic. Children may have lost a loved one, the ability to spend time with friends, the opportunity to play sports or engage in other hobbies, the chance to attend prom, and valuable learning time in the classroom (to name a few). The loss of everything from a life to the normalcy in a daily routine can seem intense and overwhelming, especially when it’s happening all at once. Helping children cope with loss is vital in developing their ability to adapt to their new day-to-day routine and be resilient as the world adjusts to a new normal in the coming months.

How Children Cope with Loss

There are two main models for outlining the stages of grief:

Model #1 - The 5 Stages of Grief:

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Model #2 – The 7 Stages of Grief:

1. Shock and denial
2. Pain and guilt
3. Anger and bargaining
4. Depression
5. Upward turn
6. Reconstruction
7. Acceptance and hope

You can click here to learn more about each model from Healthline. No matter which model you prefer to use, it’s important to understand that not everyone follows the stages in the exact same order. The experience of grief will vary daily and can even evolve over an individuals’ entire lifetime. Referencing these models is helpful to get a general idea of what a child may be going through, but it should not be assumed that the path is being followed in the exact manner listed.

Recognizing the Signs & Symptoms of Grief in Children

As children work their way through the stages of grief, they may express it in a variety of ways, and they might not express it the same way as an adult would. Here are the main signs symptoms of grief in children according to Verywell Family:

• Difficulty concentrating
• Sleeping problems
• Academic struggles
• Anxiety and clinginess
• Developmental regression (i.e., wetting the bed or reverting to bottles)
• Changes in behavior (i.e., acting out at home or school)
• Changes in play (i.e., acting out death in pretend play)
• Feelings of guilt surrounding the cause of the grief

Helping Children Cope with Loss as a School Nurse

Once you recognize that a child is grieving a loss, how can you help? Offering your health office as a place that children can come to talk or just take a break will be valuable as they experience shifts in emotions and behaviors. One resource you may be able to use as you support a grieving child is psychologist William Worden’s “Tasks of Grieving”:

1. Accept the reality of the loss
2. Experience the pain of grief
3. Adjust to an environment without the loss
4. Find a way to embark on a new life

For a deeper dive into helping children cope with loss, the National Association for School Nurses offers a course, Recognizing Childhood Bereavement as a Public Health Issue Impacting Students, which is designed to provide grief and trauma education and awareness, along with suggestions that will assist school professionals in supporting students while fostering growth and resilience. And if you’d like to do more research on this topic, below is a list of resources you may find helpful:

• Identifying Ways School Nurses Can Support Grieving Children and Adolescents, by Barbara Rubel
• Helping Grieving Children and Teenagers, cancer.net
• The National Center for School Crisis and Bereavement

To shop MacGill’s selection of bereavement resources, click here.