Different causes of death

Early on for a child, how a person died is usually less important than it is for adults. No means or cause of death is better or worse than another for a grieving child. They are all overwhelming.

If a death is expected (for example, through cancer or other illness), the family may have had time to prepare for the loss. They may have begun to adjust to the future without the person, to make sure that photographs have been taken, letters to open in the future have been written, goodbyes said. It is very likely that the family will have received help – and will continue to receive help – from a hospice-based service or other support service (such as Macmillan nurses).

However, the family may also have suffered through a prolonged period of stress in which the children felt unable to undertake normal activities or to rebel or have fun; a period when the family focused on the person who was dying in a way that the children found very hard.

If a death is sudden (for example, through a heart attack or road accident) there is no chance for goodbyes and no chance for preparations or adjustment. The last conversations linger in the memory. There is no professional whose role it is to support these bereaved families (although police family liaison officers and hospital-based bereavement services make valuable contributions). However, for some people, a sudden death may be seen more positively (for example, of a frail grandmother).

If a death is through suicide, there are particular difficulties for the families left behind. It has been estimated that for every suicide, six people will experience intense grief – and many more will be deeply affected. Those bereaved through suicide face especially intense feelings and thoughts, ask themselves more agonising questions and face more public scrutiny. For both children and adults, it can take a long time to dare to trust others again.