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Those Left Behind: Grieving Grandparents Caring for Grieving Children

Childhood bereavement is one of society’s most pervasive social and public health issues; however, it is often overlooked and misunderstood. The COVID-19 pandemic has had tragic and highly visible consequences, as over 1 million deaths have occurred in the U.S. At the same time, COVID-19 exacerbated another pandemic that had been hiding in plain sight: the child grief crisis. As of August 2022, over 260,000 children across the U.S. have lost a primary or secondary caregiver to COVID-19. In the U.S., an estimated 5.6 million children will experience the death of a parent by age 18 due to non-COVID-19 related circumstances – including accidents (including accidental overdoses), cancer, homicide, suicide, and heart disease. The loss of a primary attachment figure and the subsequent sequelae of associated adversities and secondary losses significantly impact a child’s development, placing children at elevated risks of mental health challenges (including suicide and substance use), early mortality, and worsened educational outcomes. When children experience parental death, the question arises, who will care for them? This presentation will focus on situations in which grandparents assume caregiving responsibilities for their grandchildren, following their own children’s death. In these circumstances, grandparents are tasked with not only grieving their children but also grieving the sequelae of subsequent losses following their child’s death; including, but not limited to, changes in family structure, financial stressors, shifts in worldview, and confrontation with mortality. Given that a child’s grief experience is often dependent on how the adults around them are functioning, it is imperative that individuals interacting with grieving children are also holding the needs of grieving grandparents in mind. We will discuss clinical examples of providing psychotherapy to grieving children, exploring intergenerational patterns of hurt and healing, and using mentalization-informed interventions.