Konsep kematian pada anak

Children’s Conceptions of Death

Kenyon BL; Omega: Journal of Death and Dying 2001; 43(1) 63–91

The most widely studied components of the concept of death are:

1. Non-functionality: the understanding that all life-sustaining
functions cease with death
2. Irreversibility: the understanding that death is final and, once
dead, a person cannot become alive again
3. Universality: understanding that death is inevitable to living
things and that all living things die
4. Causality: refers to understanding what causes death
5. Personal mortality: related to universality but reflective of the
deeper understanding not only that all living things die, but that “I
will die.”
(sometimes referred to in different terms (e.g., cessation for non-
functionality, inevitability for universality)
 Children’s Conceptions of Death
Kenyon BL; Omega: Journal of Death and Dying 2001; 43(1) 63–91

 In general, it appears that universality followed by irreversibility

emerge relatively early, with non-functionality and causality
understood later
 children understand the cessation of external events (like
movement) before internal events (such as thinking), after death
 Speece and Brent (1992) – studied children from kindergarten to
3rd grade:
 Non-functionality - difficult for children to master.
 90 percent of the sample understood the cessation of
motion
 only 65 percent of the sample understood that less obvious
properties, like sentience (thinking, feeling) and perception
(hearing, seeing) cease with death
 Children’s Conceptions of Death
Kenyon BL; Omega: Journal of Death and Dying 2001; 43(1) 63–91

 children understand death as a changed state by

about 3 yo
 children understand that death is universal by about 5
– 6 yo; understand what causes death slightly later
 although an understanding of personal mortality has
been demonstrated by children as young as 4 yo, it
does not reliably emerge until 8 - 9 yo.
 current measures do not detect a complete
understanding of universality, irreversibility, non-
functionality, and personal mortality until about ten
years of age
 Elements of Complete Developmental Understanding of Death
Himelstein et al; NEJM 2004;350:1752-62
Questions Suggestive Implications of Incomplete
Concept of Death
of Incomplete Understanding Understanding

Irreversibility • How long do you stay dead?

(dead things will • When is my (dead pet) coming back? Prevents detachment of personal
not live • Can I "un-dead" someone? ties, the first step in mourning
again) • Can you get alive again when you are dead?

Finality or • What do you do when you are dead?

nonfunctionality Preoccupation with the potential
• Can you see when you are dead?
(all life-defining for physical suffering of the dead
• How do you eat underground? person
functions end at
death) • Do dead people get sad?

• Does everyone die? • May view death as punishment

Universality (all • Do children die? for actions or thoughts of child
living things die) • Do I have to die? or the dead person
• When will I die? • May lead to guilt and shame

Causality (realistic • Why do people die?

understanding of • Do people die because they are bad?
May cause excessive guilt
the causes of • Why did my (pet) die?
death) • Can I wish someone dead?
Development of Death Concepts and Spirituality in Children
Himelstein et al; NEJM 2004;350:1752-62
Predominant
Age Spiritual
Characteristics Concepts of Interventions
Range Development
Death
• Has sensory and motor
relationship with • Faith reflects
• Provide maximal
environment trust and
physical comfort, familiar
hope in
• Has limited language persons and transitional
0–2 skills
others
objects (favorite toys),
None
yr • Need for and consistency
• Achieves object
sense of self-
permanence • Use simple physical
worth and
• May sense that communication
love
something is wrong

• Uses magical and • Believes death is • Faith is • Minimize separation

animistic thinking temporary and magical and from parents
• Is egocentric
reversible, like imaginative • Correct perceptions of
sleep • Participation illness as punishment
>2 – 6 • Thinking is irreversible
• Does not in ritual • Evaluate for sense of
yr • Engages in symbolic personalize death becomes guilt and assuage if
play important
• Believes death present
• Developing language can be caused by • Need for • Use precise language
skills thoughts courage (dying, dead)
Development of Death Concepts and Spirituality in Children
Himelstein et al; NEJM 2004;350:1752-62 …ctd
Age Predominant Spiritual
Characteristics Interventions
Range Concepts of Death Development

• Evaluate child’s fears of

• Development of abandonment
adult concepts of • Faith concerns right • Be truthful
death and wrong
• Provide concrete details if
• Understands that • May accept external
>6 – Has concrete requested
death can be interpretations as the
12 yr thoughts
personal truth • Support child's efforts to
achieve control and mastery
• Interested in • Connects ritual with
physiology and personal identity • Maintain access to peers
details of death • Allow child to participate in
decision making
• Generality of • Begins to accept
thinking internal • Reinforce child's self-esteem
• Reality interpretations as the • Allow child to express strong
becomes truth feelings
Explores • Allow child privacy
objective • Evolution of
>12 – nonphysical
• Capable of self- relationship with God • Promote child's independence
18 yr explanations of
reflection or higher power • Promote access to peers
death
• Body image • Searches for • Be truthful
and self- meaning, purpose, • Allow child to participate in
esteem hope, and value of decision making
paramount life