“Littles” and “Middles” Need Special Care when Going through Grief

By Giving List Staff   |   November 26, 2022
Each year, approximately 400 children and teens receive HSB Services

Many people think of “hospice” purely as end-of-life medical care. In fact, hospice care is so much more. Hospice of Santa Barbara (HSB) provides the emotional, social, and spiritual care so necessary for survivors as well as the dying. Fear of loss, uncomfortable feelings of loss, and grief itself are not easy to deal with, much less talk about. It’s hard enough for adults to process the changes they must face when a loved one receives a terminal diagnosis and passes on. Initially, friends and family offer sympathy and cooked meals; then they drift off because life goes on. It normalizes.

But for children, there is no normal again; their world has changed forever when losing a member of the family or a friend. Hospice of Santa Barbara becomes a lifeline through its school outreach and one-on-one counseling programs. That connection made concrete through HSB counselors is key, especially for young children, who may seem to accept their loss until something triggers a memory or a feeling, and they’re thrown right back into profound grief. 

The beauty of HSB lies in its therapeutic approach to the process of grieving. Charles Caldwell, Director of Strategic Advancement, describes it as “the transformative power of relationships. It is all about compassionate expression – the healing that can take place when walking together, side by side, hand in hand, all the way through the grief process, as long as it may take.” In this spirit, our children from Carpinteria to Santa Ynez can benefit from one-on-one and support group counseling. Each year, about 400 children and teens receive HSB services when experiencing the impending loss or death of a family member, the suicide of a friend, or a disaster that affects an entire community.  

Often those most in need are the Littles (4-8 year olds) and the Middles (8-12 year olds). Imagine trying to find the words to explain a terminal disease or death itself while anticipating the absence of a loved relative who is central to a child’s sense of safety, home, and family. Licensed counselors help the whole family system, anchoring children to simple, concrete answers in order to understand the big changes already happening. HSB Bereavement Services Manager and bereavement counselor Michael Cruse suggests that even one short sentence such as “time with your mom or granddad is precious” can become a meaningful mantra, reminding Middles to make a memory with a terminally-ill parent or grandparent before rushing off with friends on a Saturday morning.  

Littles may have trouble identifying how they feel and may express their fear or confusion by not wanting to go to school or having nightmares or a stomach ache. To help Littles sort out their feelings, HSB bereavement counselor Kolmi Majumdar uses play-based therapy through arts and crafts, games, and puppet play. Through HSB’s Beloved Bear program, Littles will receive plush bears handcrafted by HSB volunteers, who incorporate a deceased loved one’s favorite item of clothing in making each bear. This comforting keepsake allows the child to hold, hug, play with, and stay connected with the beloved family member.  

At Hospice of Santa Barbara, staff believe the process of acknowledging a child’s loss and validating their feelings is crucial to their eventual acceptance and healthy development. That process starts and continues through compassionate relationships that affirm both love and grief at the heart of loss.  

Compassion is the cornerstone of all HSB programs that include patient care management, spiritual counseling, family services, community education, and resources – all available in English and Spanish. 


Hospice of Santa Barbara

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(805) 563-8820
Director of Strategic Advancement: Charles Caldwell


To care for anyone experiencing the impact of serious illness or grieving the death of a loved one.

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Hospice of Santa Barbara is that rare treasure that appears in a person’s life when it is most needed, during the very darkest of times, and offers compassion and care without asking for any compensation. This heart-centered organization represents the highest ideals of humanity and is well deserving of our support.
Marybeth Carty
Natalie Orfalea Foundation,
Executive Director

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Learn how your organization can be part of the solution, along with sponsor opportunities, for grief support and end-of-life care. Please visit www.hospiceofsb.org or contact Charles Caldwell, Director of Strategic Advancement, ccaldwell@hospiceofsb.org.