News and Events

Do Very Young Children Feel Grief?

There is a commonly held belief that young children are “too young to grieve” when a loved one dies. However, we now know that preschool-age children, toddlers and even infants all experience grief.

Following is a brief guide to understanding and supporting young children through a grief experience.

Grief in Infants and Toddlers

Babies are affected by changes in household routines. If the person who died was a parent or caregiver, an infant will feel the absence of that familiar person’s voice and touch. Toddlers are likely to resist being apart from family and may develop new “babyish” behaviors or become unusually clingy. Grief in both babies and toddlers can sometimes seem like irritability or anxiety, or they may seem quieter than usual.

Preschoolers and Grief Emotions

 Preschool children are likely to express grief through behavior changes rather than words. They may demonstrate separation anxiety, a need for comfort and reassurance or regression of previously mastered skills such as potty training.

Preschoolers may seem completely unaffected at times, while at other times they may exhibit intense emotion through tantrums or outbursts. Their behavior may seem out of proportion to the immediate circumstances. Some preschoolers and young school-age children may seem worried and ask questions, such as who will take care of them.

How to Support a Young Child After a Loss

Young children tend to experience grief in bursts. It is helpful to expect that a young child’s grief responses may be unpredictable, but also short-lived. The most effective response by caregivers can be simply to maintain the child’s physical safety if needed, offer comforting touch and let the child know it’s okay to have big feelings.

As much as possible, families should try to maintain the structure and routines of the household. Give your child opportunities to express emotions through play, art or physical activities. Some families may choose to read and discuss a picture book about maintaining connection with loved ones after loss, such as “The Invisible String.”

Children’s Grief Counseling at Kids Path

Children as young as 4 years old may be eligible for individual grief counseling at Kids Path. For a no-cost phone consultation about how your young child is coping with death or illness, please call 336.544.5437 and ask to speak with any Kids Path counselor.

A Day in the Life of Amy Johnson, Hospice Nurse

Amy Johnson, a nurse with Hospice and Palliative Care of Greensboro (HPCG), arrives at Whitestone Retirement community at 11 a.m., with nothing but her laptop bag and an ever-present smile. As soon as she enters the lobby, she is excitedly greeted—and often hugged—by every person she passes.

Amy pops her head into the dining room, where dozens of staff and residents are gathered for lunch. She is met by yet another chorus of “AMY!”

Amy makes her way around the dining table, giving a shoulder squeeze and a joyful “How are you feeling?” or “Are you enjoying your lunch?” to every patient she passes.

As Amy walks toward the nurse’s station, she sees a nurse’s aide and pulls her aside: “How is Lorna doing today? Any change?”

The aide replies, “She hasn’t talked or moved much. She seems to be declining quickly.”

Clearly concerned, Amy hurries to her patient’s room. Amy’s normally bubbly mood has quickly turned into gentle concern. “Hi, Miss Lorna. It’s Amy—I’m here to visit you.”

Hymns are playing softly on Lorna’s radio. “Miss Lorna has a very strong faith,” Amy says, arranging some crocheted angels on Lorna’s pillow. “That’s why she always has angels around her.”

Lorna has been Amy’s patient for many months. As they’ve gotten to know each other, Amy has listened to stories of Lorna’s long and full life. She points to a picture on the dresser. “That’s her and her husband on vacation in the mountains.”

In recent weeks, Lorna’s health has declined rapidly. She responds when Amy holds her hand by lightly stirring but otherwise remains in a peaceful-looking sleep.

In the hour that follows, Amy talks to Lorna, holds her hand and gently examines her. More than anything, her focus is on Lorna’s comfort.

“I don’t like the angle of her neck; that doesn’t look comfortable,” Amy mutters. She quickly searches the room for another pillow, gently lifts Lorna’s head while talking softly to her, and props up her neck. “That’s better.”

“Miss Lorna does not like her socks to be too tight on her toes. She likes wiggle room. It’s very important to her; she reminded me every visit for the first few months.” Amy lifts the covers and pulls the toes of Lorna’s socks before re-tucking her blankets. “Your socks are the way you like them, Miss Lorna.”

After saying a quiet goodbye to Lorna, Amy is off to update her chart at the nurse’s station.  An HPCG social worker arrives shortly after, and they work next to each other while catching up on patients.

Amy notices another of her patients relaxing on a recliner nearby, and walks over to check in. “Hi Charles, how are you today?”

Charles lights up at Amy’s presence. “I’m doing OK!” he says softly.

She and Charles talk and laugh together as she seamlessly proceeds through the exam- checking Charles’ blood pressure, examining his skin and listening to his heart and stomach with her stethoscope. “Has your wife been here yet today?” Amy asks.

“Not yet, but she should be here any minute. Maybe you’ll get to see her.” Midway through the exam, Charles complains that his feet are hot. Amy carefully removes his shoes. Soon, Charles begins to get tired and drift off. Amy gently finishes her exam before leaving him to nap. Then, it’s back to finish charting.

Amy’s day as a long term care hospice nurse seems to balance two main things: patient care and meticulous documentation.

But to Amy, nursing duties far exceed blood pressure tests and temperature-taking. Most of her time is spent connecting with her patients, identifying what makes them uncomfortable, and taking immediate action to ease that discomfort. Whether she does this herself or coordinates with facility staff and doctors, Amy seems to leave no loose ends when it comes to the comfort of her patients.

A hospice nurse’s charge isn’t necessarily to heal. After all, hospice patients are dying. Yet whether they’re caring for a patient’s wound or adjusting the toes of their socks, hospice nurses improve the quality of the time their patients have left.

“It’s an honor to connect with my patients and ease their journey into whatever comes next. Losing patients is hard, but the memories and connections I make to each person have given immense joy and beauty to my life. I was called to this job, and I’m grateful every day for the calling.”

How to Talk to Children about Serious Illness

When a family member or loved one is seriously ill, the thought of explaining the illness to your child may feel overwhelming, particularly if you don’t think they are capable of fully understanding the situation.

However, children are often more aware of what’s going on than you might think. In fact, not speaking to your child about the illness might leave them more confused and anxious. Often, children sense tension or stress in others, no matter how discreet you try to be.

By speaking to your child about your loved one’s illness, you are providing some context for them to understand and face the changes ahead: changes in their loved one’s health, in their family dynamic or in their daily routine.

Following are some tips for talking to your child about their loved one’s illness.

  • Tell your child the truth about the illness, but in a developmentally appropriate way according to their age and cognitive capacity.
  • Let the child lead the conversation; answer only what they are asking right now.
  • Avoid making any promises about recovery or cure, but let your child know that it’s okay to have hopes and wishes for the sick person.
  • Understand that preschool-age children are likely to ask the same questions repeatedly over time. Rather than one conversation addressing the illness, plan to have an ongoing interaction that unfolds over time.
  • Prepare your child for any possible changes in their normal routine. For young children in particular, schedules are reassuring and provide security. If a routine will be altered due to a loved one’s illness, telling the child ahead of time can help them be mentally prepared.
  • Anticipate misunderstandings. Children have typically only experienced illness as a short-term issue and may be confused about why their loved one isn’t getting better. You might find that you need to explain the longevity of the illness many times before your child truly understands.
  • Prepare your child for changes in behavior. Particularly in the case of dementia or Alzheimer’s disease, it can be distressing for your child to see their loved one’s personality change so drastically. You can mitigate this distress by preparing your child for the changes they are likely to see. You might say something such as, “Grandma’s illness makes her forget things, but she still loves you and wants to spend time with you.”
  • Let the child help. Whether they want to color pictures for their loved one or even push their wheelchair, it can be incredibly therapeutic for your child to feel useful during this confusing time. By giving them a concrete task, you are providing your child both distraction from the stress and an outlet for their emotional energy.

If your child is coping with the illness of a loved one, Kids Path can help. Call 336.544.5437 to speak with a licensed Kids Path counselor.

Preventing Teen Suicide: Common Questions About How to Keep Teens Safe

It’s a difficult topic to think about—no one wants to believe that their child would consider suicide. Teens who have recently experienced the death of a loved one may be at increased risk for thoughts of suicide, particularly when impacted by other factors such as substance use, bullying or LGBTQ identity.

Here are some questions that parents and caregivers frequently ask about teen suicide risk, along with guidelines for helping to keep your teen safe.

Q: “If I bring up suicide, won’t that just put the idea into their head?”

A: It’s not possible to create suicidal urges simply by talking about it. In fact, communicating honestly with your child about their thoughts and feelings is one of the most important things you can do to protect them.

Q: “Is this just a way to get attention? Maybe my child is being dramatic.”

A: It’s important to treat any talk of suicide very seriously. Show your teen that their safety is your highest priority, and talk honestly with them about their suicidal thoughts. A “cry for help” should be addressed with the same urgency as a life-threatening physical illness.

Q: “Does suicide just happen out of the blue?”

A: There are often warning signs for suicide, but they may be subtle. A teen who is considering suicide may make statements about being a burden, such as “Everyone would be better off without me.” They may show abrupt changes in mood, such as anxiety or agitation, or begin to engage in reckless behavior. A detailed list of warning signs for youth suicide can be found at this link:

Talking with Your Teen about Suicidal Thoughts

The best time to approach this topic is before you have specific concerns. Let your teen know that it’s always okay to discuss thoughts and feelings, even ones that are negative or frightening. Bring up recent news stories that involve suicide and give your teen an opportunity to express their reactions. For some teens, communicating with you through text messages might feel less threatening.

You can also provide other resources. Some families post emergency numbers, such as 1-800-273-TALK (8225) or the Crisis Text Line (text HOME to 741741), in their home as a reminder for teens to reach out if they are in crisis.

If you wonder whether your teen is at risk, it’s best to be direct: “I’m really concerned right now. Have you been having thoughts about suicide?” Any suicidal thoughts or plan should be evaluated immediately at the nearest emergency room or emergency mental health clinic.

It’s normal to feel nervous about discussing these risks, but a teen’s safety is certainly worth broaching an uncomfortable conversation.

Ask a Kids Path Counselor

Kids Path offers no-cost phone consultations with licensed counselors, available to anyone who is grieving a loss or coping with the impact of serious illness. If you have questions about how to best support your child or teen through grief, call 336.544.5437 and ask to speak with a counselor.

Hospice Volunteers Win Governor’s Award

(GREENSBORO, NORTH CAROLINA)– The 200+ volunteers of Hospice and Palliative Care of Greensboro (HPCG) have received a Governor’s Volunteer Service Award. This honor, created by the Office of the Governor in 1979, recognizes North Carolina’s most dedicated volunteers.

“Our volunteers are so deserving of this award,” said Teresa Canady, director of volunteer services at HPCG. “When our volunteer team receives a request from a patient or family, we never say ‘no.’ We always say ‘we will try’ because we know our volunteers will come through and generously accept nearly any request in order to help a patient and family.”

This past year, HPCG volunteers donated a combined 13,365 hours of service. These hours included caregiver relief, patient companionship, cake baking, gardening, administrative assistance, special projects, transportation, event assistance, outreach, facility visits, Veteran-to-Veteran visits, pet therapy and music therapy.

HPCG was founded by a small group of grassroots volunteers in 1980. Even as hospice care has evolved and become highly specialized—utilizing doctors, nurses, counselors, social workers and chaplains—Medicare preserved the role of volunteers; every hospice is required to demonstrate that 5 percent of all care hours are provided by trained volunteers. Yet HPCG regularly exceeds this requirement.

Most often this service comes in the form of regular visits to a hospice patient’s home or facility, during which time the volunteer may run errands, read to the patient, engage in friendly conversation or simply offer quiet presence. Hospice volunteers provide much-needed relief for family caregivers and meaningful connection for patients.

“I hear so many wonderful stories about how transformative a family’s relationship with a volunteer has been,” said Kristen Yntema, president and CEO of HPCG. “From our beautiful gardens, to our handwritten thank-you cards, to our smoothly-run events and so much more, we have our volunteers to thank.”

To receive a Governor’s Volunteer Service Award, each North Carolina County submits ten nominees across a variety of categories. The governor’s office then narrows this down to 20-25 award recipients across the state. Awards are expected to be distributed during National Volunteer Week, April 7-13.


About HPCG

HPCG is a nonprofit organization that serves an average of 350 patients per day in Guilford County and surrounding areas. It is situated on a 14.75 acre campus at 2500 Summit Avenue. Since 1980, HPCG has been providing physical, emotional and spiritual support for children and adults faced with a life-limiting illness, as well as their caregivers and families. For more information, call 336.621.2500 or visit

Download PDF of press release here.

Self-Care Tips for Grieving Parents

The death or serious illness of a loved one can affect all members of a family. Often, a parent may think first of a child’s need for grief counseling. However, we know that children are more likely to be resilient in the face of loss when their caregiver is being supported as well.

Kids Path counselors often encourage caregivers to “put on your own oxygen mask first.” In other words, a parent who is not exhausted or emotionally depleted will be better able to support their children.

Here are some tips for maintaining self-care when your family is coping with loss related to death or illness.

Take care of your body’s basic needs.

Just as you would focus on basic physical needs if you were recovering from the flu, it’s important to acknowledge the impact of grief on your physical functioning. Try to ensure that you are getting enough sleep, eating regularly, and staying hydrated. You don’t have to be perfect at it, but caring for yourself physically is just as important as caring for yourself psychologically at this time.

Incorporate sensory soothing.

Consider how you can bring small sensory comforts into your day, such as using a lotion with a relaxing scent or listening to music that is soothing for you. You may find that you want additional comforts to help you sleep at night, such as white noise from a fan or a heavy blanket on your bed. This can even be a game you share with children in the family, where each person tries to name two comforting things for each of the five senses: touch, sight, smell, taste and sound.

Express emotions.

You are most likely feeling many emotions related to your loss, including sadness or anger. It’s important to find healthy ways to express these feelings, such as talking with a trusted friend. You could also try journaling about your feelings, hitting the couch or bed with a pool noodle or using movement (playing basketball, running or just dancing to the radio). Crying is also an excellent way to release strong emotions. If you prefer privacy, some people recommend crying in the shower!

Seek grief counseling and support groups.

If a significant loss is making it difficult to function in your everyday responsibilities, you don’t have to go it alone. Kids Path works closely with the Counseling and Education Center, a bereavement program for adults that is also part of Hospice and Palliative Care of Greensboro. A trained bereavement counselor can meet with you individually to provide coping tools and insight about the grief process. There are also support groups focusing on specific types of losses that present special challenges, such as overdose or suicide.

How Kids Path Can Help: The licensed counselors at Kids Path offer free phone consultations to assist you in finding an appropriate community resource for your family’s support needs. Simply call 336.544.5437 and ask to speak with a counselor.

Hospice Organizations Announce Intent-to-Merge Plans

Alamance-Caswell & Greensboro Hospice Organizations Announce Intent-to-Merge Plans to Better Meet End-Of-Life Care Needs for Patients and Families

March 6, 2019

(Burlington & Greensboro, NC)– Two of the leading not-for-profit hospice organizations in North Carolina announced plans to explore combining operations, staff and outreach efforts to better meet end-of-life care needs of residents in Alamance, Caswell, Guilford and surrounding counties. Hospice and Palliative Care of Alamance-Caswell (HPCAC) and Hospice and Palliative Care of Greensboro (HPCG) have signed an intent-to-merge agreement effective September 30th, pending due diligence reviews and final board approvals.

The two organizations currently serve more than 3,000 hospice patients annually with thousands of additional community members utilizing a wide range of palliative healthcare, education and counseling services. The combined organization will also explore adopting a yet-unchosen new name.

“Our organizations are dedicated to care for those with serious illness to help them and their families live as fully and comfortably as possible,” said Peter Barcus, CEO of HPCAC. “We have a like-minded approach to providing care as mission-driven, not-for-profit hospice organizations. Exploring a combination of our operations will allow us to determine how we might share service areas, avoid unnecessary duplication, adopt best practices from both organizations, and better align us with healthcare providers and maximize access to services.”

While leadership decisions have not been finalized, Barcus is expected to continue in a senior strategic consulting role  while Kristen Yntema, current CEO of HPCG, is expected to remain as CEO after the merger is completed. Caroline H. Durham, CFO of HPCAC, will assume the CFO role in the new organization as James T. “Tab” Haigler, CFO for HPCG, will move into a consulting role. The new organization is projected to keep open all current patient facilities, including the 22-bed Hospice Home in Burlington and the 14-bed Beacon Place facility in Greensboro. No staff layoffs are planned.

“In the coming months, our organizations will conduct due diligence and planning sessions to provide our boards with the information they need to make a final determination on merging our organizations and ensuring a seamless transition with no disruptions in patient care,” said Yntema. “We anticipate crafting a new mission, vision and name for the new organization with hopes that we will begin operations as one organization on October 1.”

In addition to ensuring more operating efficiencies, the combined organization will be able to recruit a deeper talent pool of nurses and staff. It will also strengthen the organization’s long-term position as a not-for-profit leader in a rapidly changing healthcare environment.

“A growing number of for-profit hospices are entering the Triad market, while Medicare changes are impacting how hospice care is reimbursed,” said Barcus. “This alignment between our two organizations will help ensure our communities have high-quality, not-for-profit hospice care for years to come.”

As part of this process, entities responsible for fundraising at both organizations will establish a plan for consolidating assets that honors historic donor intent and establishes a plan for future fundraising efforts. Collectively, the two organizations raise over $3 million annually to support programs and services.

HPCAC & HPCG were each formed in the early 1980s and began providing services by 1982.  Both organizations are state licensed, federally certified and nationally accredited. Services include in-home patient care, grief counseling, palliative care for families needing support and information on health-care options and Kids Path programs for children coping with serious illness and loss.

A transition team will be formed to lead the merger exploration work. The boards of directors for both organizations will be actively involved in these efforts, and the merger must be approved by both organizations before it is finalized.

“Our focus will remain on enabling our patients and their families to live more fully and discover life’s most important moments while addressing serious illness, death and grief,” said Yntema.

Questions? Click here to review our Frequently Asked Questions.


About Hospice and Palliative Care of Alamance-Caswell

Hospice and Palliative Care of Alamance-Caswell is a not-for-profit hospice and home health care provider founded in 1982 to care for those with serious illness or conditions, and their families, to help them live as fully and comfortably as possible. HPCAC also provides home health care, a 22-bed Hospice Home and counseling for children and adults.

About Hospice and Palliative Care of Greensboro

Hospice and Palliative Care of Greensboro is a not-for-profit organization serving Guilford County and surrounding areas since 1980. HPCG provides home-based hospice care, operates a freestanding fourteen-bed hospice facility, a robust grief counseling and community education program, a pediatric hospice program, and a community-based palliative care service.

Media Contact

Monty Hagler

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Dealing With Your Loved One’s Belongings

Sorting a lifetime’s worth of someone else’s belongings is a task difficult on its own, but with the added emotional burden of grief, it might seem entirely impossible.

Of course, the process will be emotional, time-consuming and difficult; but it will also be rewarding and satisfying. You will discover what matters most to you, and make room in your heart and home for those objects that are most meaningful.

If you’re not sure how to begin sorting through your loved one’s things, you can use the “Four Ps” to get started.

The Four Ps

  1. Pick Participants.

Decide who you want to involve in this process. Of course the old mantra “many hands make light work” is true of a lot of large projects, but in this instance, you may find that many hands do more harm than good. Because this is such a personal and emotional task, consider only involving those who you feel knew your loved one well. A helpful exercise is to imagine one of your loved one’s most precious keepsakes. Who would recognize its importance? By limiting participation, you are ensuring that you won’t have to worry about valuable items being discarded.

  1. Prioritize.

Start by listing out those tasks that are time-sensitive. Did your loved one own a business? Did they have a home that now has to be sold? Decide what needs to be dealt with urgently. Remember that smaller tasks can always be left for later. For example, if you need to sell a house quickly, consider renting a storage unit and going through things after the fact. If you put too much pressure on yourself to do everything all at once, you might find the emotional and physical effects to be overwhelming.

  1. Plan. 

Just starting such a large and emotionally burdensome project is often the hardest part of the whole process. Of course, start with the most urgent and high-priority tasks. But after that, consider breaking the process down into smaller projects. For example, you can sort items by room or by category. Start with something easy, such as tools or clothes, and save more difficult or sentimental things for last. You will find that having a game plan makes the whole project feel much more manageable.

  1. Pace yourself.

You’ve already decided what things are most urgent. After you’ve dealt with any time-sensitive tasks, slow down. Set small, manageable goals. If you start to feel overwhelmed, take a break and treat yourself to an outing or a conversation with a friend. Although going through your loved one’s belongings is a large task, it doesn’t have to be miserable. By taking your time and being gentle with yourself, you may find that the process becomes a satisfying, rewarding and even enjoyable way to remember and honor your loved one.

How Play Therapy Helps Grieving Children

As adults, we often picture counseling or therapy as someone sitting in a room talking to a professional about their problems. However, counseling with children often requires a different approach due to the developmental age of the child. Your child’s counselor may offer them opportunities to use different types of imaginative play materials, such as puppets, dollhouse elements, art supplies or figures in a sand tray.

Families sometimes wonder whether “just playing” can truly be therapeutic in helping children cope with grief and loss. The play therapy rooms at Kids Path are filled with carefully chosen toys, games and activities designed to let kids outwardly express their internal experiences. Dr. Garry Landreth, a pioneer of play therapy, explains it this way: “In play therapy, toys are viewed as the child’s words and play as the child’s language.”

Following are some of the key benefits of play therapy for grieving children.

Allowing symbolic expression of feelings

It can be difficult for kids to identify or verbally describe how they are feeling. Play therapy provides a safe space where a child can use a puppet to voice feelings, or demonstrate an emotion through the actions of a toy. A child who is not able to speak out loud about their inner experience will often be willing to show it through play.

Opportunities to self-regulate strong emotions

Young children have not yet fully developed their capacity for big feelings. Child-directed play therapy allows the child to engage in activities that naturally provide nervous system regulation, such as scooping and pouring sand.

A way to be in control of a scary situation

 Sometimes in play therapy, children create imaginative scenarios with elements of danger—for example, they might narrate a story about a zebra that falls into quicksand and becomes buried. Because the child is in full control of what happens next, they can use imaginative play to indirectly process feelings of worry or fear while remaining safe and in-control.

Experiencing resilience and mastery

Play therapy provides many chances for a child to explore unfamiliar activities and learn resilience. Counselors who use play therapy are trained in specific ways to support children through frustration while they are building new skills, which then become a source of self-esteem.

Children’s Grief Counseling at Kids Path

Children as young as 4 years old may be eligible for play therapy and other individual counseling at Kids Path after experiencing a significant loss due to death or illness. Kids Path counseling is available at no charge. Call 336.544.5437 to speak with a licensed Kids Path counselor.

Hospice Offers Free Lunch & Learn Series

(GREENSBORO, NORTH CAROLINA)– Hospice and Palliative Care of Greensboro (HPCG) is excited to announce the new season of Lunch & Learn at the Lusk Center, a free lecture series designed to help participants with a variety of complex care and health issues.

Each hour-long workshop is presented by topic experts and held at HPCG’s Lusk Center, located at 2501 Summit Avenue in Greensboro. Lunch is provided, along with practical, community-focused resources.

Each event is free and open to the public. All workshops take place from noon – 1 p.m. with check-in beginning at 11:30 a.m.

The program is made possible through generous support from Beverly and Patrick Wright as well as the John A. Lusk, III Endowment Fund for Hospice and Palliative Care Education.

Visit for more information and to register.

Lunch & Learn at the Lusk Center
2019 Schedule

Advance Care Planning: How to Plan for End-of-Life Decisions
Thursday, March 14
Learn about advance directives, why and when they’re used and how to talk about end-of-life decisions with family.

What Really Matters: Changing Priorities Near End of Life
Thursday, April 25
Join us for a thoughtful, interactive discussion about the end-of-life journey and how to capture meaningful moments along the way.

Palliative Care vs. Hospice Care: What’s the Difference?
Thursday, June 13
Discover the difference between hospice and palliative care, how these services can help and who pays for them.

The Caregiver Experience: Navigating Rough Waters
Thursday, July 11
Caring for a loved one can be demanding. Join us as we explore ways caregivers can maintain—or regain—balance and hope.

Dementia Talk: Why Do They Do That … and What Can I Do About it?
Thursday, August 15
Learn practical strategies for addressing the four most difficult dementia behaviors: bath wars, social problems, aggression and agitation.

Beyond the Casserole: How to Truly Support Grieving Persons
Thursday, September 12
What gives real comfort to those who are grieving? Hear what deeply grieving persons wish others understood, and learn how to be of support to friends and family in grief.

About HPCG
HPCG, a nonprofit organization serving Guilford County and surrounding areas since 1980, is situated on a 14.75 acre campus at 2500 Summit Avenue. HPCG provides physical, emotional and spiritual support for children and adults faced with a life-limiting illness, as well as their caregivers and families. For more information, call 336.621.2500 or visit


Click here to download PDF of press release.