Bereavement The loss of a loved one is one of life’s most stressful events. People with Down syndrome can be denied the opportunity to grieve because other people mistakenly assume that they don’t have the capacity to understand about death or to feel real sadness. As the life expectancy of people with Down syndrome is steadily increasing many more are experiencing the death of their friends and parents. When they are bereaved, their emotional and physical reactions to the loss are frequently misunderstood or denied. People respond to bereavement and express their grief in many different ways. Usually there is a process of working through their feelings, coming to terms with the loss and adjusting to life without their loved one. The grieving process for those with Down syndrome may however take longer and may show itself in ways that are not instantly recognisable. They will probably need help in working through the process. Many people with Down syndrome find change of any kind difficult to cope with. Routines can be particularly important to them by providing a sense of order and structure to their lives. As well as dealing with the grief of the loss of someone close to them they may also have to cope with significant change to their routines. They may feel that other people are making decisions that affect their lives without any warning, any element of personal choice or of personal control. Specialist advice should be sought if grief develops into persistent low moods, significant behavioural changes or other symptoms of depression.