September 27, 2018

A Parent’s Guide to Talking to Your Kids about Death

By the Mission Hospital Child Life Team

Talking with anyone about death and the loss of a loved one is challenging – especially with the little ones. You might not realize how that conversation would go until it’s happening and you find yourself asking, “How do I tell my child?” While they may not fully grasp the situation, it’s still important to talk with your little ones about the death of loved one – as young as one year-old to their early and later teenage years.

A Parent’s Guide to Talking about Death of a Loved One in an Intensive-Care Setting

Toddlers: 1-3 years

At this age, they will not understand anything more than something sad has happened.

What to tell them:

They will not understand the permanency of death but they will be very tuned in to the emotions in the room. Still, it is important to acknowledge the sadness with your toddler and offer some comfort through play, hugs and routine.

Here are some examples of things to do:

  • Snuggle up with a book about feelings and point to which emotion on the page best describes how you are feeling
  • Allow your toddler to have lots of opportunities to play
  • Say things like, “Mommy/Daddy is sad because she/he misses Papaw,” and, “It’s okay for you to feel sad too”

Play is one of the most important ways that a child at this age/stage can make sense of the world around them.

Preschoolers: 3-5 years

Preschoolers are still too young to understand that death is permanent and that it will happen to everyone, including themselves, someday. Preschoolers are starting to learn about death mostly from fairytales, like seeing a dead bird in the yard or that a family pet has died.

What to tell them:

Explain that fairytales are pretend and that when someone dies in real life, they do not come back. Keep your explanations simple – avoid saying things like “passed away,” “resting in peace,” “lost” or “gone to sleep.”  We often want to protect our children from scary and sad things but it is important to simply be clear and straightforward so they understand. While you may hesitate or it feels harsh, don’t be afraid to use the words “death” and “died.” Hearing these real words will help your child to better understand what has happened.

Here are some examples of things to say:

  • “[Loved one’s name]’s body cannot work anymore because he/she has died. When someone dies, that means their body stops working. They can’t talk, eat move or breathe anymore.”
  • “Sometimes on TV or in stories – like Sleeping Beauty, The Little Mermaid or Beauty and the Beast – someone may die and then come back to life again. In real life, when someone dies, they don’t come back to life.”
  • “Sometimes, our toys break and we can put some glue or tape on them to fix them. The doctors have tried very hard to fix your [Loved one’s name]’s body with medicine, but [loved one’s name]’s body cannot be fixed.”
  • “Just because you may have a cold someday or get the tummy bug does not mean that you will die. [Loved one’s name]’s body is/was sicker than a cold or a tummy bug.”
  • “[Loved one’s name] cannot do things like play outside or read you stories anymore.”
  • “It is not your fault that [Loved one’s name] will die/has died.”

School age: 5-11 years

At this age, children can begin to understand the permanency of death but they may still have some “fantasy” thoughts about death, such as how they can escape or outwit their own death like in video games.

What to tell them:

Explain that death happens eventually to all living things like plants, animals and people. It’s normal for this age to be curious about death and how it relates to the body. It’s okay to add in more details about why the death is going to happen, but give the information in small amounts. Explain the reason for death in simple terms.

Here are some examples of things to say:

  • “[Loved one’s name] has a serious kind of illness in his body called pneumonia (or cancer, etc.). [Loved one’s name]’s body is not strong enough to get rid of the pneumonia and the doctors cannot give him/her anymore medicine to make it go away. We know now that “[Loved one’s name]’s body is going to die from this illness.”
  • “The doctors are not able to fix your [Loved one’s name]’s injuries from the car accident. They tried so hard but his/her body was hurt too badly. The doctors have given him/her medicine to take away his/her pain but they cannot take away his injuries. Because of this, [Loved one’s name] will die soon.”
  • “There are three reasons why people die: people get really old, really sick or really For [Loved one’s name], he/she got really hurt (or sick or old).”
  • “The doctors are not able to fix his/her injuries enough to keep him alive.”

Adolescents: 12-19 years

At this stage, children are able to fully grasp the concept of death.

What to tell them:

It is okay to talk to them about the death using language similar to what you would use with an adult, however, their reaction to the news may be different. Adolescents are still developing their ability to cope with life’s difficulties, so they will need individual attention to help them through this change.

Adolescents tend to start questioning the meaning of life, and may begin wondering about what happens after death. Experiencing the sudden death of a close relative or peer due to injury or illness can stir up even more of these questions about why death happens – and this is normal. Try supporting them by allowing open conversations about their feelings and questions. Help them to discover healthy and appropriate ways to deal with this stress, like seeking peer support, exercise, journaling or art.

Here are some suggestions that may help:

  • Be honest and accurate with your explanation
  • Be open to talking truthfully about the circumstances surrounding the death
  • Allow for a mature discussion about your teen’s thoughts and feelings – remember, children this age need to feel valued and often want to be treated as equals
  • Ask your teen if he/she wants to be a part of the family meetings with the doctors to discuss end-of-life decisions
  • Provide a notebook or journal for him/her to have during and after any care meetings with medical staff to take notes and come up with questions
  • Make sure that someone is there to answer any questions that come up

Overall, it’s important to remember that every child reacts differently to losing someone they love.  Remember that you know your child best and using this information as a guide can help you find the best way to talk with them about death. With a child of any age, it’s important to normalize that it’s okay to feel all types of feelings. There is no wrong way to grieve, however – there are ways to grieve that are healthy and there are ways that are unhealthy. Always seek a professional for further help in knowing how to best support your child during this hard time.

It’s okay to let your children see you cry or feel upset about losing someone. Talking about it in an age-appropriate way can help normalize it for your child. There may be lots of questions during this time, and it’s important to listen to your child and talk with them about their feelings. This will greatly help them adjust over time, and remember to continue being patient with your child and yourself. One of the best ways to help your child grieve in a healthy way is for you, as their caregiver, to find healthy ways to grieve this loss.


This information is provided by the Child Life team at Mission Children’s Hospital.

Learn more about Mission Children’s Hospital and the Child Life Program at missionchildrens.org.

 

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