How to Talk to a Child About Death

How do you tell a child that a loved one is dying? Christi Kettman answers this question a lot.

“Those are the kind of calls we get every day,” says Kettman, who is outreach coordinator at Fernside – A Center for Grieving Children. Fernside is an affiliate of Hospice of Cincinnati.

If adults struggle with talking to each other about death – and they do, mightily – imagine how difficult it is to bring up the topic with a child. We want to protect our children from painful feelings, but the reality is, we can’t always do that.

Kettman recommends that, if you find yourself in the position of having to tell a child that someone is dying, you consider the following advice:

1. Prepare yourself

“Prepare yourself for the conversation, before you sit down with your child,” Kettman says. “It’s okay if the child sees your emotions, so that they know it’s okay to express them as well.”

2. Be honest, and don’t wait

Kettman advises honesty and directness with children. “Kids who are given information and have the opportunity to process it will do better,” she says. “At Fernside, we’re all about being direct when having the conversation.”

3. Be thoughtful about who informs the child

Children should hear this news from a person they trust, Kettman says, which is usually the parent or guardian. If you’re that person, and are unsure, “we can offer suggestions on what to say,” Kettman explains, “or we may suggest having other supportive people present to help if needed,” Kettman explains.

The patient may want to be part of the conversation, but if this limits what can be said, make sure to follow up with some alone time with the child to offer additional support and/or information.

Once the child is given the news, it’s helpful to contact teachers and others who care for your kids and let them know what’s going on.

4. Let the child’s questions guide the conversation

As you talk with your child, allow her space to respond and ask questions. Some may have many questions; others may not, or might want some time to reflect before asking.

Children are often satisfied with short answers, just long enough for clarification and reassurance. Some want more details than others. Your child’s age will determine how much detail you give them. Explain clearly, simply and honestly. If you don’t have an answer, it’s okay to say “I don’t know” in response to a question. You can always follow up later once you do know.

5. Keep the age of the child in mind

Obviously, very young children process information differently from middle-schoolers and teenagers. Be sensitive to what the child is capable of understanding at his age.

Here are some suggestions:

Early childhood (toddlers, pre-K, kindergarten): Children at this age are very literal. They don’t understand serious illnesses. Use clear, simple terms. It’s okay to use specific terms (like stroke, Alzheimer’s, or cancer), but be prepared to explain, what they are and how they affect the body.

In addition, prepare them for what lies ahead. “Very simply, describe how things may change,” says Kettman. For example, explain that there will be nurses or more people in the house, or a bed in the living room.

Elementary-school-aged children: As children get older, they start to learn more about life, death and illness, as well as how the body functions. But the info they have, Kettman warns, may not be accurate or apply to your situation. For example, not all cancers are alike, and different diseases take different forms. You may want to ask them, “What do you know about (cancer, Alzheimer’s, etc.)?” You’ll need to help correct any misunderstandings they may have.

They might also ask specific questions about the intricate details of the loved one’s illness or well-being. Again, be honest, and use age-appropriate language and descriptions.

At this age, children may be concerned about how their family will manage day-to-day. “Who’s going to make my lunch?” “Who’s going to take me to soccer?” Let them know how their routines might change. “We can’t change what’s happening, but we can give some control back by giving them something to expect,” Kettman says.

Pre-teen and up: At this point, kids can think in more abstract terms. They may have questions about whether roles in the family will change, like “Will I be responsible for cooking for the family?” or “Should I be helping with my younger siblings?”

Teens may ask “why me?” or “why us?” They also might not want their friends to know because kids this age often don’t want to be seen as “different” from their peers, and as such, don’t want to be known as “the kid whose mom is going to die.” Peer relationships are important at this age but grief is unique. They may want to seek the comfort of their social circle, or at other times, avoid being around their friends altogether.

6. Keep the lines of communication open

As the illness progresses, check in regularly with your child. As you learn more, share more. Ask the child, “Do you want to talk today? I have more information.” Help them understand how things are changing with the patient, including any changes in their medical care, and changes in the patient’s physical appearance and emotional well-being.

7. Seek support

There are a number of resources available to help you in talking to your child about dying. This includes:

• Anticipatory grief counselors at Hospice of Cincinnati. These are professional counselors who work with families as the end of life approaches. Phone: (513) 246-9208
• Fernside offers resources for talking to children about death, dying and grief: http://fernside.org/grief-resources/booklists-referrals/
• Cancer Family Care is a local not-for-profit organization that offers resources for children and adults. Website: https://www.cancerfamilycare.org/

8. Let your children be children

Most importantly, try to let kids be kids. Allow them to help out when they can, if they wish. However, Kettman reminds us that “they’re not adults. Don’t force them into adult roles. Allow them to enjoy activities like going to prom and participating in their favorite hobbies.”

Kettman says that our kids can surprise us during these difficult times. “They can demonstrate maturity, rise to the occasion, develop confidence and self-esteem,” she says. “We can rely on our strengths and theirs. Give them and yourself credit for being able to cope with what’s happening.”