Talking with children about death

Claire McCarthy, MD
Claire McCarthy, MD

Last week I wrote about how my children helped me care for a dying friend, and about the lessons I hoped they would learn from the experience.

Every family is different, and every family is touched differently by death, and so every family makes different choices. I chose to bring my children in very close to the caregiving and death itself, but for some families that doesn’t feel right. It may be impossible, such as when the dying person is very far away, or when the death is sudden.

No matter the circumstances, teaching children about death is hard. We don’t want childhood to be sad, so we don’t like to talk about death. And it’s hard to teach a child about something when you have so many unresolved feelings and questions about it yourself.

But if we wait until all those feelings and questions get resolved, we’ll never talk about it—and our children need us to give them guidance. And really, understanding that death leaves us with unresolved feelings and questions is part of what children need to learn. So don’t let that stop you.

Here is some general advice for talking to children about death. Some of it is taken from a really great publication from the National Institutes of Health, titled (aptly) “Talking to Children about Death.” It is thorough, and full of thoughtful and useful advice.

  • Communication is crucial. Kids pick up on things, so it’s not like you can hide it when someone is dying. Also, they have active imaginations; sometimes what they are imagining is worse than reality. Let them know what’s going on and give them opportunities to ask questions. Keep both the information and the answers simple—if they want more detail, they will ask for it. Most importantly, be honest.
  • Choose your words carefully. Kids are often very concrete, so when you refer to death as “going to sleep” or “final rest,” that can make kids afraid to take naps—or afraid you won’t wake up in the morning. Saying that a person died because they were sick can make children terrified of every sniffle unless you explain that only very bad sicknesses can make a person die. Think like a kid, if you can.
  • Understand where you child is developmentally. Preschoolers don’t get that death is permanent, and may need explanations repeated many times. Elementary school age kids understand that it’s permanent, but may have magical thinking about it, and often assume that it won’t happen to them. They may also feel guilty for reasons you don’t expect. Adolescents are beginning to understand their own mortality, and may have a different reaction. Really, each child will have a different reaction based not just on their age but their personality and the particular situation. Just because they don’t react immediately doesn’t mean they aren’t full of feelings; it may get played out in different ways. That’s why giving children lots of opportunities to talk and ask questions is important.
  • Don’t be afraid to bring the child to visit the dying person, or to the funeral. Both can be very important, and helpful, for the child. There are three things to do and remember if you are thinking about this:
  • Preparation is key. Make sure your child knows what they will see, and how other people will be reacting.
  • Make sure the child is with someone who will be calm, supportive, and answer questions. If that can’t be you because you are too upset, find someone who can do it.
  • Never force a child to go. If they don’t want to, offer options like making a card, or bringing flowers later to the grave.
  • Understand that for children, mourning is a process and can take time. It’s the same way for grownups, after all. It can be helpful to find positive ways to remember the person, like making a memory book. To the extent that it’s possible, try to keep a child’s routines; children rely on them to feel safe and to know that life goes on.
  • Look for help. Books can be a great resource. There are many out there for parents and for children. One for children that I like is When Dinosaurs Die: A Guide to Understanding Death by Laurie Krasny Brown and Marc Brown (the author of the Arthur books), but there are other wonderful books tailored to different situations. Go to the library or bookstore and explore your options. Make sure you read through a book completely before you read it to your child.

If you or your child is having trouble coping, let your doctor know. Sometimes a mental health professional can make all the difference when it comes to dealing with death; you should never be ashamed to ask for help.

As I said last week, as much as we may hate it, death is part of life. We can’t protect our children from that simple fact. What we can do is give them the understanding and skills to cope with it when it does happen—and teach them that not only does life go on, but happiness is always possible.

  • Mary Croft

    I am relieved to know that Children’s Hospital Boston is dealing with death and dying as it affects children. Having my sister die when I was 8 years old was very traumatic. When I finally began to deal with the issue as an adult, I was able to finally truly LIVE my own life. There is such a thing as “survival guilt” which happened to me. Thank you, BCH.

  • Cheri Wing-Jones

    Thanks to Dr. Claire McCarthy for her touchingly clear article, “Lessons for Living”. Good role-modeling for all: her own children as well as readers. I am a former child life specialist who is now teaching young children. I see often that families need guidance on how to help their children understand death and grief. Schools don’t always know how to help and need guidance, too. Through the help of a grant, I and a parent recently finished writing suggested guidelines and a bibliography of picture books to help parents and teachers help children with death and grief. I have been thinking about this and how to help others help children.
    Thanks, good article!
    Best Regards,
    Cheri Wing-Jones

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