Talking to children of different ages about dying

How you talk to children about dying will depend on how old they are. It is important that children are able to let out their feelings and concerns. Talking can help.

Children between 0 to 2 years

• Very young children know when a parent is away but don't understand why.
• They are sensitive to changes in their routine.
• They are aware when their caregiver is upset.

What parents can do

• Try to have the same caregiver most of the time.
• Keep to the child's routines and their familiar environment.

Children between 3 to 5 years

• Young children know when a loved person is away. They might be afraid of being separated from their loved ones.
• They often blame themselves and feel guilty that they might have caused illness or death. For example, 'I got mad at Daddy, and made Daddy sick'.
• Small children are concrete thinkers. This means they might not understand an explanation such as 'Mummy is going to Heaven'.
• They might believe that a parent who has died is living on somewhere else.
• They don't understand that death is final. They may suggest 'a new medicine or replacing their batteries'.

What parents can do

• Try to explore your child's understanding of your cancer and death in general. Correct their misconceptions and reassure them that nothing they did caused the cancer.
• If you feel withdrawn, explain to your child that you're sad or worried, why, and that they did not cause you to be upset.
• Give your child concrete descriptions of what death means. For example, the body does not work anymore. Or when someone dies, their heart will stop pumping, and they'll stop breathing.
• Be patient in repeating that when someone has died, they will not come back.
• During illness and after death, keep to the same caregivers and routines. For example, going to preschool, playdates, mealtimes, and bedtime rituals.

Their sadness or anxiety might come out in ways that aren’t easy to spot. For example, through the way they move and play:

• A quiet child might become loud, throw toys around and appear very angry.
• A normally happy and confident child could become clingy. Or they might cry at things that didn’t bother them before.
• They may withdraw from playing with other children as much as they used to.

It is important to notice these signs and changes, and to support your child as best you can.

Experts encourage adults to talk openly and honestly with very young children. You don't need to tell them everything in depth. But you can use simple language and explain things they don’t understand.

Children between 6 and 12 years

• Children at this age can understand cause and effect. This means they will understand that illness can cause death. But they may have gaps in understanding. For example, they might believe that cancer can be caught or that it is always caused by smoking.
• They may believe that stress causes or maintains illness. So, they may be worried about 'stressing out' an ill parent. For example, if they have less-than-perfect behaviour, poor school performance, or when talking about their worries.
• They may worry about the health of other important adults.
• They understand that death is final and irreversible but do not fully appreciate that it happens to everyone.
• They understand the physical aspects of death but may struggle to understand the spiritual aspects.
• They may have guilt about things they did or did not do with or for someone dying.

What parents can do

• Give a simple explanation of the diagnosis and treatment of your cancer. Give clear, accurate information about the causes of death. For example, 'My cancer had spread to so many places in my body, and there weren't any medicines that helped anymore'.
• Correct their misconceptions and reassure them that nothing they did caused the cancer.
• Try to keep to routines and expectations.
• Continue with school attendance.
• Complaints related to their body are common. Ask for updates from their school about how often they visit the nurse.
• Help them put guilt and other worries in perspective. Think together about your relationship with each other rather than only the recent past.

Their feelings might come out in the way they behave. They might also feel angry with the parent for not being able to give them enough attention. Or they could be angry because you are going to leave them when you die.

It helps to understand that children of all ages can react as if they were much younger when they are feeling stressed. Be sensitive but straightforward when talking to children of this age. If you are too subtle, they won't understand what you are trying to say. 

Teenagers

• Teenagers can do abstract thinking. This causes them to have adult-like worries. For example, they might worry about family finances or talk about the meaning of life and suffering.
• Teenagers can still be emotionally immature. They may focus on how your cancer or death affects them personally. This can feel selfish to adults.
• They understand that death is final, irreversible, and happen to everyone.
• They may feel anxious about their own death. For example, they may wonder if your cancer is passed on through genes  (hereditary).
• They are sensitive about how a loss such as your death might set them apart from their friends.
• Conflict in their relationships with either parent may cause resentment, guilt, or regrets. This can make it more difficult for them to cope with your cancer and their grief.

What parents can do

• Give information about your cancer and its treatment. Give clear, accurate information about the causes of death.
• Teenagers may look for information from other sources, such as the internet. Encourage them to check the accuracy of this information with a parent.
• Respect their wish for privacy and control over sharing information about your illness.
• Encourage them to have conversations and relationships with appropriate other adults.
• Do not expect them to take on adult responsibilities.
• Watch for signs of risk-taking behaviour or drugs and alcohol abuse in response to your dying.

Teenagers are full of emotional ups and downs. They can feel confused and unsure about themselves. Adolescence is also a time to establish independence. This can make it difficult for teenagers to express their feelings and reach out to other people for support.

They might become distant from their family and talk to their friends instead. Or they may keep it all to themselves. They might become anxious, angry, moody, or depressed. Or they may pretend that they're coping very well when they feel very scared and lonely inside.

A teenagers reactions are likely to be more intense than an adult's. It's very important to give them time to grieve about the illness and include them in what is happening.

Young Minds is a charity that supports young people with their mental health.

Grown-up (older) children

Grown-up or older children will also struggle at times. The death of a parent is one of the most difficult things to cope with. 

It can help to be as open and honest as possible and include them in the situation.

Help and support for you and your family

Many hospitals, hospices and community cancer services have people who can support children. They include psychologists or social workers. Ask your doctor or nurse about these services in your area.

We have a list of other organisations that provide support.