TALKING WITH CHILDREN ABOUT DEATH

• Ten year-old Maria diagnosed with cancer lies in her hospital bed. She experiences being in and out of consciousness and is receiving morphine to alleviate her pain as her death becomes imminent. She turns to her nurse and asks. "Am I dying?" The nurse, surprised by her question, responds to her and says, "Just relax, 1'11 be right back."
  
  
• Five year- old Sammy while driving home from school with his mother turns to her and asks, “What is dying?" The mother responds by saying, "Dying is when you are very sick or when you get old."
  
  
• Sixteen year-old Monica, makes an appointment to see the school counselor. When she arrives there are tears running down her face and she begins to tell the counselor how much she misses her father, who died a year ago. The counselor responds, "If you would like I can write a note to dismiss you from class and perhaps tomorrow you will feel better."
  

Talking about death to children can be difficult. It triggers our own feelings of loss and vulnerability. We find ourselves lost in finding ways to respond appropriately or we withdraw, not knowing what to say or do and wishing to avoid our own pain. Children have a basic need to make sense of the world and of themselves in it. When they experience the death of a loved one they become confused and vulnerable. They are in need of comfort, validation and to find a way to extrapolate meaning from the event.

Maria Tome, Certified Child Life Specialist

Adults have a tremendous responsibility when it comes to explaining death to children. These adults are parents, various professionals who work with children, or those who come in contact with children at the time of a death. It is how adults handle the entire death experience, which will send a lifelong message to children and will potentially influence how they cope with death in the future. It is here that children begin to understand something about this sad experience and that word we call "death". These experiences and messages can be positive or negative memories as children begin to make sense of the world and carry these messages throughout adulthood.

Be honest about the death and about what you don’t know. Tell the truth about the death including illness, traumatic injury, suicide and murder. Children may not want or need details but they will eventually learn what happened and may feel betrayed if a loss is due to death was explained with lies or half truths. Children may repeatedly ask many questions. Carefully choose age-appropriate words when giving explanations about death. Use words they understand to address illness, injury, suicide and murder. Avoid words that may confuse them such as “sleeping,” “gone away,” “passed away, ”or “taken from us”, “this is a blessing”, or “everything will be okay”

Talking with children can be done in ways that are meaningful, honest and developmentally appropriate. Having a child draw pictures about the death and talking about it and what it means can help adults understand what the child is thinking. It is also an opportunity to clarify any misperceptions they may have. Reading books about death and dying can also be a way to help children make sense of what they are experiencing. Taking advantage of those “teachable moments” to help children understand. For example: a dead pet, a funeral procession on the street, the buds of spring and leaves of fall, certain television shows and movies, childhood stories and fairytales, and much more. Each is a potential learning opportunity for the child.

Studies on childhood bereavement found that bereaved children who were experienced in talking about death before a parent died were more able to handle the death than were children who had not had the opportunity. Children are generally protected when a death occurs. It is difficult to tell them the truth and often adults don't know how to explain the facts. When something bad happens, then adults believe it is the time to talk about it. When adults begin to struggle to overcome their own personal resistance for whatever reasons, and involve children in discussions about death or include them in mourning rituals, this will help children view death as part of life.