Patient Information Publications Clinical Center National Institutes of Health Talking to Children about Death If you are concerned about discussing This information cannot possibly deal death with your children, you are not with every situation. It does provide alone. Many of us hesitate to talk about some general information which may be death, particularly with youngsters. But helpful and which may be adapted to death is an inescapable fact of life. We meet each family's needs. must deal with it, and so must our chil - Children are aware dren. If we are to help them, we must Long before we realize it, children let them know it's okay to talk about it. become aware of death. They see dead By talking to our children about death, birds, insects, and animals lying by the we may discover what they know and road. They may see death at least once do not know; if they have misconcep - a day on television or on video games. tions, fears, or worries. We can then They hear about it in fairy tales and act help them by providing information, it out in their play. Death is a part of comfort, and understanding. Talk does everyday life, and children, at some not solve all problems, but without talk, level, are aware of it. we are even more limited in our ability If we permit children to talk to us about to help. death, we can give them needed infor- What we say about death to our chil - mation, prepare them for a crisis, and dren, or when we say it, will depend on help them when they are upset. We can their ages and experiences. It will also encourage their communication by depend on our own experiences, showing interest in and respect for what beliefs, feelings, and the situations in they say. We can also make it easier for which we find ourselves, for each situa - them to talk to us if we are open, hon- tion we face is somewhat different. est, and comfortable with our own feel- Some discussions about death may be ings. Perhaps we can make it easier for stimulated by a news report or a televi - ourselves and for our children if we take sion program and take place in a rela - a closer look at some of the problems tively unemotional atmosphere. Other that might make communication difficult. talks may result from a family crisis and Communication barriers be charged with emotions. Avoidance, confrontation Many of us are inclined not to talk about things that upset us. We try to put a lid Patient Information Publications 1 Talking to Children about Death on or hide our feelings and hope that ■ Trying to be sensitive to children's saying nothing will be for the best. But desires to communicate when they not talking about something does not are ready. mean that we are not communicating. ■ Maintaining an openness that encour- Children are great observers. They read ages children's attempts to communi- messages on our faces and in the way cate. we walk or hold our hands. We express ■ Listening to and accepting children's ourselves by what we do, by what we feelings. say, and by what we do not say. ■ Offering children honest explanations When we avoid talking about something when we are obviously upset. that is obviously upsetting, children often hesitate to bring up the subject or ask ■ Answering questions in simple lan- questions about it. To a child, avoidance guage appropriate for their age. can be a message: “If Mommy and ■ Trying to find brief, simple, and age- Daddy can't talk about it, it must be bad, appropriate answers to children's so I better not talk about it either.” Or, “I questions; understandable answers cannot talk about it because it will only which do not overwhelm them with make Mommy or Daddy more sad.” In too many words. effect, instead of protecting our children Perhaps most difficult of all, communicat- by avoiding talk, we sometimes cause ing about death involves examining our them more worry and keep them from own feelings and beliefs so that we can telling us how they feel. The child's fear talk to our children naturally when oppor- of the unknown is worse than facing the tunities arise. reality. The child may fantasize and cre- ate the worst scenario or an incorrect Not having all the answers reality. When talking with children, many of us feel uncomfortable if we do not have all On the other hand, it is also not wise to the answers. Young children, in particu- confront children with information that lar, seem to expect parents to be all they may not understand or want to knowing, even about death. But death, know. As with any sensitive subject, we the one certainty in life, is life's greatest must seek a delicate balance that uncertainty. Coming to terms with death encourages children to communicate: a can be a lifelong process. We may find balance between avoidance and con- different answers at different stages of frontation. This balance is not easy to our lives, or we may always feel achieve. It involves the following: Patient Information Publications 2 Talking to Children about Death uncertain and fearful. If we have unresolved experienced death together, mourned fears and questions, we may wonder how together, and comforted each other. to provide comforting answers for our chil- Today, death is lonelier. Many people die in dren. hospitals and nursing homes where they While not all our answers may be comfort- receive the extensive nursing and medical ing, we can share what we truly believe. care they need. Their loved ones have Where we have doubts, an honest, “I just fewer opportunities to be with them and don't know the answer to that one,” may be often miss sharing their last moments of more comforting than an explanation that life. The living have become isolated from we do not quite believe. Children usually the dying. Consequently, death has taken sense our doubts. White lies, no matter on an added mystery, and, for some, an how well intended, can create uneasiness added fear. and distrust. Sooner or later, our children Many people are beginning to recognize will learn that we are not all knowing. We that treating death as a taboo does a dis- can make this discovery easier for them if service to both the dying and the living. we calmly and matter-of-fatly tell them that Efforts are under way to increase knowl- we do not have all the answers. Our nonde- edge and communication about death as a fensive and accepting attitude may also means of overcoming the taboo. help them feel better about not knowing everything. As part of this effort, the hospice movement provides for children and adults to die at It may help to tell our children that different home beside their loved ones, pets, and people believe different things about death, other favorite things. It may be frightening and that not everyone believes as we do. for parents to think about a child dying at For example, some believe in an afterlife, home, and by contacting the staff of a local others do not. By indicating our acceptance hospice program, families can obtain the and respect for others' beliefs, we make it help and advice they may need. easier for our children to choose beliefs dif- ferent from our own but which are more Children’s perceptions are also being stud- comforting to them. ied for a better understanding of how they think about death. Researchers have found Overcoming the taboos that two factors influence children's concep- Death is a taboo subject, and even those tions of death: their developmental stages who hold strong beliefs may avoid talking and their experiences (including environ- about it. Once, death was an integral part ment, prior experiences, ethnic, religious, of life. People died at home, surrounded by and cultural background). their loved ones. Adults and children Patient Information Publications 3 Talking to Children about Death We must realize that death is a natural are trying to overcome their fears by con- ending to the life of every living thing. firming their “control” over mortality. The sadness that surrounds dying can best The individual experience be handled by caring for one other, either While it can be helpful to know that children by providing care to someone who is ill or go through a series of stages in the way by just “being there.” they perceive death, it is important to Developmental stages remember that, as in all growth processes, Studies show that children go through a children develop at individual rates. It is series of stages in their understanding of equally important to keep in mind that all death. For example, preschool children children experience life uniquely and have usually see death as reversible, temporary, their own ways of expressing and handling and impersonal. Watching cartoon charac- feelings. Some children ask questions ters on television miraculously recover after about death as early as age 3. Others may being crushed or blown apart tends to rein- appear to be unconcerned about the death force this idea. of a grandparent, but may react strongly to the death of a pet. Some may never men- Between the ages of 5 and 9, most children tion death, but they may act out their fan- are beginning to realize that death is final tasies in play. They may pretend that a toy and that all living things die. But they still or pet is dying and express their feelings in do not see death as personal.