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. They harbor their make-believe game. They may play the idea that somehow they can escape “death games” with their friends by taking through their own ingenuity. During this turns dying or developing elaborate funeral stage, children also tend to personify death. rites. They may associate death with a skeleton or with the angel of death. Some children No matter how children cope with death or have nightmares about these images. express their feelings, they need sympa- thetic and nonjudgemental responses from From age 9 or 10 through adolescence, adults. Careful listening and watching may children begin to comprehend fully that provide important clues to learn how to death is irreversible; that all living things die respond appropriately to a child's needs. and that they, too, will die someday. Some begin to work on developing philosophical The challenge of talking to a young child views of life and death. Teenagers often Communicating with preschoolers or young become intrigued with seeking the meaning school-age children about any subject can of life. Some adolescents react to their fear be challenging. They need brief and simple of death by taking unnecessary chances explanations. Long lectures or complicated with their lives. In confronting death, they responses to their questions will probably

Patient Information Publications 4 Talking to Children about Death bore or confuse them and should be avoid- There are also times when we have difficul- ed. Using concrete and familiar examples ty "hearing" what children are asking us. A may help. For instance, Dr. Earl A. question that may seem shockingly insensi- Grollman suggests in his book, Explaining tive to an adult may be a child's request for Death to Children, that death may be made reassurance. For instance, the question, more comprehensible by explaining it in “When will you die?” needs to be heard terms of the absence of familiar life func- with the realization that the young child per- tions: when people die they do not breathe, ceives death as temporary. While the finali- eat, talk, think, or feel anymore. When dogs ty of death is not fully understood, a child die they do not bark or run anymore; dead may realize that death means separation, flowers do not grow or bloom anymore. and separation from parents and the loss of care are frightening. Being cared for is a A child may ask questions immediately or realistic and practical concern, and a child may respond with thoughtful silence and needs to be reassured. Possibly the best come back later to ask more questions. way to answer such a question is by asking Each question deserves a simple and rele- a clarifying question in return: “Are you vant answer. Checking to see if a child has worried that I won't be here to take care of understood what has been said is critical; you?” If that is the case, the reassuring and youngsters sometimes confuse what they appropriate answer would be something hear. Also, children learn through repetition, like this: “I don’t expect to die for a long and they may need to repeat their ques- time. I expect to be here to take care of you tions and hear them answered over and as long as you need me, but if Mommy and over again. As time passes and children Daddy died, there would be lots of people have new experiences, they will need fur- to take care of you. There's Aunt Ellen and ther clarification and sharing of ideas and Uncle John, or Grandma.” feelings. Other problems can arise from children's It may take time for a child to understand misperceptions about death. Dr. R. Fulton, fully the ramifications of death and its emo- in Grollman's Explaining Death to Children, tional implications. A child who knows that points out that some children confuse death Uncle Ed has died may still ask why Aunt with sleep, particularly if they hear adults Susan is crying. The child needs an refer to death with one of the many answer. “Aunt Susan is crying because she euphemisms for sleep: "eternal rest," "rest is sad that Uncle Ed has died. She misses in peace."As a result of the confusion, a him very much. We all feel sad when child may become afraid of going to bed or someone we care about dies.” taking naps.

Patient Information Publications 5 Talking to Children about Death Similarly, if children are told that someone before death, a child may be confused or who died “went away,” brief separations frightened by the sudden introduction of may worry them. Therefore, it is important religious explanations or references. to avoid such words as ”sleep,” “rest,” or Children tend to hear words literally, and “went away” when talking to a child about religious explanations that comfort an adult death. may unsettle a child. For example, the Telling children that sickness was the cause explanation, “Baby brother is with God of a death may also create problems if the now,” or, “It is God's will,” could be fright- truth is not tempered with reassurance. ening rather than reassuring to young chil- Preschoolers cannot differentiate between dren who may worry that God might decide temporary and fatal illness, and minor ail- to come and get them just as He did baby ments may begin to cause them unneces- brother. sary concern. When talking to a child about Also, mixed messages are confusing, and someone who has died as a result of an ill- may deepen apprehensions and misunder- ness, it might be helpful to explain that only standings children may have about death. a very serious illness may cause death, A calm statement, “He is happy now,” when and that although we all get sick some- coupled with tears may leave children con- times, we usually get better again. fused. Children look to adults for cues Another generalization we often make about how to behave in certain situations. unthinkingly is relating death to old age. Regardless of how strong or comforting Statements as, “Only old people die,” or, religious beliefs may be, death means the “Aunt Hannah died because she was old,” loss of a living being. It is a time of sadness can lead to distrust when a child eventually and mourning. It is important to help chil- learns that young people die, too. It might dren accept loss and grief. Attempts to pro- be better to say something like this: “Aunt tect children deny them opportunities to Hannah lived a long time before she died. share their feelings and receive needed Most people do live a long time, but some support. Sharing feelings helps. Sharing don't. I expect you and I will both live a religious beliefs also helps if done with sen- long time.” sitivity to how children are perceiving and Religion and death understanding what is happening. It is Religion is a prime source of strength and important to check with them to find out sustenance to many people when they are how they are hearing and seeing events dealing with death. But if religion has not around them. played an important role in the family's life

Patient Information Publications 6 Talking to Children about Death Opportunities in daily life deaths, funerals, and the public's reactions It is usually easier to talk about death when receive a lot of media coverage. When the we are less emotionally involved. Taking death is news-worthy, children are bound to opportunities to talk to children about dead see something about it on television or flowers, trees, insects, or birds may be hear it mentioned on the radio, in school, or helpful. Some young children show intense in our conversations. In any case, it can curiosity about dead insects and animals. rarely be ignored. It is a natural time to give They may wish to examine them closely, or children needed information or to clarify they may ask detailed questions about any misconceptions they may have about what happens physically to dead things. death. Although this interest may seem repulsive If the death is violent, a murder or an or morbid to us, it is a way of learning assassination, it is probably a good idea to about death. Children should not be made say something to reassure children about to feel guilty or embarrassed about their their safety. The media tend to play up vio- curiosity. Their interest may provide an lence under ordinary circumstances, and opportunity to explain, for the first time, that the violent death of a well-known or all living things die and make room for new admired person may stimulate their fears or living things. confirm distorted perceptions they may This kind of answer may satisfy for the have had about the dangers around them. moment, or it may lead to questions about They may become worried that “bad” peo- our own mortality. Honest, calm, and simple ple or that the “bad feelings” in people can- answers are called for. If we are talking to a not be controlled. They may need to hear very young child, we must remember that that most people act responsibly and do only limited amounts of information can be not go around killing each other, even absorbed at a time. The child may listen though everyone feels bad or angry at seriously to our answers and skip happily times. away saying, “Well, I'm never going to die.” Death in the family We should not feel compelled to contradict the child or think that our efforts have been Some children's reactions wasted. We have made it easier for the Guilt child to come back again when more Some studies have shown that when chil- answers are needed. dren experience the death of a close rela- Other opportunities to discuss with children tive, such as a brother, sister, or parent, occur when prominent people die and their they often feel guilty. While most of us

Patient Information Publications 7 Talking to Children about Death experience some guilt when we lose a for love and care. It is difficult enough to loved one, young children in particular have hear anger directed toward the dead, and difficulty understanding cause-and-effect even more so when it is expressed in what relationships. They think that in some way appears to be selfish concerns. But anger they caused the death; maybe their angry is part of grief, and we can help children by thoughts caused the person to die. Some accepting their feelings and by not scolding children may view death as a punishment: them if they express anger or fear. “Mommy died and left me because I was Children need to be reassured that they will bad.” Children may be helped to cope with be cared for. guilt by reassuring them that they have always been loved and still are. It may also Regression help to explain the circumstances of the Children may regress into an earlier stage death. Children may also feel that they will of development. For example, they may die. The idea that death is a form of punish- begin thumb sucking, bed wetting, or need ment should never be reinforced. Assure diapers. Realize that children need support the child that the recent death does not through this time and that such regressions mean that other loved ones will die soon. are temporary. The child may not know how to behave Depression and other behavior after a death. Encourage the child to talk problems about feelings and to share them with you, Some children turn their anger inward and but do not tell the child what to feel. Help become depressed, withdrawn, irritable, the child find ways to express caring. aggressive, or develop physical symptoms. If this behavior persists over several Anger months, professional help may be needed. The death of a close relative also arouses Remember, though, that each child deals feelings of anger in both adults and chil- with death differently. Experts say that 6 dren. We feel angry with the person who months after a significant death in the died for causing us so much pain and sor- child's life, a normal routine should resume. row or for leaving us alone. We feel angry If these symptoms do not resolve, you at the doctors and nurses who could not might consider seeking professional advice save our loved one, and we feel angry at (for example, a clergy member, pediatrician, ourselves for being unable to prevent the or social worker). death. After a child’s death Children are more apt to express their The death of a child is particularly tragic anger openly, especially when they have and may create special pitfalls for families. lost someone upon whom they depended

Patient Information Publications 8 Talking to Children about Death As parents, we must share our grief with life, providing that both the child and the our surviving children, for they, too, will dying person wish it. have grief to share. But we must try not to Under the right circumstances, contact with burden them with unrealistic expectations the dying can be useful to a youngster. It and concerns. For example, there is a ten- may diminish the mystery of death and help dency to idealize the dead, and we must the child develop more realistic ways of take care not to make comparisons that coping. It can open avenues of communica- could lead to feelings of unworthiness and tion, reducing the loneliness often felt by increase the guilt of the surviving children. both the living and the dying. The opportu- It is also natural to deal with grief by turning nity to bring a moment of happiness to a our attention to the living. It is understand- dying person might help a child feel useful able that the loss of a child may lead to too and less helpless. much worry about the welfare of our other A child who is to visit someone who is dying children. However, we must resist any ten- needs to be thoroughly prepared for what dencies to overprotect them or to smother will be heard and seen. The condition and their efforts to grow independent. We must appearance of the patient should be encourage them not to over-identify with or described, and any sickroom equipment try to replace the lost child. Each child must should be explained in advance. Also, it feel worthy in his or her own right. may be wise to remind the child that most It may be helpful to give children a special hospital patients get well. picture of the person who has died. The If visits are not feasible, telephone calls picture will help children remember and may be a handy substitute. The sound of a may be used later to evoke happy memo- child's voice could be good medicine for a ries of this person. hospitalized relative, provided that the child Should children visit the dying? wishes to call and the patient is well Most fatally ill people are hospitalized, and enough to receive it. Encouraging a child to hospital rules are changing. Hospital staffs write a note or send a card to the person are beginning to recognize the value of who is hospitalized can also help the child having children visit. Whether or not a par- feel less helpless and more connected to ticular child should visit a dying person the person who is dying. depends on the child, the patient, and the Under no circumstances should a child be situation. A child who is old enough to coerced or made to feel guilty for choosing understand what is happening probably not to call or visit the dying, or if contacts should be permitted to visit someone who are brief. has played an important role in his or her

Patient Information Publications 9 Talking to Children about Death Should children attend funerals? Sending children away from home Funerals serve a valuable function. Every The loss or impending loss of a close society has some form of ceremony to help family member taxes our emotional and the living acknowledge, accept, and cope physical reserves to the extreme, and it with the loss of a loved one. Whether or not becomes difficult to meet everyday respon- a particular child should be included sibilities. It is even more difficult to care depends on the child and the situation. If for youngsters, and sometimes we are the child is old enough to understand and tempted to send our children to visit wants to participate, being included may relatives or friends until we can “pull help the child accept the reality of the death ourselves together.” Keeping children at a while in the supportive company of family distance may also be a way to avoid talking and friends. to them about the death. If a child is to attend a funeral, he or she Careful consideration should be given should be prepared for what will be seen before children are sent away, for this is and heard before, during, and after the when they most need the comfort of famil- services. The child should be aware that on iar surroundings and close contact with such a sad occasion people will be family members. Children need time to expressing their bereavement in various adjust to the loss, and, if feasible, they ways, and that some people will be crying. should be prepared in advance of the If possible, the child should be accompa- death. Even young children who do not nied by someone who is calm and who can understand the full implications of death are give serious consideration and answers to aware that something serious is going on. questions. The child should not be coerced Sending them away may increase their or made to feel guilty about not wanting to fears about separation from their loved attend the funeral. ones and increase their anxiety. Having familiar and caring people nearby before Our own feelings and attitudes about the and after the death can reduce fear of death and loss are conveyed to the child, abandonment or other stresses children whether we try to camouflage our actual may feel. feelings or not. This transfer of our experi- ence to our children will occur. This is nor- On the other hand, we do not want to over- mal, usual, and to be expected. You protect them as a way of dealing with our should consider this when making deci- own anxieties and needs. Children should sions about funeral participation and how be given permission to play with friends or you prepare your child for what to expect. visit relatives. Children need the freedom to

Patient Information Publications 10 Talking to Children about Death deal with their own anxieties and needs views and questions. Encourage them just as we must handle our own. to communicate by listening attentively, respecting their views, and answering Children also mourn their questions honestly. Mourning is the recognition of a deeply felt loss and is a process we all must go ■ Every child is an individual. Communication about death depends through before we are able to pick up on the child's age and experiences. A the pieces and to go on living fully and very young child may view death as normally again. Mourning is part of the temporary, and he or she may be more healing process. By being open to our sor- concerned about separation from loved row and tears, we show our children that it ones than about death itself. is all right to feel sad and to cry. The expression of grief should never be equat- ■ It is not always easy to “hear” what a ed with weakness. Our sons as well as child is really asking. Sometimes it our daughters should be allowed to shed may be necessary to respond to a their tears and express their feelings if question with a question in order to and when they need to. understand fully the child's concern. An example here would be helpful. If the child shows little immediate grief, we For example, “Mommy, will we ever be may think the child is unaffected by the happy again?” By responding with, loss. Some mental health experts believe “Do you think we will ever be happy that children are not mature enough to again?” the parent can gain a better work through a deeply felt loss until they sense of the nature and depth of their are adolescents. Because of this, they child's worries. say, children are apt to express their sad- ■ A very young child can absorb only ness on and off over a long time and often limited amounts of information. at unexpected moments. Other family Answers need to be brief, simple, and members may find it painful to have old repeated when necessary. wounds opened again and again. But chil- dren need patience, understanding, and ■ A child often feels guilty and angry support to complete their “grief work.” when a close family member is lost. Parents should reassure the child that In summary love and care will continue. ■ Communication about death, as with ■ A child may need to mourn a deeply all communication, is easier when chil - felt loss on and off until adolescence. dren feel that they have our permission The child needs support and under- to talk about the subject and believe standing through this grief process and we are sincerely interested in their

Patient Information Publications 11 Talking to Children about Death permission to show feelings openly Lonetto, R. Children’s Conceptions of and freely. Death. New York: Springer; 1980. ■ Whether a child should visit the dying .TFrantz, T . When Your Child Has a Life- or attend a funeral depends on the Threatening Illness. Washington, D.C.: child's age and ability to understand Association for the Care of Children’s the situation, relationship with the Health; 1983. dying or dead person, and, most important, whether the child wishes to Books for children attend. A child should never be Mellonie, B., and Ingpen, R. Lifetimes: coerced or made to feel guilty for not The Beautiful Way to Explain Death to wanting to be involved (or comfortable Children. New York: Bantam; 1983. viewing a body). A child who is permit- Viorst, J. The Tenth Good Thing about ted to visit a dying person or attend a Barry. New York: MacMillan; 1987. funeral should be prepared in advance for what will be seen and heard. White, E.B. Charlotte’s Web. New York: Harper & Row; 1952. ■ Our own feelings and attitudes about death are conveyed to the child, Other books you might want to whether we try to camouflage our consider experience or not. How we talk about Agee, J. A Death in the Family. New York: and share our experience with the Bantam, 1969.Blackburn, L. B. The Class child may be what he/she remembers in Room 44: When a Classmate Dies. most. Omaha, NE: Centering Corporation; 1991. These books and organizations may pro- Brack, P; Brack, B. Moms Don't Get Sick. vide useful information for people faced Aberdeen, SD Melius Publishing, Inc.; with discussing death with children. 1990. Books for parents Braithwaite, A. When Uncle Bob Died. Grollman, E. A., editor. Explaining Death London: Dinosaur Publications; 1982. to Children. Boston: Beacon Press; 1968. Bratman, F. Everything You Need to Know Kubler-Ross, E. On Children and Death. When a Parent Dies. New York: Rosen New York: MacMillan; 1983. Group; 1992. Krulik, T., Holaday, B., Martinson, I.S. The Brenna, B. Year in the Life of Rosie Child and Family Facing Life-Threatening Bernard. New York: Harper & Row; 1971. Illness. Philadelphia: J.B. Lippincott Co.; Buscaglia, L. The Fall of Freddie the Leaf. 1987. New Jersey: Charles B. Slack Inc.; 1982.

Patient Information Publications 12 Talking to Children about Death De Paola, T. A. Nana Upstairs and Nana Lee, V. The Magic Moth. New York: Downstairs. New York: Penguin; 1973. Seabury Press; 1972. Crawford, C. P. Three-Legged Race. New Linn, E. Children Are Not Paper Dolls: A York: Harper & Row; 1974. Visit with Bereaved Children. Incline Village, NV: Publishers Mark; 1982. Draimin, B. H. Coping When a Parent Has AIDS. New York: Rosen Group; 1993 McNamara, J.W. My Mom is Dying: A Child's Diary. Minneapolis: Augsburg Fitzgerald, H. The Grieving Teen: A Guide Fortress; 1994. for Teenagers and Their Friends; 2000 Merrifield,M. Come Sit by Me. Toronto, Girard, L. W. Alex, the Kid with AIDS. Canada:Woman's Press; 1990. Morton Grove, Illinois: Albert Whitman and Co.; 1991. Miles, M. Annie and the Old One. Boston: Little Brown; 1971. Gootman, M. E. When a Friend Dies. Minneapolis: Free Spirit Publishing; 1994. Mills, J. C. Gentle Willow A Story for Children about Dying. New York: Greene, C. C. Beat the Turtle Drum. New Magination Press; 1993. York: Viking; 1976. Peterkin, A. What About Me? When Grollman, E. A. Straight Talk About Death Brothers and Sisters Get Sick. New York: for Teenagers: How to Cope with Losing Magination Press; 1992. Someone You Love, Boston, MA: Beacon Press; 1993 Powell, E. S. Geranium Morning. Minneapolis: Carolrhoda Books; 1990. Hichman, M. Last Week My Brother Anthony Died. Nashville, TN: Abingdon; Richter , E. Losing Someone You Love. 1983. New York: Putnam; 1986. Holms, C. D. Red Balloons, Fly High! Rofes, E. The Kids' Book About Death and Warminster, PA: MAR*CO Products, Inc.; Dying. Boston: Little, Brown; 1985. 1997. Sanders, P. Let's Talk About Death and Johnson J. & Johnson, M. Where's Jess? Dying. London: Aladdin Books; 1990. Omaha, NE: Centering Corporation; 1982. Shriver , M. What's Heaven? Golden Books Krementz, J. How It Feels When A Parent Publishing Co; 1999. Dies. New York: Knopf; 1981. Sims, A.M. Am I Still a Sister? Slidell, Louisiana: Big A & Company / Starline Printing, Inc.; 1986.

Patient Information Publications 13 Talking to Children about Death Starkman, N. Z's Gift. Seattle: Compassionate Friends Comprehensive Health Education P.O. Box 3696 Foundation; 1988. Oak Brook, Illinois 60522 708-990-0010 Varley, S. The Badger's Parting Gifts. Mulberry Books; 1992. Vigna, J. Saying Goodbye to Daddy. Morton Grove, Illinois: Albert Whitman and Acknowledgements Co., 1991. This publication was adapted from the Wiener , L.; Best, A.; Pizzo, P. Be A Friend: booklet, Caring About Kids: Talking to Children Who Live With HIV Speak. Morton Children about Death (DHEW Publication Grove, Illinois: Albert Whitman and Co.; No. 79-939) originally produced by the 1994. National Institute of Mental Health. Williams, M. The Velveteen Rabbit. Garden The contributions of reviewers from various City, NY: Doubleday; 1971. support groups also helped make this Zim, H.; Bleeker, S. Life and Death. New booklet more helpful to parents who need York: Morrow; 1970. to talk to their children about this subject.

Organizations

Association for the Care of This information is prepared specifically for Children’s Health p a t i e n t s participating in clinical research at the Clinical Center at the National Institutes 7910 Woodmont Avenue of Health and is not necessarily applicable Suite 300 to individuals who are patients elsewhere. If you have questions about the information Bethesda, MD 20814 presented here, talk to a member of your 301-654-6549 2006 healthcare team. Where applicable, brand names of com- The Candlelighters Childhood mercial products are provided only as illustrative examples of acceptable prod- Cancer Foundation ucts, and do not imply endorsement by 7910 Woodmont Avenue NIH; nor does the fact that a particular brand name product is not identified Suite 460 imply that such product is unsatisfactory. Bethesda, MD 20814 National Institutes of Health 301-657-8401 Clinical Center Bethesda, MD 20892 1-800-366-2223 Questions about the Clinical Center? [email protected]

Patient Information Publications 14 Talking to Children about Death