When a child's death is expected, many parents wonder whether they should talk to their children about dying and death, how much they should tell them, and what impact it will have. There are no easy answers and your decisions should be guided by your own instincts, your child’s condition, your knowledge of your children, and your cultural and spiritual beliefs. This can be a confronting and difficult decision to make and at times, parents may disagree on the approach they wish to take.
Families who have been able to talk to their children about dying and death have found many benefits, including:
- providing reassurance to children through open and honest communication – children do not feel alone because they can share their questions and fears with their parents
- opening opportunities for families to say the things that need to be said
- providing an opportunity to complete unfinished business and to create memories for the whole family.
You may wish to seek the advice of trusted friends, pastoral carers or counsellors when making this decision. Asking someone from your care team to explain to your child what is happening with their illness can also help. Talking with children can often be a matter of right time, right place, right person.
When you talk to your children, you should be aware of what they are capable of understanding at their age. Children’s concepts of death vary and are described briefly below, in terms of age.
Children 2 years or younger cannot fully comprehend what death means. However, they do have a sense of someone significant being absent. They react to disruption in their normal routine and are sensitive to nonverbal cues and will pick up on the emotional atmosphere around them.
Children aged 3 to 5 years usually see death as temporary, a condition from which you can return. They may have 'magical' thinking, thinking their sibling could come alive again, or thinking they made them die.
Children aged 6 to 10 years are much more curious about death, and tend to ask many questions. They have the ability to understand that death is forever. Their curiosity may seem blunt or 'matter of fact'.
Children aged 11 years and older have a more sophisticated and realistic view of death. They realise it is final but they also appreciate that those left behind need to grieve, find meaning and remember.
Older adolescents and young adults aged over 17 years may be experiencing this extent of grief for the first time. While their understanding of death is the same as adults, they may not have the experience to understand their reactions or express their grief, and become more easily overwhelmed by it.
Children's understanding of death will also be influenced by:
- their personality
- prior experience of death
- family norms and rituals
- film, television and books
- the experiences of their peers.
Books, online, DVDs and other resources can be useful tools to help when talking about dying and death. They can provide a safe space to share feelings and thoughts. They can also be a trigger for discussing difficult issues and may provide your children with a better understanding of the journey ahead. See the resource list for information sources.6
6 Adapted from: Journeys: Palliative care for children and teenagers, version 2, Eds. Fleming, S. Coombs, S. and Phillips, M., Palliative Care Australia, 2010.