Talking with children and youth about death

By: Lysa Toye MSW, RSW, DipEXAT

(An explanatory note: Adults caring for children are not always their parents. They may be grandparents, aunts and uncles, siblings or foster parents - particularly when the person in a family who is dying, or who has died, is a parent. For this reason, “caregiver” is used throughout this article to describe the person caring for children and youth. Educators and others involved in the care of children and youth may also find this information of value.)

Talking with children and youth about death is one of the most difficult tasks a caregiver may face, especially when the person who is dying or has died is close to the child or family. Adults can feel ill-prepared to support children, particularly if they’re overwhelmed by their own shock and grief. It’s common to feel unsure of what to say and how to support a child or young person in a way that matches their age.

Often, our first instinct is to protect children and youth from the pain of grief by withholding information. However, when someone important to a child is dying or has died, there is no way to protect them from the reality of illness, loss and death. Experts who work with grieving children recommend talking honestly, helping them understand what has happened, and supporting them through their natural feelings of grief.

This article provides information on how to go about this conversation. It discusses the importance of honest and timely conversations, using clear, simple language. It looks at the special considerations of expected and sudden, unexpected death.  And recognizing that sometimes death is a mystery, it gives permission to say, “I don’t know.” 

Starting the conversation

Although incredibly difficult, sharing the news with a child or youth that someone close is dying or has died is an important and essential conversation. Children and youth, like adults, need time to process their thoughts and feelings and to ask questions. Information will help them prepare for the physical and emotional loss of this person in their lives. Our courage and willingness to discuss difficult topics teaches our children that hard conversations can happen safely, and that they can talk with you about challenging matters.

The basics

• Have the conversation in a safe, comfortable place where you won’t be interrupted.
• If the child is young, get down to eye level.
• Tell them that you may be upset or cry while you talk because you’re feeling many emotions, and that this is natural and okay.
• Explain that they may have strong feelings too and it’s okay to express them.
• Start with what the child or youth already knows (particularly, for example, in the case of death caused by an addiction, physical or mental illness) and build from there. For example,
  • “Can you tell me what you understand about your father’s cancer?”
• Give the information in a straightforward way, using words they can understand.
• Let them know their questions are welcome. Praise them for asking questions and sharing their thoughts and feelings.
• Be gentle and sensitive, giving the information they ask for and need.
• Watch for cues to guide you around pacing the conversation, signs that will help you gauge how much information to provide and when the child or youth is ready to hear it. They may:
  • Need a break or ask for more information or clarification.
  • Start to play, busy themselves or behave differently than usual. Does this activity:
    • Help them to relax while they listen?
    • Suggest they’ve had enough?
    • Suggest they’re avoiding hearing unpleasant but important information?
    • Represent a normal way of “checking out” for their age or maturity?
  • When you’re finished, or if your child needs a break, let them know they can continue the conversation later, either with you or another adult.

Death – expected and unexpected

Death can result from illness, old age, accident, homicide, suicide, natural disaster, political conflict or war. Depending on the cause, it may be anticipated or come as a profound shock.  Each of these situations presents unique issues for children and youth and challenges for caregivers.

Expected death

When death results from an illness, children and youth are often aware that the person was sick and may even have known that they could or would die. In this circumstance, start with what they already know, clear up any misunderstandings they may have, and provide any additional information he or she needs. 

It’s important to remember that a death adults expect might be a surprise and shock to children and youth.

• They may have known about an illness, but not anticipated the death.
• The possibility of death may have been explained, but in language they couldn’t understand.
• The possibility of death may not have been explained, and he or she lacks the life experience to draw this conclusion.
• They may have been told that someone was dying, but weren’t given an opportunity to say goodbye or to understand what was unfolding.

Sudden or unexpected death

The shock and grief of a sudden or unexpected death can make communicating what has happened even more difficult. Honest and timely information helps children and youth feel included in their family’s response.

• Slowly and clearly explain what is known about the death.
• If your child or young person asks for details, consider what information will help them understand what has happened.
• While it’s important to be clear about the main details (“He was hit by a car while riding his bicycle to the store,” or “She was using drugs and accidentally took too much”), graphic or disturbing details are not helpful.
• Look after their basic physical and emotional needs. Food, drink, warmth, comfort and connection with adults who love them will help children and teens feel safe.
• Be prepared to repeat the information during the conversation and in the days following. Under extreme stress, the brain doesn’t process or hold on to information as effectively.

Open and honest conversations

Although it’s tempting to withhold or change details to soften the impact, keeping important information from children and youth frequently increases their anxiety. Trusting their caregivers is key to their sense of security, so it’s important to keep them aware of what’s taking place. Children and youth are generally finely attuned to their caregivers and can feel when something is wrong. They pick up on dropped comments, overhear conversations and kids talking at school. They gather information where they can, often guessing at what they don’t know or understand as they try to make sense of their world. 

With their vivid imaginations, children may imagine a situation that is fantastical or worse than what is actually taking place. And because children are naturally focused on themselves, the explanations they create may include some level of personal responsibility:

• “Mommy got my cold and so she got sick and died.”
• “If I had just had breakfast with my dad that day, he would have left for work later and wouldn’t have been hit by that car.” 
• “If I had been easier to take care of, my mom wouldn’t have wanted to die.”
• “I was so mad at my sister I said I hated her and wished she were dead, so I made this happen.”

Sharing information about a death and its causes, and inviting questions, helps children and youth to feel secure. They then:

• Understand the how and the why of a death.
• Know there are adults they trust, who will listen to their concerns, and who will answer their questions.

Using simple and clear language

Because language about death can be emotionally charged for adults, we have developed many euphemisms, or “code” words, to describe difficult events. These can be very confusing for children. They need to hear the words “dying” and “death.” They need to hear the illness and the cause of death named: “cancer”, “ALS”, “suicide”, “addiction”, “homicide” to name a few. Otherwise children may wonder why we’re not looking for someone who has been “lost.” They may be afraid to “go to sleep,” fearing that they might not wake up either. If they become sick, they might worry that they’re going to die too.

Children at any age can learn new words that describe what is happening. Almost any illness, medical procedure or cause of death can be described in child-friendly language. For example, we can explain that:

• When a body dies, it stops working and can never work again. It no longer thinks or feels, doesn’t get cold or hungry, and can’t come back to life. 
• Chemotherapy is a very powerful medicine that tries to kill the cancer cells in the body, but can also cause a person to feel sick in different ways. 
• Cremation means putting a body through very high heat until it turns to ashes. When a body dies, it no longer feels pain.
• Suicide is the word we use when a person decides they don’t want to live any longer and causes their own death. This is often due to mental health issues such as depression.
• Homicide is when one person kills another person.

When professional help is needed

Engaging a professional such as a grief counsellor, therapist or social worker may be useful when:

• You need help understanding your child’s behaviour or how to support them.
• Complicated issues such as mental health and addictions, war and political conflict, suicide and homicide have contributed to death.
• Death is sudden, unexpected or due to an accident.

Children and youth, like adults, can benefit from talking with people outside the family, exploring their thoughts, feelings and understanding of these issues over time. When death is complicated, health professionals with expertise in this area can often assist in providing accurate information and support in a way that children and youth can understand. In the end, it is commonly the abstract concepts and deep questions that are most difficult to explain – such as why the person got cancer, why someone was so depressed they would take their own life, or why this person was the victim of an accident or crime.
 

Faith, spirituality and the unknown

Death and dying are often referred to as “the great mystery.” They evoke deep questions about life and its meaning. “Why did this happen?” is one of the most profound and difficult questions surrounding death. Families with a religious or spiritual life may hold beliefs about death and the afterlife that provide comfort and that they share with their children. 

Sometimes there are no answers to these questions, and it is okay to say to children, “I don’t know.” It can be profound for a child or youth to hear an adult acknowledge mysteries in life to which there are no answers. We can encourage young people to wonder about what happens after death and to explore their own ideas and questions. When curiosity is supported, caregivers and their children of whatever age can grow closer as they think about these mysteries together.

For more information on conversations about death with children and youth, see:

• Caring for grieving children and youth
• Understanding death and dying: Ages and stages
• Don’t Use the “D” Word: Exploring Myths about Children and Death
• When to Tell the Children: Preparing Children for the Death of Someone Close to Them

Content reviewed May 2019