Talking to Children About Death

[David Baxter PhD]

Talking to Children About Death
By Claire McCarthy, M.D.
February 18, 2009

No parent likes to talk to children about death. We'd prefer they never experience sadness or loss?and while we know that's not possible, we like the idea of putting it off as long as possible.

But death touches every life. Sooner or later children need information and support to help them cope. Because every child and every situation is unique, there are no specific guidelines for exactly how to explain death to a child. But these suggestions may help you know what to say and how to answer the tough questions children can ask.

Where To Start?
It's easier than you might think to introduce the concepts of "alive" and "dead" into everyday conversations. For example, when you are raking leaves in the fall or you see a dead animal you can explain to a child that being alive means growing and changing, taking in nourishment and air. When that's not happening anymore, it means something is dead. You don't have to discuss it at length. Just give your child the basic vocabulary ? and the idea that death is part of the life experience.

Choose Your Words Carefully
Be careful with your words; without realizing it, you can create anxiety. For example:

• Avoid referring to death as "going to sleep" or "final rest." This can be terrifying to a child. He may think that people he loves won't wake up in the morning.
• Saying that someone who has died has "gone away" can make a child think that someone going on vacation might die.
• If a person died because she was sick, be sure to point out that most sick people don't die, or the next sniffle may give your child a panic attack!
• Don't say that only old people die. Sooner or later children figure out that it's not true and wonder why you told them otherwise.
• Religion can give a useful, comforting framework for death; the concept of a happy afterlife is particularly nice. Be careful, though, with phrases like "God took him," or "It was God's will," because without explanation these can be confusing and scary for young children.
• It's tempting to discourage any conversation or questions about death ("Why are you asking about that? Let's talk about something happier"), but don't. Answer your child's questions simply and reassuringly. Not only will your child learn something about death, but she learns that she can talk to you about it.
• Don't worry if you don't have all the answers. Nobody does, and that's an important lesson for your child to learn, too. It's okay to say "I don't know."

When Dying and Death Happen

• Be honest. Tell a child what is happening. Children are remarkably perceptive and have active imaginations. Often they imagine scenarios that are worse than the real ones. They need to know they can trust you to tell them the truth.
• Ask them if they have any questions. You might be surprised to know what they are ? or aren't ? worried about.
• Skip the gory details. "Very sick" or "hurt badly" will often suffice. Kids aren't usually looking for the gory details, anyway.
• Many people think they should shelter children when a person is dying. But including them is often a better idea:
  • If the dying person and the child want to see each other, let them visit. Prepare the child for what they will see and experience. Be ready to end the visit if it's getting too upsetting for either person. But the chance to say goodbye can be very important, and the child may be imagining something much worse than what they see.
  • Going to the funeral gives the child another chance to say goodbye, and an opportunity to be with family at an important moment. Preparation is key. Not every child can handle being at a funeral; children under five may find it confusing and overwhelming. Some simply find it too upsetting. Follow your instincts about your child.
• Reassure your children that you will do everything you can to keep them ? and you ? healthy and safe. Sometimes children can feel responsible for a death. They may think, for example, that being angry at the person made him sicker or caused the death. This can lead to terrible feelings of guilt. Make sure they know that nothing was their fault.
• Maintain a child's routines as much as possible. Children rely on them to feel safe, and to know that life can go on.
• Find positive ways to remember the person who died, such as planting a tree, or making a memory book with pictures and stories.
• Understand that just as every adult grieves differently, so does every child. Some of it is developmental. Preschoolers, for example, tend to think of death as temporary. Some of the differences are related to personality. Their reactions can vary from sadness to anger to indifference ? sometimes all in one day. They may seem completely fine and then throw a huge tantrum over nothing. This is perfectly normal.
• Use books. I personally like When Dinosaurs Die: A Guide to Understanding Death by Laurie Krasny Brown and Marc Brown (the author and illustrator of the Arthur books). But there are other wonderful books tailored to different situations ? the death of a parent, grandparent, sibling, pet, or a child's own death ? as well as different philosophies on death and grief. It's worth going to a bookstore or library to explore your choices.

With love, patience and support, your child ? and you ? can make it through anything. This is the most important lesson of all.

Claire McCarthy, M.D. is a senior medical editor for Harvard Health Publications. She is an Instructor in Pediatrics at Harvard Medical School, an attending at Children's Hospital of Boston, and co-director of the Pediatrics department at Martha Eliot Health Center, a neighborhood health service of Children's Hospital. The author of two books, Learning How the Heart Beats (Viking, 1995), and Everyone's Children (Scribner, 1997), Dr. McCarthy was a regular columnist for Sesame Street Parents Magazine from 1995-1998 and is currently a contributing editor for Parenting Magazine.