How to Talk with Children about Serious Illness & Death

When someone in your family has been diagnosed with a serious illness or is dying, it can be difficult to come to terms with what’s happening. It can be even more challenging when children are involved.

Even in the face of a such a difficult situation, being open and honest with children is always the best approach. Knowledge is power—whether it’s for an adult or a child and understanding what is happening takes some of the fearfulness out of the situation.

“Kids are more aware of what’s going on than we often give them credit for. You want them to be involved in the process, so they grieve in a healthy way later,” Hospice of the Red River Valley Social Worker Cathy Miller, said.

Cathy also recommends getting children involved earlier in the process, so they feel like they are a part of the journey and can do special things with their loved one while creating meaningful memories. “The more time children spend around their loved one, the better. If they aren’t a part of the process, they are going to have questions later that you may not want to answer because you are doing your own grieving,” Cathy said.

A child can be prepared even in the face of tragedy. This will give him or her the best possible opportunity to emerge whole and healthy.

What To Say & Do

• Tell him/ her you are seriously ill.

• Tell the child the name of your disease.

• Provide your best understanding of what may happen.

• Give assurance he/ she will continue to be loved and cared for.

• It’s OK to cry in front of children. It’s completely normal and natural. Tell your child that you are crying because you love someone, and you are sad he or she is in pain—and that you will miss them. Crying does not mean you aren’t strong. If you hold it in, there will usually be issues later. It also will show the child, it’s OK if he or she needs to cry.

This does not mean you should share everything— different ages understand things differently. You are the best judge of what your child can understand.

“Kids are often very inquisitive. They ask questions and want to know what’s going on because they don’t have the knowledge and emotion that goes with losing a loved one and not seeing them again,” Cathy said. “It’s sometimes easier for kids to accept and understand if they are a part of the conversation. It’s beneficial when you can be direct with the child.”

For younger kids, the conversations should be more playful, simplistic and can include an activity, such as coloring or Play-Doh. Incorporating an activity can help the child become comfortable so you can start the conversation. “Kids usually have an idea of what not being here means, whether they’ve experienced death with a pet or have seen something on TV or in a movie or cartoon,” Cathy shared. She also explained that using animals as a talking point can help young children relate.

Older children and teens are often are involved in caring for the family or the loved one who is ill. Whether they help with chores around the house, make meals, care for their siblings or assist with direct care, they are often put into an adult role. “It’s important to make space for older kids to pause from their everyday routine and take time to actually talk about what’s going on. They don’t often have a chance to do that,” Cathy said. “Teens might not want to talk and might do more listening. Creating an environment where they can bring their feelings forward is key.”

Regardless of the child’s age, never share anything but the truth with the child.

When discussing your illness, you may want to get an idea of what he/ she knows before explaining the illness further. This way you can correct any misunderstandings. A child can imagine much worse things than the truth.

“I don’t like to use the word ‘sick’ at all. If mom is the person who is dying, and you use the word ‘sick’ with your child, when your child becomes sick, the child can think they, too, are going to die,” Cathy explained. “I encourage families to name the illness and use whatever word, like cancer, that’s causing end of life. It’s about the body not working for them anymore.”

What To Do If They Ask “Will You Die?”

• If death is a possibility, it should be acknowledged, but put into a perspective that life has to go on until the death needs to be faced.

• Focus on living each day.

• Worrying about death cannot stop it from happening. Worrying may prevent you from fully being present and enjoying time with your loved one.

• Be prepared to answer questions: “Can I catch this?” “Who will take care of me?” “Did I do something to cause this?” However difficult, answer all questions with honesty and appropriateness to the child’s age. He/she may continue to ask questions, or the same question several times, until something makes sense. Be patient and know that he/she is struggling to understand.

• Don’t lie or make promises you may not be able to keep.

What Now? After Discussing the Diagnosis

• Routine is good for kids. Attempt to get back to as normal a routine as possible, allowing the child to resume normal activities. Ask for help from others to keep kids on their routine like carpooling to activities and school.

• Continue to keep the child up to date on the progression of your illness.

• Allow listening and sharing opportunities by providing open and honest communication.

• Help the child understand the progression of your illness by not shielding him/ her from your symptoms.

• Allow the child to help. Be realistic in what you expect of him/ her and not assume the child will know what to do. A child is very focused on him/ herself.

• Find a balance between home and outside responsibilities for the child.

• Talk to daycare providers, school counselors, teachers, etc. It’s not necessary to give all the information of the illness, but it may be helpful to make them aware.

• Make dying part of your living and explain that you are going to do the best you can to live as long as you can.

Helping children and young adults face life challenges can be difficult but allowing the child to be involved this process now will help the child turn this time into a meaningful life experience.

Young people are amazing and resilient, so take their lead, be honest, and you will get through this.

About Hospice of the Red River Valley

Hospice of the Red River Valley is an independent, not-for-profit hospice serving more than 30 counties in North Dakota and Minnesota. Hospice care is intensive comfort care that alleviates pain and suffering, enhancing the quality of life for patients with lifelimiting illnesses and their loved ones by addressing their medical, emotional, spiritual and grief needs. For more information, call toll free 800-237- 4629, email questions@hrrv.org or visit www.hrrv.org.