No Regrets: Discuss Death With Dying Child
Parents Need Hospital Staff's Help in Facing Death of a Child
Sept. 15, 2004 -- When death of a child is imminent, parents are best advised to discuss it with their child, a new study shows.
It's a delicate subject, whether or not to talk about death with a terminally ill child. All sorts of questions swirl through parents' minds: Is the child aware that death is close? Does talking about it help or not? Does the child even realize what death is?
Indeed, for some parents, broaching the subject with their child is too overwhelming -- they simply can't do it, lead researcher Ulrika Kreicbergs, RN, an epidemiologist with the Childhood Cancer Research Unit at Karolinska Institutet in Stockholm, Sweden, tells WebMD.
Her study appears in this week's issue of The New England Journal of Medicine.
Although the majority of parents in her study did not speak with the child about death, those that did have no regrets, she says. Only those who wanted to have the talk but didn't felt depressed and anxious when it was all over.
Hospital doctors and nurses have an obligation to help parents through this difficult time before death of a child, she says. "We should be aware whether a child senses their own death is coming, so we can help parents respond to their child's needs."
A Difficult Subject
For their study, Kreicbergs and her colleagues contacted parents in Sweden who had lost a child to cancer between 1992 and 1997. A total of 429 completed a questionnaire inquiring -- among other things -- whether they had talked about death with their child.
- None of the 147 parents who talked with their child regretted it.
- Almost a third of the parents who did not discuss this difficult topic with their child ended up regretting it.
- Parents were more likely to talk to their children about death if they sensed their child was aware of his or her imminent death. Half of these parents spoke with their children, whereas only 13% of those parents who felt their children were not aware of their imminent death spoke with their children.
- 49% of parents who sensed their child was aware of his or her imminent death but did not talk about it were more likely to have regrets later.
- Parents having regrets were 33% more likely to have moderate to high anxiety level; they were 48% more likely to be depressed.
- 46% of parents reported that they never sensed their child was aware of imminent death.
- 22% first sensed this awareness in the child's last week of life.
"We had no parents who regretted their decision to talk to their child. ... They all seemed very satisfied with their decision," Kreicbergs tells WebMD.
Also, those parents who instead chose to focus their talk on life were also satisfied with their choice. It's important to respect a parent's decision to go this direction, she notes. "We should not encourage parents to talk about death if they have made a different decision," she tells WebMD. "They think that is right, and we have to support them."