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    Talking to Children about Death

    How Do I Break Bad News to My Children?

    Maintaining open communication with children from the time of diagnosis onward lessens the likelihood of suddenly surprising a child with bad news later on. Keeping children up to date at every stage of treatment can make breaking bad news easier.

    When a child has been following the progress of treatments, a parent or palliative care professional can say something similar to, "Remember the medicine we hoped would make you better? It's not doing what we hoped it would do."

    Still, it won't be easy to start the conversation. Social workers and child life specialists recommend a number of resources -- such as story and activity books -- that may help break the ice and help explain difficult concepts. Professionals also encourage parents to use children's questions as opportunities to start a conversation.

    What Should I Expect?

    When a family member has a life-threatening condition, frequently children will ask questions. The older they get, the more specific their questions will be. As teenagers, they may even be the ones guiding the conversation.

    Although the answers to their questions may bring bad news, children do not process bad news in the same way that adults do. Parents may be hurt by this. Adults understand the permanence of death immediately, so we respond with tears. Children, especially those under age 12, may not understand the permanence of death right away, so they may not have a strong initial reaction to bad news.

    Children can feel insecure during heavy or serious conversation. They may want to get back to normal as soon as possible. This may mean returning quickly to the game they were playing or the TV show they were watching. This doesn't mean the child didn't hear or understand. Parents can join the child in the activity in order to be there when questions arise.

    When a child is dying, many parents want the siblings to be at the child's bedside with the rest of the family. Child life specialists will help facilitate this, but they advise parents that siblings may want to leave the room quickly and return to what they were doing before. Parents should understand that this behavior is normal.

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