Talking to Children about Death
What Can My Child Understand?
Each year of a child's life brings enhanced ability to understand the reality and permanence of death.
Infant and toddler siblings of a sick or dying child can feel loss through:
- Absence of a parent or of a sibling due to the treatment or death of the sibling
- Interruption to routine caused by the treatment or death of a sibling
Grief and stress of their parents or other family members
These tips may help manage the feelings infant or toddler siblings of a sick or dying child may have:
- Make time each day to hold, rock, and cuddle the sibling.
- Keep the child on a schedule as much as possible.
- Play a recording of parents reading a story or talking to the sibling in the parent's absence.
3- to 5-year-olds have response that are shaped by the way they see the world:
- They are magical thinkers and don't understand the difference between fantasy and reality. They may believe death is temporary or reversible.
- They are ego-centric and may believe the death of a sibling is punishment for something they did.
Tips for helping 3- to 5-year-old siblings cope with their feelings about a sick or dying child:
- Use concrete language, such as "die," not euphemisms such as "sleep."
- At this age a child can understand "Your brother's body stopped working"; "Your sister stopped breathing."
- Make it clear to siblings that the death is not a consequence of something they did.
6- to 9-year-olds have a more evolved sense of dying:
- They associate death with old age. They may not understand that they or a sibling could die.
- They know more about how the body works, so they may have specific questions about how someone dies. A sibling may think that a bruise on his own body indicates the same illness a brother or sister had.
- They may associate death with frightening images from cartoons, such as ghosts and spirits.
Tips for helping 6- to 9-year-old siblings understand their feelings about a sick or dying child:
- Use visual aids they can understand. Child life specialists have used marshmallows to explain tumor growth or described leukemia as a thickening of the blood.
- Make specific references to organs like heart and lungs.
- Make clear that death is not like the images in cartoons.
- Make clear to siblings that what happened to a brother or sister doesn't happen to everyone.