Talking to Children about Death
What Can My Child Understand? continued...
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 ssociate 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.
10- to 12-year-olds understand the permanence of death:
- They know that death is final and will happen to everyone including themselves.
- They understand that their own death or the death of a sibling will cause sadness in others. A sick child at this age may say he has to hold on for his parents' sake.
- They will respond more like adults with anger, sadness, and fear.
- They will have increasingly more specific questions about the illness and about death.
- They can find information on their own.
Tips for helping 10- to 12-year-old siblings of a sick or dying child:
- Find opportunities for constructive venting of feelings, such as sibling groups at hospitals and art or play therapies.
- Provide as much specific, factual information as possible.
- Keep siblings in regular routines as much as possible. It may not seem like long, but professionals advise that children under 12 not miss more than a week of school after a sibling has died. But they acknowledge that each child has unique needs.
- After a death, make sure siblings still have a clear role in the family, but don't let them take on a parent's role.