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Palliative Care Center

Talking to Children about Death

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What Can My Child Understand? continued...

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.

Teenagers understand death with a more personal and long-term view:

  • They may want to talk to their friends more than to their parents.
  • They understand more on their own, so adults are validating information rather than giving it.
  • They understand their lives in the context of others', so they will want to leave a legacy and plan for their own deaths.
  • They can find information on their own.

Tips for helping teenage siblings of a sick or dying child:

  • Let friends and boyfriends or girlfriends be involved. Palliative care teams encourage friends to visit and extend their support services to them.
  • Don't be hurt when teenagers seek the support of their friends more than their parents.
  • As teenagers' grief is more like that of adults, teenagers who lose a sibling may need more time off of school and regular activities.

Children can be included in discussions about death and dying, but parents need not do it on their own. Palliative care professionals can help parents decide whether, when, and how to open this difficult conversation.

WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on July 01, 2013
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