When someone we love is nearing the end of life, there is often an instinct to protect children from the sadness and uncertainty surrounding death. Parents and caregivers may wonder: Should I tell them what is happening? How much should I say? What if they ask a question I can’t answer? Will talking about death make them more afraid?
These are difficult questions, and there is no single conversation that will make grief easier.
One thing is clear: children benefit most from honest, compassionate, age-appropriate conversations about death. Even very young children often recognize that something has changed when a loved one is seriously ill. When adults avoid the subject, children may fill in the gaps themselves, sometimes imagining things that are more frightening than the truth.
Talking openly can help a child understand what is happening, ask questions, express feelings and, most importantly, know that they are not alone.
Start With Honesty and Simple Language
When talking with a young child about death, use words they can understand. And remember; children, especially younger children, tend to interpret language literally.
For that reason, experts recommend using words such as “died” and “dying” rather than phrases such as “passed away,” “went to sleep,” “went to heaven” or “we lost Grandma.” While these phrases may feel gentler to us as adults, they can be confusing or even frightening to a young child, causing them to wonder when the person is coming back, become afraid of going to sleep or think that “lost” means the person can be found.
You don’t need to give a long explanation. In fact, short, straightforward conversations are often easier for young children to absorb.
You might say: “Grandpa is very sick, and the doctors cannot make his body better. He is going to die. When someone dies, their body stops working, and they don’t come back.”
Then pause. Give your child the opportunity to ask questions or simply sit with what you’ve said. You can always provide more information later.
Let the Child Lead the Conversation
Children don’t always process information the way adults do. One child may immediately want to know what dying means. Another may ask, “Can I still have ice cream?” and then run off to play.
That doesn’t mean the child doesn’t understand or doesn’t care.
Young children often process difficult experiences in small pieces. They may ask the same question repeatedly as they gradually develop an understanding of what’s going on. They may also move quickly between sadness and their regular activities. This is a normal part of how children process grief.
Try to follow their lead rather than giving them more information than they are asking for.
If a child asks, “Is Grandma going to die?” you might respond: “Yes. Grandma is very sick, and her body is not getting better. The doctors and nurses are helping keep her comfortable.”
Then ask: “What are you wondering about?” This gives the child permission to guide the conversation.
Be Prepared for Difficult Questions
Children can ask very direct questions about death. They may ask:
- “Will I die?”
- “Are you going to die?”
- “How did they die?”
- “Does dying hurt?”
- “Where do people go when they die?”
- “Can they hear me?”
- “When will they come back?”
- “Will I ever see them again?”
- “Will I die too?”
- “Who will take care of me?”
None of these questions are wrong or inappropriate.
They are often a child’s attempt to make sense of something that feels very unfamiliar and frightening.
“Will I die?” A young child may need reassurance without being given an unrealistic promise. You might say: “Everyone dies someday, but most people live for a very long time. You are healthy, and there are lots of people here to take care of you.”
“Are you going to die?” It is understandable for a child to become concerned that one death means everyone they love could disappear. You can acknowledge the truth while providing reassurance: “Everyone dies someday, but I expect to be here with you for a very long time. There are lots of people who love you and will take care of you.”
“Does dying hurt?” The answer depends on the person’s illness and circumstances. Rather than making promises you can’t keep, explain what you know. Something such as: “Grandma’s doctors and nurses are taking care of her and working hard to keep her comfortable. If she is uncomfortable, they will help her.”
Hospice professionals can also help families explain changes a child may notice as a loved one’s illness progresses.
“Where do people go when they die?” This is where your family’s beliefs and traditions factor into the conversation. You can explain your beliefs while making it clear that some questions may not have answers at all. It’s perfectly acceptable to say: “I’m not sure, but I can tell you what I believe.”
And sometimes, the most helpful answer is simply: “I don’t know.”
Children don’t need adults to have every answer. They need adults who are willing to listen, be honest and stay with them through the uncertainty.
Reassure Them That It’s Not Their Fault
Young children can sometimes engage in “magical thinking,” believing that their thoughts or actions cause things to happen.
A child may wonder: “Did Grandma die because I was mad at her?” Or: “Was it because I didn’t visit?”
It is important to tell them directly: “Nothing you said, did or even thought caused this.”
Children may also worry that something they did caused the person’s illness. Reassurance may need to be repeated more than once.
It’s Okay for Children to See You Grieve
Parents sometimes feel they need to remain strong in front of their children. But seeing a trusted adult cry or express sadness can actually help children understand that grief is a natural response to losing someone we love.
You might say: “I’m crying because I love Grandpa and I’m very sad that he is sick. It’s okay to cry about this.”
This teaches children that difficult feelings are not something they need to hide.
At the same time, children should not be expected to comfort adults or take responsibility for an adult’s emotional wellbeing. Make sure they continue to play, ask questions and simply be a child.
Try to Maintain a Sense of Normalcy
When a loved one is dying, life can suddenly feel upside down. There may be hospital or hospice visits, changes in schedules, more family members in and out of the home or increased emotional stress. Whenever possible, try to maintain familiar routines. Meals, school, bedtime rituals, activities, friends and playtime can provide children with a sense of security when other parts of their world feel uncertain.
It can also be helpful to let a child know what will happen next: “Mom is going to visit Grandpa this afternoon. Aunt Sarah will pick you up from school, and then we’ll have dinner together.”
Simple information can help reduce anxiety. Knowing what to expect is of great importance for children.
Consider Including the Child in the Experience
Whether and how a child participates in the end-of-life experience is a very personal decision. There is no requirement that every child visit a dying loved one, attend a funeral or participate in every family ritual and families typically have very strong feelings about these things.
But children should have the opportunity to be included in ways that are appropriate for their age and comfort level.
If a child wants to visit, explain beforehand what they might see.
For example: “Grandpa is very sick. He may be sleeping a lot and he may look different. You can sit with him, talk to him or hold his hand if you want to. You can also leave whenever you’re ready.”
Giving children choices can help them feel more secure.
If they do not want to visit, they can still participate in other meaningful ways; drawing a picture, writing a note, looking through photographs, choosing a favorite song or helping create a memory box. These types of activities can give children a way to express love when words are difficult.
Help Them Understand What Happens When Someone Dies
Children may have very practical questions about death, particularly after a loved one dies.
They may wonder what happens to the person’s body, whether the person can hear them, what happens at a funeral or whether the person will come back.
Answer the question they are actually asking, using simple and honest language.
For example: “When someone dies, their body stops working. They don’t breathe, eat or move anymore. Their body doesn’t feel pain.”
Then allow them to ask more.
If your family will be attending a funeral, visitation or memorial service, explain what the child might see and hear beforehand. Let them know that people may cry, hug one another, pray, tell stories or look at photos.
Preparing them for what to expect can help make an unfamiliar experience less frightening.
Grief Doesn’t Follow a Straight Line
Adults sometimes expect a grieving child to look sad all the time. Children don’t necessarily grieve that way. A child may cry one moment and play the next. They may seem unaffected and then become upset days or even weeks later. They may talk about the person constantly, or hardly mention them at all. They may become more clingy, have trouble sleeping, become irritable or return to behaviors they had previously outgrown.
There is no single “right” way for a child to grieve. Their understanding of death develops over time, which means they may revisit the loss with new questions as they grow older. Rather than asking, “Why aren’t they grieving?” or “Why are they still upset?”, try asking: “How are you feeling today?”
And continue reminding them: “You can always talk to me about Grandma. You can ask me anything.”
Watch for Changes That May Need Additional Support
Most children experience a range of emotions following the serious illness or death of someone they love. However, if concerning behaviors or emotional difficulties persist, intensify or significantly interfere with daily life, it may be helpful to talk with the child’s pediatrician, school counselor, therapist or another qualified professional.
Additional support can be especially important when a child has experienced a sudden, traumatic or particularly complicated death. Seeking help doesn’t mean a child is grieving “wrong.” Sometimes they simply need another safe adult who understands grief and can help them express their feelings.
Above All, Let Them Know They Are Safe and Loved
There is no perfect script for talking to a child about death. You may stumble over your words. You may cry. Your child may ask a question you aren’t prepared to answer. You may have the same conversation many times. That’s okay.
What matters most is that your child knows they are allowed to ask questions, express their feelings and talk about the person they love.
Death is one of life’s most difficult realities, but children do not have to face the uncertainty of it alone. With honesty, reassurance, patience and love, adults can help children begin to understand what is happening while giving them the security they need to grieve in their own way.y
And sometimes, the most important thing you can say is simply: “I’m here. You can talk to me. We will get through this together.”
How Hospice Can Help Children and Families Through the Process
If your family is receiving hospice care, don’t hesitate to ask the hospice team for guidance. Hospice professionals understand that end-of-life care affects the entire family and can help families think through difficult conversations and ways to support children during this time.
When a loved one is nearing end of life, families are caring for more than a person’s physical needs. They are also navigating extremely difficult conversations, a change family routines, complex emotions and, for many parents, the challenge of helping a child understand what is happening.
Hospice can be an important source of support for the entire family.
Hospice care is built around an interdisciplinary approach, which may include nurses, social workers, chaplains, aides, volunteers and other professionals who address the physical, emotional, social and spiritual needs of patients and families.
We’re here to listen and support the entire family.
If you have questions about hospice care and are in one of these counties, reach out to learn more about our hospice services and to meet our care team. Feel free to call us at 866-282-6090. We’re ready to speak with you and answer your questions.
Families looking for additional guidance may find these organizations helpful: