By: Andrea Warnick RN, MA
Parents want to protect their children from emotional pain and suffering. This natural parental urge can be difficult to balance with the desire to be honest and upfront about harsh realities, such as talking about death and dying. As a therapist who specializes in working with grieving children, one of the most frequent questions I’m asked is: “When is the right time to tell the kids that a family member will likely die from this illness?” While there is no “right time” that works for every family, there is one certainty: children of all ages benefit from being prepared in advance for the death of someone close to them.
Children benefit from honest information
Telling children in advance about the potential death of a family member or friend is beneficial because it:
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fosters an environment of open and honest communication;
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enables children to get factual information from caregivers;
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leaves less opportunity for children to imagine different or inaccurate explanations;
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helps children make sense of the physical changes they see happening to a person who is unwell;
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creates an opportunity for the ill person to play a role in preparing children for the possibility of his or her death;
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allows time to put additional support systems in place, such as school counsellors and grief programs, where available;
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enables children to grieve with the adults in their lives, instead of alone and from the sidelines. Caregivers can help children understand that their emotions and those of others around them are healthy and natural;
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gives children the chance, when the death of a loved one is imminent, to say goodbye in a way that feels appropriate for them or to just be with the person with a shared knowing that their time together (at least physically) is limited;
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enhances the trust between children and their primary caregivers.
Withholding information can create challenges
Most children and youth can sense when adults are withholding information, which can cause them to worry more. When information is withheld, children may learn about an impending death only by overhearing conversations not intended for their ears. Or they may hear it from people outside the immediate family. Children really benefit from learning of such news directly from their parents or guardians before hearing it from others. It can be difficult, if not impossible, for parents to control the flow of information outside the family. Therefore, the sooner parents open up conversations about dying with their kids, the less likely kids are to learn such upsetting news elsewhere.
There is a trust issue as well. If children discover that their parents or guardians knew about a loved one’s impending death but intentionally didn’t tell them, they may have difficulty trusting their caregivers in the future. This creates additional challenges in the children’s grief process.
Determining timing
Even when caregivers are convinced they need to be honest about an impending death, deciding when to share this heartbreaking news with children can be a daunting task. Some times are certainly better than others for telling children (while dropping them off at school is definitely not a good time). For most families, the “right time” will always be hard to determine. It rarely feels “right” to share such information, especially in the case of a dying parent or sibling. The task is always difficult emotionally and often feels opposite to what parents think they should do.
But there are some strategies families can use to help them decide when to share this information. These include:
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Ask children to describe what they already know about the situation. Many caregivers are surprised to learn that some children have already considered the likelihood of the loved one dying.
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Reassure children that talking about the likelihood of death does not increase the chances of the death occurring. Children often engage in “magical thinking.” This can make them feel responsible for good and bad outcomes, despite not actually having any control over them. Providing children with facts and concrete explanations can help them focus on things that are actually within their control (such as how to spend time with their family member). Knowing what to expect can help them let go of things beyond their control (such as worrying about when the person will die).
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Ask children how much information they want. Do they want a lot of information or just a summary of the most important information? Some children need more information than other children and benefit from being told about the prognosis as soon as possible. It’s also important to let children know that they can change their minds later on if they would like more or less information.
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Create an environment where children feel safe asking questions. Adults can invite children to ask any questions they have about the illness, even the hard questions. Children may ask: “Could Dad die from his cancer?” It’s important to answer such questions honestly. Keep in mind it can be a relief for children to hear that adults may not have all the answers to their questions. Adults can provide reassurance that even though they do not have all the answers it is still important to talk and wonder about these hard things together.
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Recognize that it’s unnecessary to hold off telling children until “all of the medical information” is obtained. Many families think they shouldn’t talk to children until they have more information (more test results, a more accurate prognosis). But children and youth can appreciate being a part of the experience of uncertainty with the adults in their life.
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Ask the physician directly for an estimation as to how long the person will live. If the death may be imminent, it’s important to share that information with children right away
While I have worked with many families in my therapy practice who wish they had started the discussion about a loved one’s dying earlier, I have yet to encounter anyone who feels they shared this information “too early.” Children and youth benefit from having as much time as possible to prepare for this profound life event.
Some families are open with their children about the likelihood of death from the time of diagnosis. This is an approach that works well for many children. Phyllis Silverman is Project Director of the Harvard/MGH Child Bereavement Study and author of Never Too Young to Know: Death in Children’s Lives. She writes:
[t]elling them the truth from the beginning sets the stage for an openness that needs to be there throughout the illness and afterward. When they are involved in this way, they will always be certain that they are part of the family. They will know that there are no family secrets that isolate them from each other and that do not honor what they see, what they know, and what they feel. (p. 80)
Many families are pleasantly surprised to find that children tend to resume their regular activities and interests quite quickly after learning a parent or sibling may die. Children possess a remarkable ability to balance deep joy and deep sorrow. As well, parents often feel greatly relieved once this information is out in the open. They no longer need to spend energy on trying to control the flow of information.
Yet knowing someone will die and actually experiencing the death can be two very different things. Children and youth may still be shocked or surprised when a family member dies, even if they’ve been well prepared beforehand.
Honesty helps prepare children for life
When parents choose not to inform children of an impending death in the family, they usually have the best of intentions. Often, they are just trying to protect their children from emotional pain. In addition, facing one’s own mortality or dealing with the potential death of a family member takes a tremendous emotional, physical, and spiritual, toll on an individual. This makes finding the best way to support children that much more of a challenge. Many parents fear they will say something that “makes things even worse.” It’s important for parents to be compassionate toward themselves during this time while reminding themselves that the best protection for their children is to prepare them for life’s hardships, such as an impending death.
Preparing children for a death does not eliminate the heartbreak of the death. It helps children make sense of what is unfolding around them. Being prepared by caring adults for one of life’s most difficult situations helps equip children with the emotional tools they need to withstand life’s inevitable windstorms.
See also:
Resources
Eaton Russell, C. (2007). Living Dying: A Guide for Adults Supporting Grieving Children and Teenagers
Hamilton, Joan. (2001). When a Parent is Sick. Helping Parents Explain Serious Illness to Children
Max and Beatrice Wolfe Children's Centre, Talking with Young People About Illness and Dying
Winston’s Wish. (2007). As Big as it Gets: Supporting Children when a Parent is Seriously Ill
Content reviewed January 2023