A How-To Guide: 4 Tips to make the difficult a little easier
Several years of working as a psychologist in pediatric palliative care gave me an array of gifts, including many opportunities to rehearse and refine ways to talk about death with children of all ages. It has been an invaluable part of feeling more prepared for this one part of motherhood, from my oldest child's first hospice visit at age 3, to the recent death of our beloved family pet, mourned by all three of my children, ages 3, 6, and 8. Death may be the most certain part of life, but it is also a parenting essential we often feel the least prepared to handle.
There's no doubt we live in a culture that fears and can painfully delay death at many costs (financial and psychological). So it's not a surprise that we are not eagerly and openly discussing this parenting milestone like we do so many others, leaving us that much less prepared when it blindsides us. I put out the question to my online parent groups about what they would want to know about this topic and heard many personal and very painful stories of loss, compounded by uncertainty about the best way to manage it with their children. We usually don’t choose when our child has her first exposure to the concept of death, and then we either have to think on our toes, or our own grief makes it seem impossible, or both.
In my years as a pediatric palliative care psychologist, I had hundreds of conversations about death with parents and children. It never got easier. I got better about knowing the words and what to expect, but I came to accept there was no way for this to feel like an “easy” or “good” conversation.
What I learned from this work, however, changed me as a person and a mother. I witnessed how strong and resilient children are (especially compared to adults) and how we often sell them short, thinking they need our protection when they can handle life’s ugly and painful parts quite beautifully.
I learned that handling death with children in a way that does not respect their autonomy can have lifelong repercussions. Children “protected” from the sadness by either never talking about the deceased loved one, or not having any part in the death rituals, can feel confused and that they are not allowed to express grief. On the other end of the spectrum, children pushed to confront death in a sudden and unplanned way can feel traumatized.
I believe most adults are doing what they truly believe is best for the children. And as with all things parenting, this involves instinct. But instinct can be clouded by grief, and these best intentions may end up not being the best for the children.
Dying, death, grief, and loss are heavy and complex. There are not easy answers. But my years of having the hardest conversations of my life, combined with what I have learned from grief experts, have given me good starting points to share with any parent.
This list offers a starter's guide to the question I hear the most: How do I talk to the kids?
1. Be Specific. In our culture of death avoidance, we use a lot of language that can be very confusing to kids, without us even realizing it.
For young kids, usually 7 and younger, stay as concrete as possible. Example: “Grandpa’s body isn’t working right anymore, and there is no more medicine that the doctors have to fix his body. Grandpa’s heart is going to stop beating, he will stop breathing, and he will die. This means he will not ever walk or talk again. We will always remember him, but we will never see him again.”
Death is abstract to young children and it is very normal for 2-4 year-olds to keep asking, “When will we see Grandpa again?” even after you have explained the permanence of death. It’s normal, and the best you can do is calmly repeat what you have already explained. They will understand over time.
Part of being specific is to avoid euphemisms.
When a young child hears, “he’s going to sleep and will never wake up,” they might develop a fear of falling asleep in case THEY never wake up.
“We lost Grandma” means she might be found.
Even saying “passed away” doesn’t make sense to young children, and they probably won’t understand this means “died.”
The more you can calmly use the words, “die,” “dying,” and “dead,” the better your child will understand what’s happening.
It’s important to explain that someone who is dying after being sick, is very different from the other kinds of sick we all get, like a cold or flu. If kids associate being sick with dying, they may become terrified when either they or their parents get a normal virus.
2. Be Honest. It can be tempting to give a child a gentler, alternative version of reality, and it’s definitely important to explain information in a way that matches a child’s development. But they trust you as their parent, and in an effort to protect them you may inadvertently teach them they can’t trust you.
This is especially true in cases of more tragic deaths that may have involved very grown-up details. It’s okay to give details that are appropriate for your child’s age (as long as the details are true), and then reveal more over time, as long as you are building on truths. For example, in the case of a drug overdose: “Your uncle put a lot of bad pills in his body that weren’t good for his body. It was too much for his body, so his body couldn’t work right anymore, and he stopped breathing.”
Your child will most likely ask, “Are you going to die too?” It is so tempting to reassure your child with “No! Of course not!” But that’s a lie, and if something were to happen (especially soon after that conversation), your child will feel betrayed, and have more complicated grief. Instead, I say to my own children, “Most people die when they are really old, and I will probably be very, very old when I die. You will probably be a grown-up.”
3. Be Available.
I have explained to a six-year-old that her younger brother is dying in the hospital. Her mother requested I be the first to tell her because the parents could not say the words out loud and they were managing their own grief. I talked to her for about two minutes, her eyes large and serious. I asked if she had questions. She didn’t. Then she ran off to play.
This is actually the most typical response – no questions and then dashing off to be a kid. It may seem like they didn’t understand, but they are processing information at the pace they need to. Explaining it to them over and over may be too overwhelming and stressful. Instead, let them know you are there to talk more or answer any questions when THEY are ready.
4. Be Prepared. They may sprinkle questions in at random times throughout the next few days, so be ready. Whatever questions they have will guide you to focus on what is important for them to know instead of guessing.
It’s actually better to let them take the lead in communicating to you what they are ready to know. You tell them about a death that is about to happen or has happened so they know about the actual death. You don’t need to do it all in one discussion – why it happened, what happens in the afterlife, etc. That’s usually too much for most kids in one sitting. But be prepared for their questions over the coming days or even months.
Many parents struggle with the question, “What happens after someone dies?” For those without their own strong convictions about the afterlife, kids usually accept the explanation, “I believe (insert belief here), but many people have different ideas, and nobody knows for sure.” Or if it's true for you, it's okay to say "I don't know." Especially for older kids it can be worth asking, “What do you think?” Then they have a chance to give you their vision that you may use in future discussions.
Just the Beginning
There are many more questions to answer about kids and death, but it’s too much for one blog post. I am going to pace it for you, just as we should pace it for our kids. So I will be doing a series on Kids and Death to give parents a comprehensive resource. It will cover topics like how to prepare a child to visit someone who is dying, whether a child should go to a funeral, and what grief looks like in children across different ages.
When I worked in palliative care, managing deaths of children every week, I quickly learned no one wanted to hear about it or talk about it. At social events, my answer to “what do you do?” stopped conversations as people politely smiled and then turned to my husband, “and what do you do?” His job as a forensic psychologist garnered much more dinner-party-appropriate small talk.
If people did respond, they always asked me, “Isn’t that depressing?” I would answer that my job was full of sadness, but I found meaning in it. The opportunity to share such a profound journey with these families offered a deep connection with other people and the fragility of life in a way that made me appreciate life as I never had before.
If you are interested in following the Kids and Death series, sign up for my bite-sized, weekly newsletter so you don't miss out. Every newsletter features the week's blog post before it's published anywhere else, and the Kids and Death series will be for subscribers only!
Lifetimes: The Beautiful Way to Explain Death to Children (A simple book about the cycle of life and how all animals, people, and plants die)
The Next Place (A non-religious, spiritual book about what happens after death)
Birds & Bees (This American Life podcast; the third part is about talking to kids about death)