Telling a child someone is dying

You may wonder if it is better to ‘protect’ children from difficult truths by hiding them. Or you may feel you are just not able to give them the time and patience they need right now and that it will be better done later.

But research shows that having an ongoing, open and honest conversation about what is happening, in an age-appropriate way, is what is best for the child or young person. It will help their mental wellbeing now and long into the future.

Children and young people will notice changes in atmosphere, body language and routine.

You may think you’re protecting them, but they will almost certainly overhear things or see objects like letters or medication.

If they don’t know what is going on they are likely to fill in what they don’t know with their own ideas and concerns. These can be worse than reality, or not really make sense. For example, we know sometimes children blame themselves. Or sometimes they worry that other people will get ill too.

You won’t always be sure of things yourself, but being honest about what you do know is a good start.

Children and young people need to be able to trust the important people in their lives. If a child or young person feels something is being hidden from them, even when your intention is good, this could harm your relationship. Now and in the future.

Children and young people are still learning so many important skills for life. They need to feel comfortable to ask questions and get advice. Things that may seem obvious to you may not be something they’ve thought of. And you may not have thought of things that are clear to them.

When the important person dies, the child knowing what has happened and having trust in you and other grown-ups will help them with their grief.

This conversation is never going to be easy. But we hope these suggestions help you feel more confident.

It may not always be possible, but it is a good idea to take some time to prepare and plan how you’re going to tell a child that someone important to them is dying.

Children and young people do best when they are told the truth by someone they love and trust, in a place they feel safe. So think about who is best for this task and where the child will feel most comfortable.

Find a time when you are unlikely to be disturbed, and you are not in a rush. You may want to have another person they know with you for support. This can give your child an extra person to talk to later.

How will you begin? This can sometimes feel like the hardest part of the conversation, so write down or memorise your first sentence or phrase.

To help get their interest, you could point out something about how their life has changed recently. Or perhaps there’s a question they’ve asked that you didn’t quite get to answer before.

Letting them know straight away how you are feeling also lets them know its OK for them to feel sad too.

Examples of how to start the conversation:

• “Can you come and sit here with me for a while? I’ve got something important, but also difficult and sad to talk to you about.”
• “I know you have noticed that Dad has been sleeping a lot more recently, and I wanted to talk to you about why.”

You or people around you may believe in heaven or an afterlife and be comforted by it.

Your family’s beliefs are important, but make sure they understand:

• they can’t visit
• that a dead person’s body will not come back to life
• that dying themselves would not be a good way to see the person who has died again

Spiritual or religious leaders may be able to help you find a way to talk about this with your children.

Children tend to think very literally. This means they think you mean exactly what you say.

Try not to describe things in ways that could be confusing, for example:

• "Nanny is going to sleep"
• "Mummy is going to the stars"

In these examples, the child they might think that the person could wake up, or that they will see them again when they come back from the stars. They might get scared of going to sleep in case they die too.

This is an example of explaining something directly:

• “Mummy has a problem with her tummy. It is called cancer. It is making her very tired and sick. The doctors think she will die. Dying is when your body stops working completely. This is really really sad for us all and it makes me cry every time I think about it.”

Information on how children understand death at different ages can be found at:

• Cancer Research UK
• Child Bereavement UK

For children with learning disabilities, this resource from Marie Curie, may be helpful.

Children may ask very practical questions that can feel uncomfortable, blunt and surprise us. It might help to think about some answers beforehand.

For example:

• Question: Is she hurting?
  Answer: It does hurt mummy yes. She has really good medicines to help stop it hurting but the medicines can’t stop her from dying.
• Question: What will happen to his body?
  Answer: Grandad’s body won’t work anymore when he has died. But we can’t keep his body. We will bury it in the ground so it becomes part of the earth, or we spread his ashes somewhere special.
• Question: Will we get sick too?
  Answer: The sickness dad has is not the sort of sickness you can get from being near him. Something has gone wrong in his body that the doctors can’t fix. There is no reason why it happened to him. It’s just really really bad luck.
• Question: Will I forget them?
  Answer: We will miss mummy very much forever and we will always remember her. We will slowly learn how we can find ways to be happy without her. That is what she wants us to do.

If the question has come at a difficult time, when you can’t or don’t want to answer, that’s OK. But let them know how important you know the question is to them, and make a plan about when and where you’ll talk about it with them in the near future.

Being honest about your emotions shows them that it’s OK for them to have these feelings, and talk about them, too.

So don’t just tell them its OK. Let them know some of the ways you are taking care of your own difficult emotions.

For example:

• “Daddy is feeling very sad about grandma, so he’s going to give Aunty Karen a ring. It’s good to talk to someone we trust when we’re feeling sad.”

Older children might find these ideas about a volcano or a suitcase of emotions helpful, from Child Bereavement UK.

For example, depending on the age of the child you might ask:

• “Do you know where your tummy is?”
• “Do you know what cancer is?”
• “Do you know what dying means?”

If you’re not sure what they want to know, you could ask them what they think before you answer. This can help you make sense of what they are asking.

Older children are more likely to know about illness and death, but it is still a good idea to check. They may like a deeper more spiritual or philosophical conversation.

Older children and teenagers may also want to do their own research. Offering some advice on reliable places to look online may help. It might also be a good idea to check in with them regularly about what, if anything, they are looking at online and any questions they have about what they have found.

Information on reliable information online:

• SaferInternet
• Childnet

The Mix’s discussion boards is a safe and reliable place for young people to connect with people going through the same thing.

If you don’t know the answer, it’s OK to say so. Tell them you will try to find out and talk to them about it later.

If you don’t know how long someone will live, then it is better to talk to the child about the illness first and wait to talk to them about death. It is still important to be honest if your child asks about death directly.

For example, you might say:

• “We don’t know if dad will die or not. The doctors are doing tests and working hard to find the right medicine. They will tell us when they know more about what will happen and I will tell you straight away. I know it’s really hard not to know straight away.”

It’s important to make sure you do come back with an answer when you’ve said you will.

This might seem obvious to you. But young children often think that their thoughts and actions can control and affect their world. It’s important to be clear that nothing is their fault and that they can’t change things by, for example, being extra well behaved.

Sometimes it can be tempting to try to protect a child’s feelings. For example, if they ask you if the person will get better, you may wish to stop their distress by saying "yes".

Although it can be difficult, it is always better to be honest, rather than to make a promise that you can’t keep.

Children need to know that whatever they feel is OK. Emotions like anger and jealousy are common.

Children might know that things like smoking and drinking can make you ill. They might then blame the person who is dying and feel angry about it.

Or they might feel jealous and resentful that the person who is dying is taking so much of your time. Depending on their age and understanding, they may also feel guilty about how they are feeling.

As an adult it can be incredibly hard to deal with these emotions, especially if they are directed at you. It might help to talk to them about how it is possible to feel more than one kind of emotion at once.

For example:

• “I love grandad very much. But I also feel frustrated with him sometimes that he doesn’t look after himself properly, and angry that this is making him die.”
• “It’s normal to have lots of different feelings at once, but it is also confusing and difficult, isn’t it?”
• “It’s OK to feel cross or upset with Daddy because I have to spend so much time looking after him and don’t have a lot of time for playing right now. I miss playing with you and sometimes feel cross too.”

Reassure them they are very much loved by the people around them, including the person who is dying (if appropriate).

It may be helpful to understand that younger children can seem to move from feeling intense emotions one minute, to being fine the next. This can stop them being overwhelmed by what they are feeling. It does not mean they are not upset, or don’t need support.

Child Bereavement UK call this ‘puddle jumping’ and have made a short animation to explain it.

It is very unlikely that talking to a child or young person about someone important to them dying will be a one-off conversation. In fact, we think it’s a good idea to talk to them regularly about what is going on, unless they are very clear they do not want to.

This was a hard conversation. There will probably have been tears and confusion. There may even have been some harsh words aimed at you. Tell yourself you did your best, and nothing you could have done would have made this easy. Take some time. Do something for yourself or speak to someone you trust if you’re feeling overwhelmed.

Children often need the same information retold lots of times. It can take time to understand the concept of death and accept the person will not get better. This can be difficult to cope with, especially when dealing with your own emotions. But this retelling is important to help them make sense of what is happening.

Whether you feel the conversation went well or not, it may be helpful to think of other ways they might find ways of processing their emotions and questions. This is because some children and young people may struggle to put their questions into words.

Writing, drawing, art or play could all be useful to them. Talking about what they have written, made or drawn can help you get a sense of what they understand and what they still would like to know.

Older children may like books, TV or films about dying and grief, that you read or watch together.

As they process things they may ask more questions, or the same questions in different ways. This may continue to happen for a long time, after the person has died and as they get older and their understanding grows.