Experiencing the illness and death of a loved one is a difficult experience for adults and children alike. Although children may react slightly differently in handling their anticipatory grief, they will still go through an array of emotions.
Hospice of the Piedmont and Kids Path® would like to support you through this difficult time with our full team of trained professionals. If you have any questions or if we can provide additional services please feel free to call us at 336.889.8446.
This booklet is designed to help you and your child cope with the changes your loved one will experience as they approach the end of life.
Many adults struggle with what information to share with their children and how to include them as a loved one declines. Families may have to juggle work and school schedules. Parents may find it difficult to spend time with both their loved one and their children during this time. This may cause the children to feel left out and confused about what is happening to their family.
We know this is a complicated time, and Hospice of the Piedmont’s Kids Path® program is available to help your children and teens through this transition.
It is not until about the age of 9 when children have a true understanding of the permanency of death. Therefore, it is not uncommon for young children to talk about wanting to visit their loved one after death or also wanting to die so they can be with their loved one. This may be alarming to adults who do not realize their child does not fully understand death and its finality.
Adults need to understand that although children can verbalize information given to them such as, “their loved one is in Heaven,” the child may have no concept of what this means. Young children are concrete thinkers and cannot separate the concept of a physical being from a spiritual being. Therefore it may be puzzling to them that their loved one’s body may be buried in the ground, but is in Heaven as well.
Some children may be curious and ask questions about what will happen to the body after the person dies. Many adults may find these questions morbid or unnatural, when in fact it is very common for children to want to know more about the process the body goes through before and after the death.
Furthermore, children often feel responsible for the declining health and death of a loved one. Older children may feel they are to blame or guilty that their actions or words may have been, in part, the cause of death. Although it may seem obvious to adults that the child was not in any way responsible for their parents cancer, renal failure, etc., it is good to verbalize to the child that it is not their “fault” their loved one is ill and dying.
What should I tell my child?
Many families want to know how much information they should give their child about a loved one’s diagnosis. It is important to be honest and share information with your child at a developmental level that is easy for them to understand.
It is good to tell the child what the diagnosis is rather than say the person is “sick.” All of us get “sick” from time to time, but as adults we recognize that a cold is not the same as cancer or congestive heart failure. The child may not be able to understand this difference unless it is explained to them. Older children may appreciate information printed from the computer about the diagnosis or an opportunity to talk with the nurse or doctor.
The most important thing is not to mislead the child about recovery. In many cases, hospice patients have made a conscious choice to stop treatment and it is okay to tell the child this. It can be comforting to know the patient has made a decision about what they want and still has some control as they approach the end of life.
If the patient is still hoping for recovery, it is important to let the child know the patient is showing signs of decline and recovery is not very likely at this point in the diagnosis. If their loved one has been fighting their diagnosis for a long time, they may have experienced remissions and relapses before. Explaining why this time is different can be an introduction to why the patient may not go into remission again.
I want to be strong for my child.
As an adult, it is your responsibility to provide your child with security and stability during a time of crisis, such as a family member’s declining health.
Your children will need you to continue providing for their needs in spite of periods without much rest or having to be away from the home for long periods of time. You may need to secure the help of other family or friends to provide this ongoing security.
However, being “strong for the children” should not be confused with showing no emotion. When explained in an age-appropriate way, your children should be able to understand if you are tearful or upset during this difficult time.
Modeling your emotions and then managing the situation to the best of your ability will help your children realize it is okay to be sad and that your emotions don’t need to interfere with your ability to provide security for your children.
If you need to express a state of extreme emotion that might appear out of control or frightening to your child, it would be best to express those feelings with an adult, away from children.
What factors will impact my child’s reaction to this loss?
- Your child’s age developmentally
- Relationship to the person who is dying
- Involvement with the person who is dying
- Ability to express feelings and anticipatory grief
- Suddenness of the illness and/or death
- Previous experiences with illness and/or death
- The responses of family and friends around them during this time of transition
What does my child understand about death?
What your child is able to understand is based upon their age developmentally and what you convey to them through conversations. Children under the age of 5 usually cannot understand the permanency of death. They think it is a temporary state of being and reversible.
When is the right time to talk with my child?
Often we delay telling our children about a diagnosis because we are hoping the person will have a good response to treatment and we do not want to worry children unnecessarily.
However, it is helpful to start a dialogue as early as possible. If you are seeing a decline in your loved one’s health and have not told your child about their diagnosis, it is important to start talking as soon as possible. Generally, children recognize when something is not going well, so pick a time that would be best for your children so you can talk and answer their questions.
We don’t want to give up hope.
My child still wants their family member to get better. No one ever wants to think negatively about their loved one’s recovery. At Hospice of the Piedmont, we do not want to give up hope either. However, it might be better to offer some alternative suggestions for hope.
For example, you might hope for a night of rest or to control their loved one’s pain, so they can enjoy a visit or have reduced suffering.
How long should my child continue to visit?
This depends on you and your child’s comfort level. The important thing is that, while the answer varies from family to family, the best approach is to talk with the child.
Don’t assume they do not want to visit or be present at the time of death. Explain what it might be like to be with their loved one at that time and let them make the choice.
If a decision is made to stop visits, be sure the child has an opportunity to say and do all of the things they would like to do for their loved one in a last visit.
I want to make this easier for my child. How can I do that?
Dealing with the loss of someone we love is never easy. However, it is best not to say things that will be confusing to the child.
Statements such as, “Your loved one will be watching over you” can be scary to a young child. A better comment would be, “We will always have good memories” or “We will always love and remember our special person.”
It is important to be available to your child as much as possible during this difficult time and support them. It is also essential to allow your children to express their feelings through words, tears, and at times anger.