How to talk to children about a terminal diagnosis or illness and how to prepare them for the death
Adults often struggle with how to tell a child a loved one is terminally ill and how to prepare them for the death of their loved one. Adults fear that a child is too fragile or will easily bounce back. The truth is children are emotionally strong and want to know about the illness. In fact, the truth will help children understand what is real and what is imaginary. It is not uncommon to want to avoid dealing with having this conversation with a child; and it is not an easy conversation. It is normal to want to protect them from heartache as long as possible; however, a child should be told about the terminal illness so they can prepare themselves for what will happen next. Children who are kept alight of the situation tend to have a more positive recovery.
Breaking the News:
There is never a good time to tell your child that someone important to them is dying. But is it's important to talk with them as soon as possible. Telling them as a family gives a sense of reassurance you all are going through this together. Reserve the time so there will be no interruptions of visitors or phone calls. It may be best to give the information; slowly and in small chunks. Let them know you are available to answer any questions. You may start with asking them what they already know about the situation. They may have overheard conversations about what is happening and feel confused and worried.
It is helpful to begin to with general terms such as "You know Mom has been at the hospital a lot lately and now it is worse." It is important to use the correct language, what the disease or condition is and how it is different from being sick. You will eventually need to use concrete words like cancer, death and die. Try not to use euphemisms like "gone to sleep"; this will only confuse a child or create some fears of going to sleep.
If you find that this is too difficult to do by yourself, then seek the assistance of a hospice nurse or other supportive adult. Please remember what's important is the information that you are telling them. Your love and sincerity will speak louder than the words they will hear.
When deciding how to talk to children about the illness of their parents, the age and maturity level of the children must be taken into consideration. Preschoolers are typically egocentric and have magical thinking that can lead them to believe they may have caused the illness. It is helpful to keep the information simple and answer all questions they may have. Older children and teens are likely to require more information and may have many more questions once they process the information.
Children don't always fully understand the concept of death and may view death as a kind of temporary separation. They often think of people who have died as being far away, perhaps on a trip. They need understand that death is permanent and the person will not be coming back like they may see on a video game or television.
It is not uncommon for a child to believe that they and/or someone close to them will die. Parents often reassure children; but it is important to promise something you cannot keep. You may wish to shield children from death is understandable; but when a death directly affects children, this reality can no longer be hidden from them.
Children, just like adults, struggle to make sense of a death. If they do not understand that death is an inevitable part of life, they will make mistakes as they figure out why this particular death occurred. They may assume it happened because of something bad they did or some thing they failed to do. They may think it happened because of bad thoughts they had. This leads to guilt. They may assume the person who died did or thought bad things, or didn't do something he or she should have done. This leads to shame.
These reactions make it difficult for children to adjust to the loss. Many children don't want to talk about the death because it will expose these terrible feelings of guilt and shame. It is important to talk to your child their behavior, statement or did not cause the death or illness.
Reassurance and routine
Hearing the news that someone they loved is terminally ill is sure to bring on a wide range of emotions in children and the greatest of which may be fear. Some children may be sad or worried but others may misbehave or be prone to angry outbursts. A child may need some extra attention not only while the person is ill but after the death as well. The grieving process begins when a child is told of the illness.
Children benefit from a sense of security and routine while they are coming to terms with how their world is changing. When a loved one is terminally ill it's inevitable there will be some changes. Talk to your children about why the changes are taking place. Try to keep the routine as consistent as possible once the changes have occurred.
It also is essential to provide some time in the new routine to spend some individual time with each child to check in. You can follow-up to determine what a child understands, fears, and provide reassurance. There may be some confusion or anger as to what is going on and may need to have re-explanation. Some children may be reluctant to talk about their fears or other aspects of the situation and may request other outlets to express their fears. These outlets may be through play and or art.
A great way of helping a child is to focus on sharing memories together and on building new memories for the future. Many families will make memory boxes or put together scrapbooks. It is not so much of saying goodbye but to talk about their loved one and stay connected to their loved one.
Each family must decide for themselves when to have the conversation about the illness of the loved one but it is not wise to stay quiet about the situation. It is important to prepare a child and give them the message that they are an important part of the family.