Talking to Children about Death

Article | June 2016

Talking to Children about Death

If you are concerned about talking about death with your child, you are not alone. Many of us struggle with the topic of death, especially with children. We must deal with it and so must our children. By talking to our children about death, we can learn how they understand death, what they know, and what they do not know. We can help them with any fears or worries they have about death.

What we say to children about death depends on their age, their experiences and how they see the world. It will also depend on your beliefs (spiritual), feelings, cultural background, and the situation.
Each situation will be different. How you talk about it will depend on how close you are to those who are affected. You may have learned about this solely from the media, you may live in the area, or be someone who may know and be close to those affected.

This article is a general guide to help you understand how to approach the subject of death with children of different ages. When explaining death, it is important to take into account a child’s capacity to understand the concept.

General communication cautions

Be aware that you communicate a great deal even without speaking. Children are keen observers of the environment and are quick to pick up on the emotional climate. They watch our faces, see how we hold ourselves, and cue on our tone of voice. They are experts at figuring out how we are feeling.

Avoiding the topic may not be best. If we, as adults, avoid talking about something children will hesitate to bring up the subject or ask questions. They will usually get information from other, less reliable sources.

Choose your words with care. While spiritual and religious beliefs can be a source of strength, if they have not played a role in your lives before the event, children may be frightened by some of the concepts. What you find comforting may actually scare your children. Consider how a child might hear and interpret what you are saying. Avoid saying, “sleeping peacefully,” “lost,” or “passed away.” Reinforce that death happens to everyone, every living thing.

Monitor what they hear. Limit exposure to media accounts for your children and yourself. The continual exposure and intensity of the media message can make the situation even more stressful.

Listen carefully. Try to find out what your child knows and understand about the situation before responding to their questions. Talking to your children about their worries and concerns is the first step to help them feel safe and begin to cope with the events which have occurred. What you talk about and how you say it will depend on their age, but all children need to know you are available and will listen to them.

Grief and developmental stages

How children understand death and express grief differs as they develop, as does how we can help.

Infancy to 2 years

Understanding of death

  • Not yet able to understand death
  • Can sense the loss
  • Pick up on feelings of grief

Expression of grief

  • May change eating and sleeping habits
  • May be unusually quiet or cranky

How to help

  • Keep environment calm
  • Be aware of your tension and seek support to cope
  • Child may need holding, comfort, closeness and reassurance in a calm tone

3-6 years

Understanding of death

  • Death is like sleeping, considered reversible
  • The dead can think, feel, know, but they do it somewhere else
  • Believe that only old people die
  • Death may be punishment for bad behavior or
  • Thoughts

Expression of grief

  • They may stop talking and feel overall distress.
  • Ask many questions - (Where did they go? When are they coming back?)
  • Problems in eating, sleeping, and bladder and bowel control
  • Show fear of abandonment
  • Tantrums
  • Magical thinking – they have faith in magic and the power to make things appear or disappear at will
  • May think they did something to cause the death
  • May fear they will die if they go to sleep

How to help

  • Talk in simple and honest language
  • Follow their lead in terms of how much information to give
  • Ask them if they have any questions for you
  • Never equate sleep with death
  • Talk about what happens to the body when it dies– i.e. the heart stops beating, breath stops flowing, the body doesn’t move anymore.
  • If the child is close or knows the person who died, reassure them that they did not cause the death
  • If the child is going to a funeral, prepare them in simple detail about what happens at these events
  • If physical problems persist, contact your doctor.

6-9 Years

Understanding of death

  • Death is no longer thought of as reversible
  • Know death is final and that may be frightening
  • Believe that only old people die
  • Don’t believe it can happen to them
  • Death is thought of as a person or spirit – a skeleton, ghost, monster or bogeyman

Expression of grief

  • Obsessive interest and curiosity about death
  • Have many specific questions
  • Acting out, physical aggression (especially boys)
  • Can become afraid of school, have learning problems
  • May have concerns about their health (e.g. developing symptoms of imaginary illness)
  • May withdraw or become too attached and clinging.

How to help

  • Refrain from using confusing terms such as “sleeping peacefully,” “lost,” or “passed on”
  • Address questions honestly with direct language
  • It is okay to say you don’t have answers
  • Share your own feelings and grief
  • Provide assurance about their safety
  • Encourage them to draw, write a poem, or create an art piece about their feelings
  • Allow children to participate in memorial ceremonies

9-12 years

Understanding of death

  • Understands that everyone dies and they will too
  • Death is final and cannot be changed
  • Will have been exposed to media accounts of violence
  • Fear their own death and burial
  • May still have some magical thinking

Expression of grief

  • Mood swings and heightened emotions, possibly including guilt, anger, shame
  • Increased anxiety about their own death
  • Fear rejection – don’t want to be different from peers
  • Disrupted eating and sleeping patterns
  • May show regressive or impulsive behaviors

How to help

  • Encourage expression of emotion, even if it is anger
  • Remember they are still children and need nurturing
  • Talk with them about their fears about their school and bad people. Remind them that most people act responsibly and this is an unusual event
  • Encourage a return to normal activities

Adolescents

Understanding of death

  • Understanding of death is similar to that of an adult, but teens tend to deny that death can happen to them

Expressions of grief

  • May respond in unexpected ways, such as acting as if everything is alright and they are fine, or that the death has interrupted their life
  • Tend to turn away from family and look to peers for support
  • Unsure of how to handle their emotions
  • May withdraw from everyone
  • May have questions about mortality, vulnerability and the meaning of life
  • Can feel guilty, especially if the deceased was close

How to help

  • Don’t wait for them to come to you, approach them.
  • Express your fears and concerns and ask them to share theirs with you.
  • Support involvement in activities that allow them to help others – volunteer opportunities, for example.
  • Encourage a return to regular routines
  • Be available to them as a family, but allow time with peers

Children and the grief process

In general, it is helpful to remember that a child's grief process is different from an adult's. You may see different, perhaps unexpected, reactions.

  • Children may appear to show grief only briefly. They may be sad one minute and happily playing with friends the next. Parents may mistakenly believe that the child doesn’t understand what has happened or that it has not affected them. Generally, this is not the case. More likely, this is due to the fact that children do not feel strong emotions for long periods of time. Plus, we all have a protective mechanism within our consciousness that insulates and protects us. The initial feeling of being numbed and in shock is the mind’s way of protecting us emotionally from the full effects of a traumatic event. Children have this capacity as well.
  • Coping with death and loss is a process for children that may continue over many years. Experiences of separation, such as returning to school, sleepovers, or going to camp may trigger feelings of loss and, possibly, fear.
  • Children have less experience and may not know how to express their feelings of grief. They may become very active, instead of withdrawing or showing sadness the way adults do.
  • Children may not have the developmental skills to work through their thoughts and feelings. They may have trouble finding the words to use. Their behavior may be the only way that they communicate feelings such as anger, worry, or sadness. Be aware that children often play games about death as a way of dealing their emotions and fears. Play such as this offers a safe way of expressing and working through feelings.
  • Children may also be very talkative about death and have many questions about what happened. They may bring up the topic with anyone who is around them, even strangers, to see how they react. This gives them information on how they should respond to the situation.

References:
National Cancer Institute. (n.d.). Children and grief. Updated March 6, 2013. From https://www.cancer.gov/about-cancer/advanced-cancer/caregivers/planning/bereavement-pdq#section/_62
NIH Clinical Center Patient Education Materials. (n.d.). Talking to children about death. April 2015 from https://clinicalcenter.nih.gov/ccc/patient_education/pepubs/childdeath.pdf

The information provided is for educational purposes only. It is not medical advice and is not a substitute for proper medical care provided by a doctor.

Cigna assumes no responsibility for any circumstances arising out of the use, misuse, interpretation or application of the information provided. Individuals are encouraged to consult with their doctor for appropriate examinations, treatment, testing and health care recommendations.