All children need to be helped to realise that death is part of life and that it can be frightening for adults as well as children. Children at different ages, have different understanding and beliefs about death. Your child may know more or less, depending on their age, maturity and experience. Children being treated at a hospital may well know other children who have died. They are likely to have more of an understanding of death than could be expected in most children of a similar age. It can seem confusing but children are capable of holding conflicting ideas at the same time, that at times they know they are dying, but will also talk about their hopes for the future. The following sections are only a rough guide to how children may understand death.
Pre-school children
A pre-school child may not necessarily understand the word death. When introducing the subject to a pre-school child, start by letting them tell you about death. Reply to any questions with very simple short explanations. When you have answered them, stop. Try to relate death to things they can understand, such as the death of a pet, or finding a dead insect. They may not believe that death is final and sometimes think it is like sleep, and that you can wake up. At ages three and four, children often include death in their play and can get very confused about the difference between fantasy and reality.
At first, a pre-school child may seem to accept it but then expect the person to return. They ask lots of questions such as “Do dead people eat?” or “Can they watch TV?”, “What happens when people die”, “Why do people die?” Their understanding will be linked to their experience and curiosity. They may have known other people who have died, and this can mean that they understand more about death than other children the same age.
At this age, it is most important for the child to feel safe. Try to keep to their normal routine. This, along with plenty of cuddles, will help them feel secure.
Short, simple explanations are best. Always try and give an answer to a question, even if you can’t give the reply immediately.
Children aged 5 to 9
Children of this age group begin to understand more about the meaning of death. At 6 to 7, magic and myth are very important concepts. Death is often associated with ghosts and witches and can be a very scary idea, but they also quite like this dark side of death. They may fear that a dark scary monster could take them away. Children at this age may start to talk about heaven, paradise or an afterlife. Children at any age can also feel responsible in some way for the death of their brother or sister. Feeling that somehow, something that is happening is their fault is called ‘magical thinking’. Children of this age often strongly feel this guilt and responsibility, and may need a lot of reassurance that it is not their fault.
Children of 8 to 9 begin to sense that death is more final. They may feel responsible or relieved and may worry about parents’ reactions. This age group generally cope best when they receive simple, honest and accurate information. They can be told that it was nothing they did or did not do that caused the death.
Children aged 10 to 12
Most children by this age realise that everyone dies. Death is often seen as frightening, gloomy and horrible, but fascinating. Death is final and not reversible. Children’s thoughts can become abstract and spiritual, stretching their understanding of what is happening to them and within the world.
At this age, children cope best by establishing support systems with parents, friends and other family members. They can be given the opportunity to express their feelings, using conversation or other creative and artistic means.
One father sat down with his 10-year-old son and talked about how his friend had died during his bone marrow transplant. His son said “I’m not even going to get to transplant am I? I am going to die, aren’t I?” They talked about death, how the body stops working and that actually everybody dies but he may die quicker than everyone else.
Teenagers
Teenagers are often concerned with their own identity and their position within their family and circle of friends. They may think about the deep issues of life and death. Teenagers are very aware of their own body image and as death is involved with the destruction of life and body, it can feel particularly threatening. Expressions of emotion may be hard. Some teenagers will want to grieve openly and others will find it easier with friends, rather than with family. Helping teenagers cope is about trying to get the balance between support
and respecting their space and identity, and will most often be a compromise on both sides.
What questions might you be asked?
It can be helpful to think about and anticipate questions you might be asked. It is perfectly alright to say you do not know the answer. You may want to say that you will think about it and try to answer later on when you have thought it through or have talked to someone else. There really are not any right answers, just ones which are right for you and your family. Other families have found the following suggestions useful:
Questions from the ill child
"Why do people die?”
Dying is a natural part of life, all living things will die, time or illness wears out important parts of our bodies and they can no longer work.
"Why can’t the hospital stop someone from dying?”
They do sometimes and always try their hardest, but sometimes they can’t make someone better.
"Will you be able to hear me?”
I hope so, it is hard to say, but you’ll always be in my thoughts and dreams.
"Will I still be able to see you?”
I hope so, no one really knows, but I’ll always remember what you look like. If you close your eyes you can get a picture of me in your head, like I can of you. Even if you can no longer see me, it doesn’t mean I am not there.
"I’m frightened.”
I’ll be there with you, looking after you. (It is important to make the child feel safe, by surrounding him or her with favourite things and people to cuddle touch and smell, and feel surrounded by love.)
"Is this really happening to me?”
Yes, it is happening to all of us, we are in this together as much as we can be.
Questions other children might ask
"Where do dead people go?”
Some people believe they go to paradise, or heaven, where there is no pain and it is peaceful and happy. Some people think you come back to earth.
"Why is someone I love dying?”
Sometimes life is just not fair. It was nothing you or anyone else did or did not do. Their body is just not strong enough to carry on living.
"How do I know they are really dead?”
They will stop moving and breathing, and will be quiet and peaceful.
"Is my sister really going to die?”
I know it is hard to accept, but she probably will, because we don’t think she can get better.