Cara Allen, LCSW
I have worked as a therapist in an emergency department, an ICU, a cancer center, and private practice. I have walked many caretakers, often the parent or parents, sometimes a trusted relative or friend, through the heartbreaking process of telling a child that their parent is going to die. No one is prepared for this, and everyone feels lost. Here is what I recommend:
The truth is always best.
I don’t use the word always lightly. However, in this case, it is. Being direct and clear and honest in an age-appropriate way will lay a foundation of trust that will be helpful in the days, months, and years to come. It is very likely that this conversation is more difficult and dramatic in your mind than it will be in reality.
You will want to wait too long. Don’t.
Almost everything in you will want to avoid this conversation. You will likely rationalize it by saying you don’t want to rob them of hope or make them sad before they need to be, or that they’re too young to understand or that they have a big game coming up or an important test, or a birthday or… In my 20 years in this field, I have never heard a child say “I wish they had waited longer to tell me, or I’m not glad I know”. What they do say is “I wish I had known and I wish I had gotten to say or do certain things.” These are moments that you can not replace for this child. Give them control during an uncontrollable event to make choices about what to say or do. It can dramatically change the course of their grieving process.
If you are the parent who is dying, you can see the opportunity to help walk them through your death as one of the final gifts you give your child. Tell them about your hopes and dreams for them. Give them permission to live their life and be happy. Let them know it’s ok to feel whatever it is they are feeling.
What exactly do I say?
If you’re struggling to picture how this will look:
Be clear and direct: “John, you know mom has been sick. The doctors told us today that she will not get better. They don’t know exactly when, but mom is going to die.” *
Pause and ask what questions the child has.
Answer the questions honestly. It’s ok to say you don’t know. Depending on age, maturity, and the situation, there may be many detailed questions or no questions at all.
Allow any emotions. It is normal to have a very wide range of responses. This could mean tears, anger, shock, or even a blank look. Tell them directly it is ok to feel whatever they are feeling. Those feelings might change, or stay the same. It’s OK to show whatever feeling you are having as well.
Tell them they can ask anything, at any time. The door is always open.
Let them know it is not a secret, and suggest people (a trusted relative, friend or counselor) who they may choose to speak with.
Think of this conversation as the first of many, not one where you need to cover absolutely everything. Wait a day (or less depending on the situation) and if the child does not bring it up, ask them if they have any other questions about what will happen. Give choices about attending doctors’ appointments, seeing the person, attending services, etc. Suggest ways to communicate, like writing a letter, making a music playlist for the person to listen to, or drawing a picture if appropriate.
*Children age 5 and younger may not yet be able to grasp the permanence of death. Let them know that death means the body stops working and that people who are dead can’t do things living people do like walk or talk and that it means they are not coming home. Stay away from comparing it to being asleep (this can be scary since the child sleeps every night) and know that they may continue to ask when mom is coming home or act like nothing is different.
This age group also may experience magical thinking that can lead them to believe that if they are very good or bad that it will influence the situation. Some may even believe that something they did wrong could be causing mom to die. Reassure them directly that this is not the case. “It’s no one’s fault. Nothing any of us did caused this and nothing any of us can do will change it.”