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Preparing a Child for the Death of a Loved One
By Robin Fiorelli

If an adult is able to prepare a child for the death of a loved one, it is important to do so as soon as possible before the death occurs. The adult first should ask the child what he or she knows about the loved one's illness. This allows the adult to discover any misperceptions the child may have and assists the adult in knowing where to start in educating the child about the illness and prognosis.

It is imperative that the adult present the information in a gentle and calm manner, allowing the child to voice questions and concerns. Children usually can absorb only a little information at a time.

It also is important to look for "teachable moments" -moments when the child seems open to learning. It should be explained that all living things must die. The adult could show the child plants and insects that have died and explain that because people are living things, they die, too. The adult also can explain that the changing seasons are another example of the cycle of life and death. The child should be told that the images of death on TV and in cartoons are not always authentic and that death always is irreversible.

The adult can explain to the child that people usually live a long life, but sometimes, when someone develops a serious illness, he or she dies before reaching an old age. The adult also can explain that doctors usually help people live long, healthy lives, but sometimes even doctors cannot stop some people's bodies from malfunctioning. Using descriptives such as "very very sick" or "very very old" helps the child distinguish between getting a common cold and having a terminal illness, as well as between their parents-who may seem old to them-and elderly people. The child should be reassured that this is not a punishment, or God's fault, or anyone's fault-that it just happens. They also can be reassured that death usually is not painful and that it is almost always quiet.

When a loved one is dying, if the child is old enough to understand what is happening, and both the child and the dying person would like the visit, the child should be allowed to visit. The child should be prepared beforehand about what he or she might see, hear and what feelings might be experienced. The child should be told what the loved one might look like; the setting, including medical equipment, if applicable, should be described.

Depending on the age of the child, it may be advisable to keep the visit short. Visiting with a dying loved one might be a way for the child to understand the reality of the death and a way for important communication to take place between the child and the loved one. The key is that it must be the child's choice. If the child does not want to visit, a supportive adult should attempt to elicit why the child is resistant-but the child's wishes should be honored.

Throughout the illness, the child should be told about changes in the loved one's condition as they arise. The child should be allowed to care for the loved one in a way that he or she chooses-be it through writing cards or bringing a glass of water or tissues. Caring for the loved one sometimes allows the child to feel less helpless.

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