As parents, we often feel a sense of dread or anxiety about how to address the big questions our kids have for us; after all, how do we possibly explain the large, sweeping spiritual questions of life to a person who’s mostly preoccupied with where his or her next peanut butter and jelly sandwich is coming from?
But just as cancer can change the dynamics of any family, a parent, sibling or other relative who has been diagnosed with terminal cancer will cause the children in the family start asking the big questions that we may not feel totally prepared to answer. Remember that when we talk about dying with children, it’s a concept that needs to be explained to them from back to front. Because young children tend to be the centers of their own tiny universes, taking steps to explain death in concrete, certain terms can be as challenging as it is important.
So, what do you do, to make sure your child understands what dying means, and how do you start the conversation? While the answers will be different for every child, and depends on their age and stage of development
, here are some general guidelines:
Set the stage appropriately. Remember that you know better than anyone how to talk to your child, and setting the scene and tone will be different for every child. Some children are more focused and attentive during a more formal, quiet sit-down, either alone or with another parent, sibling or even a doctor, counselor or social worker. Other children respond better to a less formal setting; try chipping away at conversations about death during other quiet moments such as during hair brushing or dressing, bathtime or over breakfast.
Find out what your child thinks is happening.
A good way to start the conversation is by asking your child
how they think things are going. Start with an open-ended question, such as “How do you think I (or your brother, or your grandmother) are doing?” Your child may have picked up on cues that something is changing and that the situation is becoming more serious. Physical appearances may have changed, there may be more frequent trips to the hospital or there may be a sudden influx of new people in the house helping with daily activities. Talk to your child about the changes they have noticed, and what they think those changes may mean.
Remember, children who are old enough to understand that people who are sick, receive medicine, and that medicine stops people from being sick, may assume that since a patient is receiving treatment, it means they won’t die. When children begin to understand the order of the universe, and the relationship between causes and effects, they may think those “rules” are ironclad. It’s up to you to ask them to explain their theories, because the assumptions we make about what children do and don’t understand can be incorrect.
Talk about the details of treatment.
It’s important for kids to understand changes in treatment; either that treatment isn’t working, or that treatment may have seemed like it was working, and then stopped. This is especially important for kids who have been told that treatment was going to provide a cure. Try something like, “The cancer has come back and is getting worse, and when it gets worse, my body isn’t going to work like it’s supposed to, and I will die.” Explain that cancer treatment doesn’t always work
, in spite of everyone’s hopes, and that sometimes, death is the result.
Use the difficult words.
Many of us tend to bury death in euphemistic language, but when talking to children, it’s important to use words like “death” and “die,” as opposed to much nicer-sounding terms like “pass on” or “go to sleep.” Children may not always understand what these nicer-sounding words really mean
, and may not grasp the gravity of the situation as a result. A child’s understanding of the world is based on what they can directly experience, and so we need to explain death in terms they understand. A person who dies won’t physically be in our lives anymore, though we will have nice memories of them. Death isn’t like when someone goes away on a trip; when a person dies, we won’t see them again.
Reassure the child that their needs will be met.
Children need to be reassured frequently that even when a parent or relative dies, their physical and emotional needs will continue being met
. Explain to your child what arrangements have been made, and who will be there to care for them after a loved one dies. Children worry about being abandoned, and lack the language to adequately describe these feelings, so it is our job to explain the changes death will make to the family but that no matter what, they will be OK.