When you’re faced with telling a child that a member of the family is in the hospital and may die soon, that can be confusing and overwhelming. It is surely not an easy task, especially when compounded by the likelihood that physical visits may not be possible. Whether this is the case, as is with recent COVID-19 related hospitalizations and deaths, children will need the support of parents and caregivers in order to process the situation. This needed support begins with the information they receive from you.
There are some helpful things to consider before your discussion and information-sharing with your child or teen.
Begin the conversation. Talking with children and teens about this kind of situation is not easy, but there’s the possibility that your child already knows that something is ‘out of the ordinary’. Don’t put off the conversation, hoping for a ‘perfect’ time to talk about what’s going on. There is never a perfect time. It is just important that they are informed and that the best decisions are made about how they wish to be involved in the process.
Use honest, clear and open language. Be honest and give clear and accurate information using words your children can understand. You want to avoid using words like’ not getting better’, ‘won’t be here much longer’ or ‘passing on’. These phrases can be confusing, especially to younger children. It may be difficult to say, but use the word ‘dying’. It helps children understand what is happening. Rather than saying ‘daddy is really sick’, name the illness so children can differentiate between someone getting sick with a cold and sick with COVID-19 or cancer.
If a family member is hospitalized due to an accident or other sudden event, share that in clear and developmentally appropriate language. Young children need concrete, basic information about what they can expect to happen and when. Teens may need and want more details, especially as the family member’s death approaches. Being honest and open models for children that they can talk honestly and trust you to tell them the truth, even when things are hard to talk about.
Acknowledge and normalize their feelings and thoughts. Listen without interrupting or minimizing whatever they think or feel. Let them know that it’s normal to have a lot of different feelings and thoughts when a loved one is dying. You can help children and teens learn to express their experiences by naming your own thoughts and emotions.
Model being okay with not knowing. Children and teens will ask questions that you won’t have the answers to. That’s okay. Appreciate their questions and tell them that you don’t know the answers. Then assure them that if you find out more, you will let them know. This teaches them that it’s important to ask questions, even questions that we may not have the answer to.
Just like adults, children benefit from feeling included and being given the opportunity to be involved in decisions. Ask them if they would like to do or say something now that they know. They may want to verbally share their thoughts and feelings with the person who is dying. Others may want to make a card or drawing, write a letter or leave a treasured item with the person[a stuffed animal…]
If the person is unable to have visitors or the child chooses not to visit, there are other ways to communicate. If a family member, social worker or medical professional can be at the bedside, they can read the child’s or teen’s letter, share their picture or facilitate a phone call or video chat. If your child or teen doesn’t know what to say, write or draw, here are some prompts that might get them started:
- I will not forget….
- I love you…
- I’m glad you’ve been my….
- One thing I’ve learned from you is….
- I wish….
Remind children that their messages matter. In this time of the COVID-19 global health crisis and physical distancing requirements, families might face the heartbreaking inability to be with the person who is dying. You can acknowledge how painful and unfair that feels and work to create rituals in your own home that help children and teens feel connected while also saying or doing what feels right for them before the person dies, even from afar. Some ideas include:
- Sharing stories about the person. You can do this with your immediate family or invite others to join via video chat. You may want to record the stories.
- Preparing a meal together and eat the person’s favorite foods.
- Creating a playlist of the favorite songs the person likes or just reminds you or other family members of them.
- Creating a place in your house with pictures and other items connected to the person who is dying. Let the children know that there is a place they can go to think about them or talk to them as if they were there. By all means, allow the children to contribute items, as well.
It’s important for children and teens to have the opportunity to honor the person and to choose if and how they want to engage in activities and conversations with and for the person before
they die. If they choose not to, let children and teens know that this is okay and there will be ways for them to do so in the future, even after the person has died, if they want to participate. Your continuing love and support is what holds most importance in helping children through most life events in healthy ways.