Telling children and young people that someone is going to die
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Preparing a child or young person for the death of a parent, guardian, friend or family member is challenging. People with a terminal illness often find telling children that they’re going to die extremely difficult. There are things that health and social care professionals can do to help support them.
On this page:
Caring for someone with children and young people
If someone has children or young people who are close to them, they and the children may need extra support from health and social care professionals. This is part of palliative care.
On this page we talk about children and young people as meaning anyone who is under the age of 18. The adult who is ill may be their parent, guardian, close friend, grandparent or other relative.
How you can help them
Take time to get to know the person you’re caring for and the people who are important to them, including children. Every family is different. Don’t make assumptions about family roles or relationships.
Be understanding and compassionate – if someone has children, having a terminal illness can be extremely difficult. They have the challenge of facing their illness, as well as looking after the children’s needs. Knowing that they will die and leave children behind can be very distressing.
Many parents and guardians want guidance and support from health and social care professionals on how to tell the children about their illness and prepare them for their death.
Health and social care professionals often find it difficult to support children and worry about not having the right skills and training to help. There are things that you can do to help the person who is ill and the children close to them, including supporting them to tell the child that they’re dying or helping them understand the child’s needs at different ages. There are also other sources of support for children and families that you can share with them.
Why is telling children important?
Telling children or young people that someone is dying can help them to be more prepared for when the person dies. It can also provide opportunities for them to spend time with the person who is dying.
Understanding what’s happening
If children or young people are told that someone close to them is dying, it can help them to better understand what’s happening.
If young people notice that something is wrong, they may start to search for information themselves. This might lead to them getting inaccurate or irrelevant information, for example from searching on the internet. Children may overhear fragments of conversations between other people, leading them to ‘fill in the blanks’ by themselves or misinterpret the situation. It is better for information to come from someone they know and trust.
Getting support
Talking openly and honestly about the person’s illness may also help the child to speak about the things they’re worried about. It gives everyone the chance to share their feelings.
This can help children feel less lonely and worried about the situation.
How can I support someone to tell children and young people?
Let the person know you’re there to talk to them about their children’s needs and that you can support them.
Parents and guardians might feel unsure about telling children or young people that they’re dying. They may want to protect the child from the bad news by not telling them, feel that they don’t have enough information themselves or are worried about being able to answer the child’s questions.
Telling a child or young person
It’s best that the child or young person is told that someone is dying by a person that they know and trust. As a health and social care professional, you might be asked to support the person who is going to tell them, or you might be involved in the conversation itself. You may find the following tips helpful:
- Prepare for the conversation. Know what the key things are that you want to say and try to anticipate any questions the child might have.
- Think about the child’s age and how this will affect how much they understand about what illness and death are. This may be different for different children within a family.
- Have the conversation when you have lots of time and won’t be rushed.
- Choose a quiet place where the child feels comfortable and you won’t be interrupted.
- Check how much they understand already.
- If they already know something, you could acknowledge this. You could say: “You know that your dad has been ill for a long time, and the doctors have been trying to make him better.”
- Listen to how they respond.
- Ask them how much they want to know – some children might want more detailed information, while others may prefer to just know the basics.
- Try to use clear and simple language.
- Avoid euphemisms as they can be confusing, especially for younger children – for example, say “dead” instead of “passed away” or “gone to a better place”.
- As you go through the conversation, check that they understand what you’ve said.
- Giving information in small chunks is sometimes easier than telling them everything in one go.
- You don’t have to cover all the information in one conversation. You can take time to build on their understanding over a few conversations.
- Let them know that you can talk about it again, if they’d like to.
- Let them know that it’s okay if they want to ask questions.
How the child might react
You may be surprised at how the child or young person reacts. They might seem less affected or upset than you expected. Try not to worry if this happens – children may react differently to how you’d expect when they hear bad news.
The young person might ask questions which you find difficult to answer. It’s OK if you don’t know the answer to all of these – you can tell them you don’t know but you’ll find out. Some children might not have any questions at first.
Having these conversations can be emotionally difficult. You may find it helpful to speak to a more experienced colleague for support, or to debrief afterwards.
How can I support children at different ages?
How much a child or young person is able to understand about the person’s illness and death may depend on how old they are, their stage of development and any previous experiences of illness or death they’ve had. Some children may be the same age but will be at different stages of development.
It’s important to give them information which is appropriate to their age and level of understanding. You may find it helpful to share this information with the person you’re looking after so they can prepare the child or young person in the best way for them.
Children under three
Children under the age of three might not be able to understand the situation or the concept of death, but they may notice if the person isn’t around as often. They may be upset by changes to their environment, like if the person can’t spend as much time with them, and they may miss their voice and smell.
Children aged three to five
Children aged three to five may understand that something is wrong, but they might struggle to understand that death is permanent. They will be able to notice physical changes in the adult, like if they can’t pick them up anymore.
It can be helpful to explain that if the adult is acting differently, it doesn’t mean they love them less. For example, if the adult can’t play or speak as much anymore. Children this age often use play to communicate, so you could explain difficult things using play or art. If they aren’t able to see the adult in person, they might like to make gifts, write note cards to them, or record a voice message on a phone for them.
Sharing stories about illness or death might be helpful. We have more information about talking to children and a list of books you might find useful to share with the person you’re caring for. They might find it helpful to read books with the children to allow them to think about dying and what it means for them.
Children aged six to eight
Children this age tend to understand that death lasts forever and the adult won’t come back when they die. They might connect thoughts that they have had, or things that they have done (such as misbehaving), with their parent’s illness, fearing that they have in some way caused the illness. This is known as magical thinking.
Try to give the child simple but clear explanations of the illness. For example, it might help them to know the name of the illness, how it affects the person and any treatments they may have. Explaining what is happening can help them to feel more comfortable with asking questions.
Children this age might become quite emotional, and they may get upset if they can’t spend as much time with the adult. If they are worried that it’s their fault, or worried that the adult doesn’t love them as much, try to reassure them that they are loved and that the unwell adult still cares for them. Let them know that it’s not their fault.
Some children feel like they need permission to ask questions as they’re worried they might upset someone if they do, so reassure them that they can talk about their worries if they want to. You can also reassure them that it’s OK to be happy and have fun, if that’s how they feel.
Children aged nine to eleven
Children this age will generally be able to understand more about the illness, so you may need to give more detailed explanations. You could try giving them small amounts of information as the illness progresses. It will also be important to reassure the child about ways that illnesses spread, and that they cannot ‘catch’ terminal illnesses from hugs and kisses.
They might want to visit the adult in hospital or help out with their care. They might like to do small things, like making cups of tea for the person. Children feel more involved and their self-esteem is boosted by being able to help in caregiving, even in small ways such as adjusting the person’s pillows or making them a card. However, it’s important to make sure they also have time for their favourite hobbies and usual routine.
Some children this age may find it easier to show their feelings about the person’s illness. They might find it upsetting to see the person’s appearance change, and they may find it difficult to think about a future without them. It often depends on the child’s personality – some may be less willing to show how they’re feeling.
If they’re worried they’re to blame for the person’s illness, try to reassure the child that the illness isn’t their fault. Encourage the family to tell the child’s school so that they can be prepared for any changes in the child’s behaviour.
Adolescents
Being given information about the illness, symptoms and any treatments can help young people cope when an adult close to them is ill. Having honest conversations and being kept up to date may help them understand what is happening better, and can reduce any feelings of uncertainty they have. They may have more questions about the illness, or more generally about how this will affect their family – for, example the family’s financial situation. They may also have worries about whether they are at risk of developing a similar illness in the future.
Some teenagers may struggle to talk about how they are feeling. They may worry about upsetting the person who is ill or adding to the stress for other members of the family, or they might be struggling to come to terms with the fact that the person is dying.
Teenagers may also benefit from having support from someone else, like an adult at school who knows about the situation, or from the person’s doctor or a counsellor. It can also be helpful for the school to be aware of the situation, so that they can be prepared for any changes in the young person’s behaviour and academic progress.
The person you are caring for may be worried about disruptions to the usual routine, and how this may affect the young person. You could let them know that spending time with friends, or going to school, may help them keep a sense of normality in their lives when lots of other things are different. Reassure them that the young person might also want to spend time alone, and this is normal.
The young person might also want to speak to others who are in a similar situation. The charities Child Bereavement UK and Winston’s Wish have helplines and online chats to support young people.
Children with disabilities
Children and young people with learning disabilities may be able to understand information about the person’s illness and that they are dying. Talking to them might help them to cope with the situation better.
You and the person you’re caring for might find it helpful to speak to a health and social care professional involved in the child’s care, like a key worker or special educational needs coordinator, about how best to explain the illness to them.
Some may find it difficult to understand the concept of death. It can be helpful to use simple language, repeat information, and check they’ve understood what you’ve said. Spending time with the person, or playing a role in the person’s care, if that’s possible, might also help them to understand the illness.
The charity Mencap has information on children with learning disabilities and a learning disability helpline.
We have more tips on talking to children when someone is dying. You may find it helpful to share our booklet on supporting children when someone is ill. You can order or download a copy for free.
Paola shares how she told her children that she was going to die. You may find it useful to share this with the people you're caring for.
What other support is available?
Reassure the person you’re caring for and the people close to them that there is help available. Encourage them to ask for support from people close to them, such as family and friends, so that the children don’t feel alone.
The person who is ill may be able to speak to a counsellor or social worker at their local hospice. Some hospices have counsellors who specialise in supporting children and young people. Ask the person’s GP or district nurse about what help is available in their area.
There is a list at the bottom of this page of different charities that support children and families when someone is ill and after someone has died.
You might it helpful to share information about the Marie Curie Support Line with the person you’re caring for. Our nurses and trained officers provide practical or clinical information and emotional support for people living with a terminal illness and those close to them.
Useful resources
Key points
- Telling children and young people that someone is dying can feel very difficult.
- Telling them what’s happening can help them to prepare and feel more in control.
- The news should come from someone they trust.
- Children and young people’s understanding of the situation will vary depending on their age and stage of development.
- There is support available for children and families when someone is dying.
Let us know what you think
Email your feedback to knowledgezone@mariecurie.org.uk
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Disclaimer
This information is not intended to replace any training, national or local guidelines, or advice from other health or social care professionals.
The Palliative Care Knowledge Zone is not intended for use by people living with a terminal illness or their family and friends, who should access our information for the public.
