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Helping a Child When a Loved One Is Terminally Ill

Many of us have difficulty talking about death or terminal illness, especially with youngsters; but death and illness are part of life. Without talking to our children about this subject, we may not be aware of how much they know or what they are thinking. This hinders our ability to be helpful to them when they need us.

Talking with Children about Death

Children’s questions about death and illness may occur when someone they know is sick or after they have seen something on the television news. We can encourage them to talk to us by showing interest in their questions and by providing true information. We may be uncomfortable allowing our children to see our emotions, or we may not be willing to answer a question. Maybe we avoid the subject altogether. The child may get the message, “If this is too bad for mom and dad to talk about, maybe I should not talk about it, either.” Avoidance can prevent our knowing how our child is feeling.

Confronting children with more information than they are able to understand is not helpful, either. Finding a balance somewhere between avoidance and confrontation involves:

  1. Being sensitive to what they want to know and when they are ready to know it

  2. Offering honest, simple explanations

  3. Really listening to what they say

  4. Accepting their feelings, whatever they may be

  5. Not putting them off

  6. Examining our own feelings and beliefs

Everyone feels anxiety when someone is terminally ill. Some experts call this anticipatory grief. Children feel this anxiety, too. Because the possibility of losing a loved one can be especially hard for children. If a parent is overwhelmed with their own anticipatory grief and anxiety, perhaps a close family member or friend the child trusts could be asked to help.

Children especially need assurance of two things: (1) There will always be someone to care for them. And because children engage in something called magical thinking, they may believe that their anger toward the person may have caused the illness; so they need assurance that (2) Nothing they did or did not do could have caused the illness to occur.

How Age Affects the Understanding of Terminal Illness

Age affects how children understand things such as terminal illness. Infants and toddlers may simply react to the emotions of others, sense a disruption in their schedule, or show distress if their primary caregiver is suddenly not there. To help an infant or toddler feel more secure, keep the routine and schedule as near the same as possible, stay physically close to them, and hold them more.

For children three to six, explain the illness in simple terms: “Grandmother’s body doesn’t work anymore.” Assure the child there will always be someone to care for them.

Children six to nine need honest answers, for example, “Grandmother became very sick from a disease called cancer.” Encourage them to talk about this and to ask questions if they want.

During the stressful time surrounding terminal illness, otherwise emotionally mature nine to twelve-year-old children may regress to an earlier stage of behavior. It helps to encourage the child to talk about the person who is sick. Let them know it is okay to express their feelings by expressing yours.

Adolescents may:

  1. Feel they don’t need help

  2. Act as though they don’t want to talk

  3. Hide their feelings

  4. Try to be strong for others

  5. Feel guilty or angry

Teenagers may prefer to receive support from their peers. Even so, it is important to maintain family closeness while respecting their privacy. Teenagers need adults to be with them when they are grieving. They need adults to understand their feelings and to teach them how to respond. They need someone to talk to who will provide guidance.

Activities for Children in Grief

Activities are helpful for grieving children. Memory books and memory boxes can be helpful now and in the future. Small children may need help.

A memory book may be made by collecting a series of photographs of the beloved person. They can be attached the same way as in a photo album. Underneath each picture, the child can write memories connected to the photos. The child may want to decorate their book with stickers or drawings.

A memory box can be a shoebox or any kind of box that has been decorated by the child. The box may then be filled with photos, keepsakes, poems, letters, or other items that help the child remember the loved one. Favorite colognes or shaving lotions may be included.

Adults might want to make these books and boxes, also. Kids always like to have a partner, and these kinds of activities help them prepare to say goodbye. It is important to say goodbye.

Anticipatory Grief in Children

Children’s anticipatory grief is often expressed in their behavior because their ability to express themselves with words may not be adequate. They may act out aggressively or withdraw when feeling abandoned and helpless. Parents may wish to provide added attention and affection if these behaviors are apparent. On the opposite side of the spectrum, some children may seek to protect adults by taking on a caretaker role. Children do not need to be burdened with this responsibility. Of course they can help if they want to, but the adults will want to be in charge.

Some signs that indicate your child may be having problems with grief are:

  1. Extreme behavior change

  2. Nightmares

  3. Withdrawal

  4. Physical complaints

If these symptoms persist and do not improve with extra attention and physical closeness to you, it would be a good idea to consult the child’s doctor.

In addition, informing the child’s teacher or counselor at school of the terminal illness of a beloved person may be very helpful to the child and the school staff.

It helps adults to know that when we provide conditions that allow children to express themselves and to see the adults in his or her life doing the same, the young people are able to heal and grow.


Help bring comfort, healing, and hope.

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