Talking about death and dying with young people

Blog post written by Dr Catherine Pitfield, Clinical Psychologist (Roots Psychology) working in Brighton and Hove

Most of us are raised to embrace life and so we become skilled at “life talk”, talking about death and dying can seem scary and leave us feeling unskilled at this kind of conversation. Talking about death and dying is undoubtedly an unsettling and emotionally demanding task for most people.

There is no right or wrong way to talk about death and dying. As adults we may not have a complete story or idea ourselves of what we think or believe happens when someone dies. Having to explain death to a child or young person can therefore challenge us; and their questions may invite us to think more about our own stories about death.

Death and dying can be difficult to talk about as we may want to “protect” children from knowing what has happened. The “knowing” can also be difficult, as depending on the age of the child we may not be sure of what they “know” or understand.

Age-appropriate explanations:

It is important that children are given an explanation around death that is suited to their development and capacity to understand the situation, whilst being respectful of their cultural norms.

Children will be aware of the reactions of parents, siblings, and other important people to them as they interpret and react to the news of a death.  It is OK for your child to see your emotions.

Your own child’s understanding and curiosity about what is happening will depend on many different factors; their understanding, their experience of illness and death, their culture etc.

It is important that you give your child honest and factual information, but adjust the amount and detail to fit their age. All children are different, the below is a guide on what children may or may not understand about death based on their age and development. However, culture, religion, race, class, gender and experience will have a big effect on how much a child knows or understands about death and dying.

For all children, it is often useful as a first step to find out what they already know. For example, you might ask, “what have you been thinking about Uncle Steve’s death”, “what do you think happens when people die”?

Developmental ideas on ages and understanding of death:

Under 2:

• No understanding of the concept of death

• From around 8 months, babies begin to develop a “mental image” of a person and will likely have a sense of missing them

• You may notice:  A distress at change in routine, more clingy behaviour, changes to eating, toileting, and sleep

2 – 5 years:

• Show an interest in the death of animals

• Beginning to have an awareness about death and an understanding that this is different to being alive. However, do not yet understand abstract concepts like ‘forever’ and will likely not understand that death is permanent

• You may notice: Disrupted sleep, poor appetite, less interest in play, more anxious with separations even when left with familiar adults. There may also be a regression of skills such as potty training, or with language.

5 – 7 years:

• Children begin to gradually develop an understanding that death is permanent and irreversible

• Children may believe that wishing or doing something special, like magic, might bring the dead person back.

• You may notice: May become anxious about their own and others’ lives as they realise that death is a part of life.

7 – 12 years:

• Children aged 7 and above are said to have a “mature” understanding of death, so tend to understand that death is irreversible, that the dead person’s body stops working completely and they cannot come alive again.

• They may be curious about the physical process of death and what happens after a person dies

• You may notice: Increased anxiety and fear related to death.

Teenagers:

•  Will have an adult understanding of death, and will likely have their own beliefs and strongly held views

• You may notice: Some teenagers may become more withdrawn, some may “act out” their distress and others may cope with the awareness of their own mortality through risk-taking behaviours.

Further Ideas:

• Explore your own beliefs:  How do you explain death to yourself? Which ideas about death are you most comfortable with? What do you believe happens when people die / after people die? What would others say in your community / family? It may be really difficult to think about this, and you may be left with a lot of “don’t knows”, that is ok. It may be useful to think about what you would like to believe, is there an explanation about death that brings you some comfort?

• Explore your child’s beliefs: You may wish to invite older children to share their ideas with you about what happens when someone dies. You could look together about what others believe and think about death from different members of the community or faiths. Avoiding there being a right or wrong way to think about death, but a way that fits more closely for you as an individual or family. Children may also have misunderstood or heard things incorrectly, clearing up misunderstandings is really important.

• Involvement and closeness: Talking about death can raise people’s anxiety and to manage this may cause us to start avoiding conversation or time alone with children. This can unintentionally mean that a time when children need closeness and connection they may find themselves alone.

• Follow your child’s lead: Children will often initiate a conversation about death in an attempt to establish who knows what, who is open to talk or tell, and whether it is acceptable to talk about death with that person. They are likely also conveying messages like “I am aware of death” or “I would like to talk about this or know more”.

• Avoid euphemisms: Clear words such as “he has died” are easier for children to understand than “lost” or “passed away”. When we use words such as “gone to sleep” this can inadvertently confuse children and they may start to fear going to sleep.

• It is OK to not know: Children may ask lots of questions about what happened and why. It is OK to say you don’t know the answer to a question and to come back to them once you know. This can also allow you some time to think about how you may want to answer any questions they have.

• Using play:  Younger children may find it more comfortable to learn about death through play. Children up to the age of 8 learn best through play. They may tell you that one toy or teddy has died, this could be to “test the water” and see whether it is ok to talk with you about this, it could also be to learn “at a distance” and make sense of what is happening in a comfortable way for them.

• Allow a range of emotions: The death of someone close will likely elicit a range of emotions, there is no right or wrong way to feel after someone has died. We used to talk about stages of grief, but this idea is no longer used anymore as there is little evidence that people move through emotions in any particular order.

• Saying goodbye: Some theories on grief suggest that children (and adults) benefit from saying goodbye to the person who died. This can be from attending a funeral or burial service, or you may wish to think about having your own memorial that children can help plan or think about songs to play or where to do this. You may want to think about what role the person who has died would have had at something like this – would they have chosen the music, or served the snacks – could they be held in mind in the planning?

• Making a connection: some people find comfort in making a connection through visiting a cemetery or talking to the dead person.

• Sharing memories: Some families find it helps to share memories of the person who has died. This can help people connect again to important memories of the person, it also sends a message to children that we can talk about the person who died and keep memories alive. Some families choose to put pictures in an album together and involve everyone in the process of choosing the pictures and where they go.

• “Saying hello again” : This is from an idea put forward by Michael White (1989); when someone is very important in our life they help us to know things about ourselves or to know that we are important or special. It may be useful to talk with your child about what the person who has died contributed to their life, what would they admire or feel proud about them now?