Preparing a child for loss

Preparing children for the loss of a relative or someone close to them is an incredibly hard thing to do. You will know the best way to do this for your own family. But talking over the different ways of approaching this can be helpful.

You do not have to do it alone. You may need a lot of support from family and close friends. Professionals such as social workers, palliative care nurses, doctors, counsellors, and psychologists can also help you.

Sometimes, your closest relatives are so distressed themselves that they may not be able to understand the best way to help you or the children. And family members may have different views about when and how to talk to the children. It might help you to involve them in your discussions with professionals, but only when you are ready to do this and are clear about what you want.

The way children understand and react to death can depend on their age and their level of understanding. It may be helpful to know how the children might react before you talk to them.

Emotional reactions in children and teenagers can also appear as physical symptoms, such as headaches or stomach aches. There may also be changes in their behaviour.

You may find yourself becoming upset or tearful when having difficult conversations with children. But that is okay. It can help children to see that sometimes adults cry too when they feel upset.

The organisation Child Bereavement UK has information about these age groups. They also worked with bereaved young people to develop an app for teenagers.

Children under 3 can pick up that something very serious is happening, even if they cannot understand what death means. Children as young as 3 can grieve. Some children in this age group may slip backwards in some of their developing behaviours, for example toileting or feeding.

Children aged 3 to 5 may have heard about dying, but they may not understand what it means. For example, they may imagine that a dead person will come back or is living somewhere else.

How you can help:

• Keep reminding children that you do not want to die and leave them. But, explain that when it does happen, you will not be able to come back.
• Keep to everyday routines when you can.
• Let them know that the cancer is not their fault.
• Reassure them that they cannot catch the cancer from you.
• Ask someone that you and the children know and trust to keep a special eye on how they are coping and feeling. Tell the children who you are asking to do this.
• Tell someone you trust at playgroup or school what is happening, so that extra support can be arranged.

Children aged 6 to 12 know about death, but they may not always understand the emotions they feel. By about 8 or 9, children begin to understand death more like adults do. But, they may still believe that if they are very good, the person who has died may come back. Their worry is more likely to be that death is frightening or painful.

How you can help:

• The suggestions for children aged 3 to 5 will still be helpful to many children in this age group.
• Use books to talk about the end of life.
• Encourage them to keep up with school work, activities they enjoy and friendships.
• Let them know it is okay to enjoy themselves. It is also okay to be sad.
• Give them small tasks to do to help out. For example, they could put flowers in a vase or bring you a glass of water.
• Explain the situation to their teacher. You may also want to explain what is happening to a few parents of their close friends, who you know they trust. They can also offer support.

Teenagers may find it harder than younger children to cope with the news that someone is dying. They are old enough to know that this means a major change and loss in their life. They may cope in ways that are difficult for you to understand or deal with.

Some teenagers may refuse to talk about the illness. Others may try to become closer to their parents. Some may get angry with you or your partner in ways that seem thoughtless. They may then feel guilty about how they have acted. Or they may feel bad about spending time with their friends.

Teenagers need to know that there is no right or wrong way to feel at this time and that it is okay if their feelings change a lot.

How you can help:

• Ask them what they think and, if they want to be, include them in the same way as you would include an adult.
• Help them see that talking about feelings is a positive and mature way of coping. Encourage them to talk to someone they are close to, such as their friends, a relative, a family friend, or a trusted teacher.
• Give them time and space to themselves when they want it.
• Tell them about useful sources of information and support.
• Encourage them to keep up with their friendships, activities, and normal life as much as possible.
• Keep to usual rules and boundaries. These can be even more important now than before, as they can help teenagers feel safe.
• It might help to gently remind them that their behaviour may affect any younger children in the family.

Preparing a child or young person for loss can be an incredibly difficult thing to do, but you do not have to do it alone. You can ask for help from the health professionals looking after you, such as your GP or your specialist nurse.

Friends and family may also be able to support you, but sometimes it is easier to talk to someone who is not directly involved.

Organisations such as Winston’s Wish or Marie Curie provide information about supporting children and teenagers when an adult is dying. You can also look for local bereavement services near you at the Childhood Bereavement Network. Your local hospice may also be able to support you and your children.

When a child has a parent with terminal cancer, they are likely to have complicated emotions. It is important for the school, nursery, or club staff to be aware of the cancer diagnosis and any extra support the children may need. If your child is facing exams or coursework, keeping the staff updated on how your child is coping means they can offer the right support.

Teenagers in particular may look for information about cancer on the internet. You or your doctor could help them understand whether the information they find is accurate and relevant to your diagnosis. Some teenagers may feel more comfortable joining an online support group rather than speaking to a counsellor.

• The Hope Support and Rip Rap might also be helpful. They are for teenagers who have a parent with cancer. You can also use them to search for other useful organisations that can help you.
• Cruse Bereavement Care has information for bereaved children and young people, as well as a free helpline: 0808 808 1677.
• Child Bereavement UK has information and support for bereaved children, young people, and families. They also have an app called Grief Support for Young People and a free helpline: 0800 02 888 40.

You can visit Macmillan’s Online Community, where you can chat with others in a similar situation. Or you can call our cancer support specialists for free on 0808 808 00 00. Our team can tell you more about counselling and can let you know about services in your area.