Preparing a child or teenager for loss

Preparing children for the death of a parent, guardian, or close relative is an incredibly hard thing to do. You know your child best, so will have some idea of the best way to talk to them. 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 can also help you, such as:

• palliative care nurses
• doctors
• social workers
• counsellors
• psychologists.

Sometimes, your closest relatives are so distressed themselves that they may not be able to understand the best way to help you or your children. 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, when you are ready to do this and are clear about what you want.

Before you talk to your children

Before talking to your children, you may need some time to process your own feelings. If you are finding it particularly hard to manage your own emotions, it will be harder to talk to your children about what is happening.

If you have a partner or close family or friends supporting you, try to talk to them about your feelings and concerns.

If you not feeling emotionally strong enough to begin any difficult conversations with your family and friends, It may help to talk to your healthcare team or a counsellor. Your healthcare team can tell you more about what to expect at the end of life.

Talking things through with someone can help you to make sense of the options you and your family have at this painful time. It can help you plan how you are going to tell your children about what is happening to you and them.

You may find it helpful to practice what to say to your child to another adult first. You could also think about the kind of questions your child may have and plan your answers.

If you prefer to talk to someone outside your situation, you can call the Macmillan Support Line on 0808 808 00 00 or contact Winston’s Wish. Some people find online support a good source of help too.

Who should tell them?

If you are a two-parent family, it is usually best to tell your children with the other parent. But this can depend on how you usually talk as a family. If you are a single parent, you may want to do it on your own. Or you might prefer to do it with someone who your child knows and trusts, or a healthcare professional you trust. Do whatever feels right for you and your child.

You may find it too difficult to tell your children yourself. If you are not the one telling them, it is a good idea to be there, so you know what has been said. Your children can then see that everyone knows what is happening and there are no secrets. But some parents or guardians find it too difficult and prefer to let their partner tell the children, and not to be there themselves.

Rarely, some types of cancer can affect how someone thinks or communicates – for example, a brain tumour. In this case, the parent or guardian affected by cancer might not be able to be fully involved in the conversation.

The best time and place

Choose a time when you are feeling fairly calm and when you usually feel at your best. It should be at a time when your children are most likely to listen and feel at ease. If it is during school term time, the start of a weekend is better. Children can then take some time to think about what you have told them and ask questions.

Try to find a place that is quiet and private. It should be somewhere you and your children can talk freely and where you will not be interrupted. Make sure it is somewhere they will feel safe to express their feelings. Turn off any distractions, such as phones and the television. If possible, sit so that you can all see each other clearly.

If you have more than 1 child, it is best to tell them together, if you can. This stops them feeling that their siblings know more than they do, and perhaps wonder why they were told last. If you are telling them separately, do it as close together as possible.

How to tell them

Some children will not have experienced a loss of any kind. Other children may have been to a relative’s funeral or been through the death of a family pet.

The thought of talking to your children about dying will feel very emotional. It may help to talk to a friend, healthcare professional or counsellor before you talk to your child. This allows you to prepare and practice what you want to say and how you will say it. It will also give you a chance to think about some of the questions they may ask. But do not try too hard to have the perfect conversation. If you plan too much, a question from your child may surprise you. Children can ask questions you were not prepared for, and these may come hours or days later.

We have examples of some questions your child may ask and suggestions of ways to answer. It is okay to say ‘I don’t know the answer to that right now. But I will try to find out for you’. The important thing is that they feel their concerns have been heard.

The first conversation can be a starting point. Allow the conversation to be directed by your children’s reactions and the questions they ask. Listen and keep it as open as you can.

It can be helpful to find out what your child understands first. You can do this by asking them to tell you what they think has been happening. From here, you can gently correct anything they are confused about. You can then gradually tell them what is happening at this.

Support is available for you and your family. If you need more support, it is important to ask for help. You can talk to your doctor or another healthcare professional about this.

Healthcare professionals

Cancer doctors and specialist nurses can offer support and advice. You can also talk to your GP if you need emotional support, whether you are the person with cancer or a relative.

Sometimes it is easier to talk to someone who is not directly involved. Your specialist or GP can usually refer you to a counsellor or psychologist.

Your local hospice will have different services to support you and your family. You do not need to be in the hospice to be able to use these services. They can also offer support for your family after you have died.

Schools and clubs

It is very important for school or nursery teachers and school club staff to be aware of the cancer diagnosis in the family and of any additional support children may need. Tell the teachers what you have told your children and what sort of support you think they may need. It is important that children get the same message from everyone.

This will help teachers understand any unusual or difficult behaviour and be sensitive to your child’s needs. If children know the school is aware, it can help them feel less alone. You could also tell the school nurse. They will be able to help with emotional support for your child. Let your children know who you are going to tell and why.

Supporting teenagers in their education

Teenagers may be facing exams or coursework at school, college or university. They may find it difficult to keep up with their studies. It is important that their teachers or tutors know what is happening so they can offer extra support. If your teenager has exams coming up, you could talk to their teacher about how they are coping and what can be done to support them during the exams. In some situations, exam marking might be adjusted to take into account what your teenager is going through emotionally.

You should speak to your teenager before contacting their school. School or college may be one of the few places where things still feel normal, and they may be hesitant about letting people know. Asking them will also show them that you are telling them everything and including them. You can reassure that them the school will be sensitive to their needs and keep the information confidential. Teachers and staff may notice issues or behaviours that are not always apparent at home. They can offer support if your child is not coping.

For teenagers who are looking after someone who is ill, we have  information about being a young carer for someone with cancer.

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. They can tell you more about counselling and services in your area.

Lots of organisations exist to support children, young people and families through bereavement:

• Winston’s Wish provides information about supporting children and teenagers when an adult is dying.
• Child Bereavement UK has information and support for bereaved children, young people and families – it also has an app called Grief Support for Young People and a free helpline at 0800 028 8840.
• Childhood Bereavement Network can help you and your children find local support.
• Cruse Bereavement Support has a website for bereaved children and young people at hopeagain.org.uk, as well as a free helpline at 0808 808 1677.
• Fruitfly Collective helps families talk about cancer, death and grief, and to support children by giving them coping tools and knowledge that they are not alone – it also produces Pip’s Kit to help children who have a parent or carer with an incurable illness. They also have a project called Parenting with cancer.
• Hope Support Services are for young people aged 5 to 25 when a close family member is diagnosed with a life-threatening illness, such as cancer.
• RipRap is for teenagers who have a parent with serious illness such as cancer.
• Marie Curie provides information about supporting children and teenagers when an adult is dying.
• Ruth Strauss Foundation has a family support service and resources that help families prepare for grief, death and dying.

Older children may want to know more about what happens when someone is dying and need more detailed information.

We have more information about cancer and the end of life and in our booklet A guide for the end of life.

Our easy read booklet Your feelings when someone dies and what can help uses simple language and pictures. It can be useful for anyone who finds it hard to read.

Winston’s Wish has an activity book called Muddles, Puddles and Sunshine. It has lots of ideas and activities that your friends and family could do with younger children, to help them understand their thoughts and feelings after your death.

Some of these books are about bereavement rather than serious illness, but they may still help.

Books for children whose parent is seriously ill

• The Secret C – Winston’s Wish
• Flamingo Dream – Jo Napoli
• No Matter What – Debi Gliori
• When Someone Has a Very Serious Illness – Marge Heegaard
• When Dinosaurs Die – Laurie Krasny-Brown
• Always and Forever – Debi Gliori
• The Sad Book – Michael Rosen
• The Memory Tree – Britta Teckentrup
• The Copper Tree – Hilary Robinson and Mandy Stanley
• Is Daddy Coming Back in a Minute? – Elke Barber & Alex Barber
• Why do things die? – Katie Daynes

Books for adults with an illness that cannot be cured

• As Big as it Gets – Winston’s Wish
• Late Fragments – Kate Gross

Other resources

• Stepping Stone Postcards – Childhood Bereavement Network
• Making a Memory Box: Activity sheet – Winston’s Wish
• Memory boxes – Macmillan Cancer Support
• Grief Encounter Work Book – Dr Shelley Gilbert
• Beyond the Rainbow: A Workbook for Children in the Advanced Stages of a Very Serious Illness – Marge Heegard
• Standing on His Own Two Feet: A Diary of Dying – Sue Grant