Pediatric palliative care is a specialized, growing area of medicine that focuses on providing comfort and improving the quality of life of children with serious or life-threatening illnesses. It addresses the emotional and physical symptoms of patients with severe conditions – from the time of diagnosis of the illness and throughout the course of treatment. Pediatric palliative care specialists also provide resources to families to help them cope with the stresses of their child’s condition and treatment.
From Nemours' KidsHealth
- How Can Spirituality Affect Your Family's Health?
- Caring for a Seriously Ill Child
- Complementary and Alternative Medicine
- Managing Home Health Care
- Helping Your Child Deal With Death
- Relaxation Techniques for Children With Serious Illness
- End-of-Life Care for Children With Terminal Illness
- Palliative Care
- Taking Care of You: Support for Caregivers
Helping Your Child Deal With Death
When a loved one dies, it can be difficult to know how to help kids cope with the loss, particularly as you work through your own grief.
How much kids can understand about death depends largely on their age, life experiences, and personality. But there are a few important points to remember in all cases.
Explaining Death in a Child's Terms
Be honest with kids and encourage questions. This can be hard because you may not have all of the answers. But it's important to create an atmosphere of comfort and openness, and send the message that there's no one right or wrong way to feel. You might also share any spiritual beliefs you have about death.
A child's capacity to understand death — and your approach to discussing it — will vary according to the child's age. Each child is unique, but here are some rough guidelines to keep in mind.
Until kids are about 5 or 6 years old, their view of the world is very literal. So explain the death in basic and concrete terms. If the loved one was ill or elderly, for example, you might explain that the person's body wasn't working anymore and the doctors couldn't fix it. If someone dies suddenly, like in an accident, you might explain what happened — that because of this very sad event, the person's body stopped working. You may have to explain that "dying" or "dead" means that the body stopped working.
Kids this young often have a hard time understanding that all people and living things eventually die, and that it's final and they won't come back. So even after you've explained this, kids may continue to ask where the loved one is or when the person is returning. As frustrating as this can be, continue to calmly reiterate that the person has died and can't come back.
Avoid using euphemisms, such as telling kids that the loved one "went away" or "went to sleep" or even that your family "lost" the person. Because young kids think so literally, such phrases might inadvertently make them afraid to go to sleep or fearful whenever someone goes away.
Also remember that kids' questions may sound much deeper than they actually are. For example, a 5-year-old who asks where someone who died is now probably isn't asking whether there's an afterlife. Rather, kids might be satisfied hearing that someone who died is now in the cemetery. This may also be a time to share your beliefs about an afterlife or heaven if that is part of your belief system.
Kids from the ages of about 6 to 10 start to grasp the finality of death, even if they don't understand that it will happen to every living thing one day. A 9-year-old might think, for example, that by behaving or making a wish, grandma won't die. Often, kids this age personify death and think of it as the "boogeyman" or a ghost or a skeleton. They deal best with death when given accurate, simple, clear, and honest explanations about what happened.
As kids mature into teens, they start to understand that every human being eventually dies, regardless of grades, behavior, wishes, or anything they try to do.
As your teen's understanding about death evolves, questions may naturally come up about mortality and vulnerability. For example, if your 16-year-old's friend dies in a car accident, your teen might be reluctant to get behind the wheel or even ride in a car for awhile. The best way to respond is to empathize about how frightening and sad this accident was. It's also a good time to remind your teen about ways to stay safe and healthy, like never getting in a car with a driver who has been drinking and always wearing a seatbelt.
Teens also tend to search more for meaning in the death of someone close to them. A teen who asks why someone had to die probably isn't looking for literal answers, but starting to explore the idea of the meaning of life. Teens also tend to experience some guilt, particularly if one of their peers died. Whatever your teen is experiencing, the best thing you can do is to encourage the expression and sharing of grief.
And if you need help, many resources — from books to counselors to community organizations — can provide guidance. Your efforts will go a long way in helping your child get through this difficult time — and through the inevitable losses and tough times that come later in life.
Mourning the Loss
Is it right to take kids to funerals? It's up to you and your child. It's appropriate to let kids take part in any mourning ritual — if they want to. First explain what happens at a funeral or memorial and give kids the choice of whether to go.
What do you tell a young child about the funeral? You may want to explain that the body of the person who died is going to be in a casket, and that the person won't be able to talk or see or hear anything. Explain that others may speak about the person who died and that some mourners may be crying.
Share any spiritual beliefs you have about death and explain the meaning of the mourning rituals that you and your family will observe.
If you think your own grief might prevent you from helping your child at this difficult time, ask a friend or family member to care for and focus on your child during the service. Choose someone you both like and trust who won't mind leaving the funeral if your child wants to go.
Many parents worry about letting their kids witness their own grief, pain, and tears about a death. Don't — allowing your child to see your pain shows that crying is a natural reaction to emotional pain and loss. And it can make kids more comfortable sharing their feelings. But it's also important to convey that no matter how sad you may feel, you'll still be able to care for your family and make your child feel safe.
Getting More Help
As kids learn how to deal with death, they need space, understanding, and patience to grieve in their own way.
They might not show grief as an adult would. A young child might not cry or might react to the news by acting out or becoming hyperactive. A teen might act annoyed and might feel more comfortable confiding in peers. Whatever their reaction, don't take it personally. Remember that learning how to deal with grief is like coping with other physical, mental, and emotional tasks — it's a process.
Nevertheless, watch for any signs that kids need help coping with a loss. If a child's behavior changes radically — for example, a gregarious and easygoing child becomes angry, withdrawn, or extremely anxious; or goes from having straight A's to D's in school — seek help.
A doctor, school guidance counselor, or mental health organization can provide assistance and recommendations. Also look for books, websites, support groups, and other resources that help people manage grief.
Parents can't always shield kids from sadness and losses. But helping them learn to cope with them builds emotional resources they can rely on throughout life.