Children are intelligent, observant and tend to know that something is going on in the adult world even when they haven’t been told.

When children are not told about matters of illness and death, they may draw their own incorrect conclusions with the help of their imaginations, or they may hear the information from someone else.

Children may also worry more, struggle to trust, and decide that death is not something that should be spoken about. It is best to provide children with direct, factual information appropriate to their age, development and maturity.

Having conversations with caring adults supports children’s understanding of illness and death, facilitates the expression of their feelings and grief, and opens the door for children’s questions and concerns. (source)

When faced with the news of a serious and potentially life-threatening illness, children tend to have several questions that are known as the 5 C’s (Nicky Seligman, Heart House Hospice). These questions are:

Did I cause it?
Can I catch it?
Could I have cured it?
Who is going to take care of me?
How can I stay connected to the person?

Addressing these questions can help put children at ease and reduce worries that may have formed.

Sharing developmentally appropriate information about the illness, such as its name, its cause (if known), its effects, and treatments in a matter-of-fact manner can support children in understanding the first three questions.

It is important to be aware of the language that you use to tell children what is happening. Young children think in literal terms and may misunderstand phrases such as ‘gone to sleep’, ‘passed away’, ‘lost’ and ‘gone’.

It is better to use the terms ‘dying’, ‘died’, or to explain that the person’s body, “Stopped working and will never work again because…” Name the illness that caused the person to die. Giving information about the illness helps children to understand that this is more serious than a stomach ache or flu that they may have experienced themselves as their own understanding of what it means to ‘be sick’. (source)

For the question, “Who is going to take care of me?” your child is likely wondering about how their routines will change. This question can be answered by saying something like, “Grandpa will take you to hockey practice from now on,” or, “Aunt Mary will be picking you up from school.”

You can reassure your child that although things might be different, they are still very loved and will continue to be cared for by their loved ones.

In answering the question, “How can I stay connected to the person?,” you can offer your child practical ways that they can continue to be involved in their person’s life, such as through drawing pictures, writing letters, decorating the person’s room, reading stories, listening to music, having conversations, or any other activity that you feel is appropriate.

If the person is expected to die, children may be interested in how this connection can continue after death, such as through sharing memories, looking at photos, creating keepsakes, and developing legacy activities.

Knowing that a person is dying allows the child to make meaning of the changes that they are seeing, spend time with the loved one, feel included in the family’s grieving process, and to decide how they would like to say goodbye.