Talking about Death with your Children

     For those of you that read this blog, I’m sure you’ve noticed it has been radio silence on my end for about one year. Let me first apologize for my hiatus, but my friends, LIFE has happened. The full-human experience: the crazy, the heart-breaking, the miraculous and the beautiful. It is only now that I feel like I’m coming up for air. I will give you fair warning, this post is getting personal. Why? Well, I teetered for a while on this one, but I felt that I owed it to my patients and their families to be real and honest. Not that I wasn’t doing all these things before, but I could have just picked right up where I left off without mentioning what has gone on in my personal life this past year and I decided I didn’t want to do that.
     When I started this blog four years ago, I wanted a resource for my patients and their parents that would provide accurate and straightforward information on common pediatric problems and give general parenting advice. I know from personal experience that when you’ve lived something that others have lived, you become more relatable and what you say is taken more to heart because you've been there. As a new practitioner, and before having children of my own, I gave parenting advice as best I could. My education and training gave me a good base, but no amount of education or training could prepare me for the moment I welcomed my first son into the world four years ago. As a new parent, I entered into the same ranks as my patients’ parents. I immediately had more credibility as I knew what it meant to love and care for a child: the fears, the joys, the highs and the lows. I want you to know that this blog is not only written from the perspective of a Pediatric Nurse Practitioner, but also from the perspective of a mother, a sister, a daughter, an aunt and a friend. What you read here will not only be accurate and evidence-based, but it will also come from the heart.
     Approximately 1 year ago, my mother passed away peacefully after a long and valiant battle against breast cancer. Less than 3 weeks later, I gave birth to my second child, a sweet baby boy. In less than 1 month, I witnessed life leave this world and witnessed life enter it. I went from overwhelming grief to overwhelming joy and my life was turned upside down. Looking back, it is all a blur.  Nevertheless, the reason I mention any of this is that through it all, I had a very inquisitive and tender 3-year-old son who was also trying to make sense of everything that was going on. He had questions like “Where is yaya (my mother)? What is heaven? When I'm sick does that mean I'm going to die? Mommy, are you going to die too?” These are only a select few of the myriad questions he had, many of which I had trouble answering. You guys, I'm a Pediatric Nurse Practitioner, I'm supposed to know what to say in these situations, and I struggled. I felt I was often coming up short. I hope that you never have to have these tough conversations with your children. These are the kind of conversations that break your heart and bring you to your knees, but if you do, I hope this post makes them easier for you. And, my deepest sympathies to you as you grieve for that special person in your life who is no longer here. I'm so sorry for your loss.
     So what do you say to your child after someone close to you has died? Where do you even begin? This all depends on your child’s age. Your toddler isn’t going to comprehend death in the same way your teenager will, so, the method you choose to explain death will depend upon your child's age.  If you have an infant or toddler in the house, know that they will not understand that someone has died as they can’t comprehend death, but they will pick up on what you and other loved ones are experiencing. Let yourself grieve and know that it is okay to let them see you when you do. This is actually true for all ages. Grief is a funny thing sometimes, it sneaks up on you when you least expect it, so if and when you have a moment in front of them know that it’s fine. Hold them close and tell them you are okay, you are just missing whoever has died. Try your best to keep to a typical daily routine as this provides security for your child. If you can, avoid being separated from your children during this time and give more physical attention. Hug them, kiss them, and hold them. This not only comforts your child or children, but I promise it will comfort you as well.
     For those with a preschooler in the home, know that they view death as a temporary thing. It is important to give these concrete thinkers clear and simple explanations to what has happened. Avoid euphemisms like “He went to sleep” or “She is gone”. To your three-year-old “He went to sleep” becomes “when is he waking up?” Or, “She is gone” becomes “Where did she go?” Instead, tell them simply “Your grandma has died and that means we no longer can see her anymore.” These straightforward answers can be softened by reminding your child that they will always have memories of the loved one who has died. Finally, don’t be surprised if they will randomly bring up the person who has died, sometimes weeks or months after they’ve died. You may also see this in their play, so pay attention. If your child, all of a sudden, has a new-found obsession with his plastic dinosaurs dying as my son did—this could be his way of expressing your loved ones death. Continue to provide support and encouragement.
     School-age children may be able to understand that death is final, but they may not be able to comprehend that death is universal. It is best to be simple and honest with your explanations about what has happened and then be sure to ask them if they understand or have questions. It is also important to clear up any misconceptions. Your child may have trouble expressing his or her emotions. Try to listen more than offering words, give your support and repeated opportunities for them to express how they are feeling. Your child may also worry they will be left all alone. My son repeatedly asked me if I was going to die after my mother died, this was especially true when I was leaving for the hospital to have his baby brother. The fact that I was going to the hospital made him worry I wasn’t coming back because this was true of his grandma. Again, clarifying to your child that not everyone who experiences sickness progresses to death will help them, as will explaining that not everyone who goes to the hospital dies. Reassure your child of your health and that there are many people in their life that care for them. This should help ease their anxiety. Be patient, it’s a process.
     Your teenager is going to understand death in the same way an adult does but they may resist expressing any emotion about it. He or she is now able to think more abstractly and may start having some big questions into the meaning of life or futility of it. Do your best in answering these questions and supporting them. They may also rebel a little and participate in risky behavior, which is typical of teenagers. Try to be a model of healthy ways of grieving, be present, and keep them accountable.
     Whether you have babies, teens or are somewhere in between, experiencing the death of a loved one and discussing it with your children is no easy thing to navigate. Let your love be your guide. Be sure to be patient and be honest with your children. You will get through it. Life does carry on. Believe it or not, your heart will ache a little less with each passing day and your children will be lucky to have you there helping them through it as you are lucky to have them helping you. Hang in there and keep on, keeping on.
           
Information presented adapted from:
 https://www.healthychildren.org/English/healthy-living/emotional-wellness/Building-Resilience/Pages/How-Children-Understand-Death-What-You-Should-Say.aspx