When a parent, main carer, brother or sister or other special person is not expected to live, the prospect of communicating this to a child can be daunting, especially when you are upset or in shock yourself.

For a parent who is seriously ill facing the prospect of your child growing up without you, or for a parent facing the death of your partner while trying to support your child, the situation can be extremely challenging. Families facing the loss of a child can feel devastated and completely overwhelmed at the prospect of having to talk to their child and any siblings about what will happen. 

To protect children, and themselves, parents or carers may want to avoid the subject for as long as possible. This can be even more understandable when it is not certain what course an illness will take, or how their child’s life might be affected. However, children can often sense when important things are not being shared with them, picking up on signs of tension and distress, and this can lead to them feeling anxious, confused and excluded. They will feel more secure if they are kept informed in a way that they can understand. Avoiding the subject may leave them afraid that they have done something wrong, or make them feel guilty or too worried to ask questions. 

Should I tell my children that someone special to them is going to die?

Children have an ability to deal with the truth that adults often underestimate. Not knowing what is happening can leave them feeling confused and anxious and having only bits of information or inaccurate information is often more worrying for children than being told the truth. They may hear the truth from others outside of the family and this can lead to greater anxiety and distrust.

In not talking about the upcoming death of someone important to them, your child’s feelings, the thoughts they have and their responses are left unacknowledged. We cannot stop children from feeling sad, but if we talk about our feelings and give children clear information, we can support them in their sadness.

How can I explain to my child that someone important to them is going to die?

What you tell your child will depend on their age and understanding, and how much they already know. It is best to start giving them information early on, in bite-size chunks, allowing them time in between to process what they have been told and to ask you any questions. You don't need to tell them everything all at once if this will be overwhelming, you can just give them the information they need at the time; you can always add more information later. 

If your child knows something already, begin by acknowledging this. The way in which your child responds will help you to confirm what they know and gauge their level of understanding. If someone is not expected to live, you could ask what they have noticed about them recently. They might say something like, 'he’s too tired to play with me.' They may go on to say more about what they think is happening.

You might say:

'Daddy’s illness is called cancer. Because of it, his body can’t work very well. Have you noticed any changes in Daddy?'

or: 

'Mummy was badly hurt in a car accident and is in hospital, but she is so hurt that the doctors can't make her better.'

The courage it takes to talk to a child about a serious illness or death cannot be underestimated. Children can often sense when something is wrong or when things are being kept from them which can result in them feeling fearful and isolated. Their security is based on trusting the people who care for them. Avoiding the subject may leave them too worried to ask questions, afraid that they have done something wrong or are in some way to blame for what’s happening. Some may need direct reassurance that this is not the case.

Some children may ask directly if the person is going to die. It is best to be honest and support children in the reality of what is likely to happen rather than trying to protect them with false hopes, which can lead to them not trusting you later. Although this may feel like it is going against your instinct to protect, in fact, by enabling children to have age-appropriate information in a timely manner, you are protecting them from a future where they feel they cannot trust you. Half-truths or inaccurate information can cause more problems for everyone. When a child finds this out – and they often do – the trust between an adult and a child has been broken and trust is so important at such a challenging time. 

Many children and young people we have supported tell us how glad they were that they could be involved in what was happening as a parent is dying. This is only possible when a child or young person has clear, accurate, truthful and timely information. 

If your child knows something already, acknowledge this. You might say:

'You know that Joe has been ill for a long time, and the doctors have been trying to make him better.'

Guided by what they say, you might say:

'Joe’s illness has got a lot worse, and the doctors have tried everything they can. There isn't anything more they can do now to make him better, and that means Joe won't live for much longer. This means that Joe will sadly die. We don’t know when this will be, but the doctors think it could be very soon.'

Allow your child to express how they feel about what is happening. It is OK, and can be helpful for them, for you to show some of your feelings. You might say:

'I am very upset and sad too, but you can still talk to me.'

Reassure them that nothing they did caused their special person to be ill or injured. Comfort them and assure your child that they will continue to be loved and looked after. 

Acknowledge your child’s grief and support them emotionally by saying you (and others) are there for hugs, time to talk, and to do things together. You can also ask them how they might like to help support their special person such as by visiting them in hospital, making them a card, or doing other tasks, depending on what is possible.

How much information should I share with my child?

Try to build up any information you share like a jigsaw puzzle for a child or young person. It’s not necessary to give your child the whole puzzle (all the information) all at once. A younger child might only manage “daddy is very ill” at first, then you can give the child another piece, such as “he has cancer” or “he might die,” shortly after. Older children will require more information about what is happening and what the future may bring.

Information to share:

1. That someone close to them is seriously ill

2. The name of the illness

3. What may happen

For example, when first telling your children about the situation you could say:

“You know that daddy has been feeling really ill and the doctors have been trying to find out what is wrong? The doctors have found out what is wrong with daddy – he has something called cancer. Cancer is a serious illness and daddy will need special medicine and possibly an operation to see if the cancer can be taken out of his body.”

As the illness progresses, you can add to the jigsaw puzzle – explain what the medicine is and what it will do to daddy (e.g. make him tired and lose his hair), what the operation will involve and eventually what will happen at the end of life stage. In the days leading up to the death of someone special, it is time for the last pieces of the jigsaw.

The key points to convey are:

• The doctors have tried everything

• It is no one’s fault

• The person doesn’t have very long to live

Children may ask fewer questions at this time as they may be guarding themselves from the reality of what will happen next. It is important at this stage to keep the information flowing and checking that they understand what is happening. Where possible, give them explanations of what to expect.

“So you know I told you daddy will die in the next few days, well when that happens we will be able to say our special goodbyes and spend time with him. It is possible that he can still hear us, but won’t be able to talk with us. Soon his breathing will slow right down and then there will come a moment when his heart will stop and he will die.”

The last days of life will inevitably be heartbreakingly sad for everyone. Yet with the right help and support, children will be able to look back on those days with love and closeness.

As a child grows older, following the death of their special person these jigsaw puzzles can grow and more pieces of information can be added. 

Where should I tell my child that someone special to them is not expected to live?

Wherever possible it is always best for children to hear the truth about the death of someone special from those they trust the most. Even if the person is too ill to say the words, it is important (if possible) that they are present when the child is told.

This helps children to feel included, informed and aware that the person who is dying also knows what is happening. There will never be a right time to tell your children, but finding a time when there is plenty of opportunity for them to ask questions and a place where they feel comfortable is important. It can also help to follow the conversation with some space to have time for a bit of normal family life – if it is possible, maybe by watching a film or having a pizza. For further guidance, see our resource on explaining death and dying to a child. 

How can I prepare my child for the death of someone from cancer?

It will inevitably be very difficult for children and young people when someone important to them has cancer and may die. From having open and honest conversations to building memories, there are a number of ways you can prepare a child. 

If a parent is not expected to live and there is another parent or stepparent around, he or she may feel torn between caring for and worrying about the children and also the person who has cancer. Sometimes, it may feel impossible to give everyone the attention they need. 

For children, witnessing the illness of someone special to them is very emotional; they want to be caring and supportive but sometimes they just feel cross and want the “old” mum or dad back. The illness, as it progresses, intensifies the distress and the fear of the future without a loved parent. 

This can be particularly complicated, emotionally, if the person who is ill has been living apart from the family. A child or young person may feel they want to establish a connection while this is still possible, yet the ill person may not have the capacity to be who their child needs them to be. 

When a single parent is seriously ill and there are no supportive family and friends on hand, it may be hard to be alone in supporting children while also being ill and thinking about a future in which there may be a need for different arrangements.

How might my child react to the news that someone is going to die?

When someone is not expected to live, our grieving for them often starts before they die. How a child or young person grieves is influenced by their age and understanding, their previous experience of bereavement, their culture and family beliefs or religion if they have one, and the closeness of their relationship with the person who is dying. 

When first told that someone important to them is going to die, your child’s reactions may include shock and numbness, sadness, anxiety, anger, and even guilt. Some children may look blank, or not show any immediate reaction, as they need time to process what they have been told. Reassure your child that whatever they are feeling is OK and that there is nothing they thought, did or said to cause the situation.

Younger children may not fully understand the implications of what you are telling them, or that death is permanent, and you may need to tell them repeatedly as their understanding develops.

How can I help my child cope with any uncertainty?

There is often uncertainty about when someone will actually die. Some people can die sooner than expected and others can respond to various treatments and live longer than it was thought they would. Young children often only understand things in very concrete terms, and being unable to provide them with a definite answer can prove difficult. Your family may have had to live with uncertainty for many months, or years, and may have prepared for the worst several times. In such circumstances it can be hard to believe that the person is actually going to die, and so children may not be willing to accept what is now being said to them. It can help to acknowledge how they feel and encourage any questions they have.

You may find it helpful to look at our creative activities for bereaved children and young people for ways you can help your child express their feelings and talk about any worries or concerns. 

How can I answer any questions my child may have?

Your child may have lots of questions as they try to make sense of what is happening and may need answers to be repeated frequently, with sensitivity and patience.

Adults can often fear the questions children may ask. They may be the very questions you dread or can’t bear to think about, but it is vital to try to respond to your child. If your child is asking a question it is an indication that they are ready to hear the answer and it is important to take the opportunity to support them and give them the information they need. Answer any questions honestly and simply, and check that they have understood what you have said. If you don’t know the answer, it is OK to say, 'I don’t know, but if I find out, I’ll tell you'. 

When a child asks, 'What happens when people die?', a simple answer that can be understood by most children is: 'When someone dies, their heart and breathing stops, and their body doesn’t work anymore'. View our resource for more on explaining to a child that someone has died.

You can also acknowledge that this is a good question which can be hard to answer and then ask the child what they think. This can help you to find out the child’s level of understanding and correct any misconceptions they may have. It can also be a chance to share thoughts according to your family’s culture and beliefs.

Just as adults seek to protect children, so children may try to protect the adults around them by not showing their feelings. Younger children may move quickly in and out of feelings, sometimes being upset and sometimes wanting to play. This is normal and is because young children are often not able to stay with very difficult feelings for very long. However, it doesn’t mean that they are not affected. For more information watch our short animated film Puddle Jumping.

Older children may not express or share their difficult feelings which can make their grief harder to manage in the long-term. Our short animated films Volcano and The Invisible Suitcase explain how young people can cope with difficult feelings.

How can I support my child when someone is not expected to live?

Each child is likely to react in their unique way. How they respond will be affected by their personality, age, level of understanding and the nature of the relationship they have with the person who is not expected to live.

Spend time together
Try to spend time together as a whole family, including time with the person who is dying if this is possible, and if this reflects their needs and wishes. If the person is in hospital or in a hospice, you could talk to the staff for guidance around what might be possible and how they can support you.

Keep to familiar routines
Although it may be difficult, it can help to try to keep to familiar routines as far as possible, which help children feel secure at a time of upheaval. It will help them if you can be honest and clear about what routines will continue and what may not be possible for a time. Older children and teenagers are likely to want more detailed information as their thinking and emotional understanding develops. They may ask searching questions about the impact of what is happening in the family, the implications for them, and what may happen in future. While you may not know the answers to some of their questions, it is helpful to reassure them by answering as patiently as you can with the information you have.

Talk to your child's school
Keeping contact with school and telling your child’s teachers what is happening at home can help them support your child appropriately while they are in school, where they spend a considerable amount of their daily life. It may help the school to understand any pressures around homework or exams. You may find it helpful to share our resources for education professionals with your child’s school.

Maintain boundaries
Continuing normal boundaries of behaviour can help a child feel safe. Children’s feelings often show through their behaviour which may be more challenging or disruptive than usual with angry outbursts, or they may become quieter or more helpful than usual. These are both normal reactions to an event in their life that feels anything but normal. Try to continue with normal expectations of behaviour: 'normality with compassion' is a good thing to aim for. Anger can often form a large part of the grieving process and children of all ages express it in various ways. It is important to help your child understand that while anger is a normal response to grief, it is not OK to hurt themselves or others. It may help to find safe ways for them to release their anger such as through physical exercise, or, for instance by punching a cushion.

Try to be aware of any unusual behaviour. Children who are anxious may show behaviour changes, including becoming clingier, not being able to sleep, or behaving as if they were younger. This often settles down with reassurance and support. If it continues over a long period of time, and is affecting how your child functions in daily life, it may be helpful to seek some additional support. 

You may also find it helpful to watch our short animated films with your child on managing emotions: Volcano and The Invisible Suitcase.

Maintain open communication
Make time and space for your child to ask you questions. It is very important to make time to keep communicating, even if talking about the situation or the future feels difficult. Equally, taking a break and just spending time together can be very comforting for both you and your child.

Look after yourself
When you are coping with stress and uncertainty it is important to look after yourself and to keep in mind your child’s physical health too, such as making sure everyone eats well and tries to keep to healthy sleep routines. 

How can my child be involved in caregiving?

Children feel more involved and their self-esteem is boosted when they are able to help in caregiving, even in small ways such as adjusting the person’s pillows or making them a card.

A child can offer a lot of support to someone who is seriously ill, by playing normally with them, or by simply keeping them company, depending on what is possible. Some people who are very ill, including children, can benefit greatly from a sense of 'normality' in those around them.

Living with the tension of hope and current information can be extremely difficult. Treatment may well have been all about cure and recovery and the switch to palliative (end of life) treatment can result in a change to the pace of life. You may go from lots of treatments, visits to hospital, and appointments to a slower pace of occasional appointments and visits from community teams. Children will pick up on this and it  can feel when the pace changes that all hope is gone. 

Where possible, ask your child what they would like to do to support their special person, and provide them with the information they might need to make that choice. Being involved in making decisions can give your child some control in a world where so much feels out of control. 

How can I help my child make memories when someone is not expected to live?

If recovery is unlikely and it is possible, then it becomes important to think about what the person who is ill would like to say or do with their children before they die. Making new memories and remembering old memories link children to their special person long after they have died. They become treasured and special memories as the child grows and develops, helping to shape their identity and stay connected.

Ideas for making memories might include writing a letter to your child in the future, this can be an enormous comfort to a child, while writing down special memories, thoughts about the past and the future can be a lasting reminder for children of a shared bond. Making a memory box together can be comforting and help a child feel close the person.  

Watch our animated film remembering someone special who has died for other ideas. 

How can I help my child say goodbye to their special person?

Telling a child that someone important to them is likely to die allows them to think about the person and perhaps to communicate with them in some way to say goodbye. 

When a person is seriously ill, the child may not be able to see them in person because of the need for isolation or perhaps a special hospital ward. Instead, maybe they could make or sign a card, send a picture or a recorded message, or even video call if possible. This will be helpful to the child in future, because they will be able to think back on how they did something for their person before they died. 

Use creativity whenever possible to support the expression of the child or young person’s feelings. Suggest they write or draw how they are feeling, you may find it helpful to look at our resource on creative activities for bereaved children and young people.

Books and stories can also be helpful - see our list of books and resources for books you can read together or give to your child. 

How can I find support?

The courage it takes to talk to a child about serious illness or death cannot be underestimated. When someone is not expected to live, it is an enormously difficult time for the whole family and for those supporting them. Meeting the needs of your family alongside your own emotional or practical needs may seem overwhelming at times. Use whatever support is available to you, ask for help, and try not to expect too much of yourself. We can provide support when someone is not expected to live, please contact our Helpline for more information.

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