Different views of death

In preparing children for the loss of a parent or another significant person, it’s helpful to understand how death is perceived at different ages. Children’s grief may be expressed through play or behaviour.

Learn about the different views of:

Newborns, infants and toddlers
Preschoolers
Primary schoolchildren
Teenagers

Listen to podcasts on Explaining Cancer to Kids and Family Dynamics and Cancer

Newborns, infants and toddlers (0-3 years)

Babies don’t have any knowledge of death, but can sense when their routine is disrupted and when their carers are absent. Toddlers often confuse death with sleep and do not understand its permanence.

Possible reactions	Suggested approaches
babies: unsettled and clingy toddlers: may worry persistently about the well parent and think that they or their behaviour caused the advanced cancer may also be angry with parents for not being able to give them more attention	avoid explaining death as “sleeping”, because that can cause distress about sleep provide comfort be prepared to patiently answer the same questions many times maintain routines and boundaries

Preschoolers (3-5 years)

By the preschool years, children are starting to understand the concept of death but struggle with its permanence (e.g. they may ask when the dead parent is coming home). Young children don’t have an adult concept of time and understand only what’s happening now.

Possible reactions	Suggested approaches
may feel it is somehow their fault may be angry with their parent for not giving them enough attention can react as if they were much younger when under stress may have frightening dreams may keep asking about death	watch their play for clues to their feelings offer comfort answer questions in an open, honest way maintain routines and boundaries

Primary schoolchildren (5-12 years)

By the primary school years, children may understand death but often don’t have the emotional maturity to deal with it. Younger children may think death is reversible and that they are responsible.

Possible reactions	Suggested approaches
may be openly sad or distressed may express anger may worry about being responsible for the death, but also might blame someone else may ask confronting questions about what happens when somebody dies may be more able to talk about their feelings and act sympathetically	encourage them to talk, but realise they may find it easier to confide in friends, teachers or other trusted people provide plenty of physical and verbal expressions of love be sensitive but straightforward discuss changes to family roles provide privacy as needed maintain routines and boundaries

Teenagers (12-18 years)

Teenagers can understand death, but may not have the emotional capacity to deal with its impact. They need as much preparation as possible for a parent’s death. Like adults, teenagers’ responses to death vary. Some may be more upset when their parent is unwell than following the death, others become distressed after the death.

Possible reactions

Suggested approaches

may deny their feelings or hide them in order to protect you
may think they can handle it alone and not look for support, or may distance themselves from family and talk to friends instead
may react in a self-centred way and worry about not being able to do their normal activities
may express distress through risk-taking behaviours (e.g. skipping classes, experimenting with drugs and alcohol, acting recklessly)
worry that death is frightening or painful, and struggle with their own mortality

encourage them to talk about their feelings with friends or another trusted adult
support them to express their feelings in positive ways (e.g. listening to music, playing sports, writing in a journal)
negotiate role changes in the family
maintain routines and boundaries
let them know that support and counselling are available (see page 51 for some options)
offer them the opportunity to participate in a public or private memorial service

This information was last reviewed in December 2018. View who reviewed this content.

We thank the reviewers of this book: Professor Kate White, Chair of Nursing, The University of Sydney, NSW; Sarah Ellis, Psychologist, Behavioural Sciences Unit, Kids with Cancer Foundation, Sydney Children’s Hospital, NSW; Kate Fernandez, 13 11 20 Consultant, Cancer Council SA; Chandra Franken, Program Manager – NSW & ACT, Starlight Children’s Foundation, NSW; John Friedsam, General Manager of Divisions, CanTeen, NSW; Keely Gordon-King, Cancer Counselling Psychologist, Cancer Council Queensland; Stephanie Konings, Research Officer, CanTeen, NSW; Sally and Rosie Morgan, Consumers; Dr Pandora Patterson, General Manager, Research and Youth Cancer Services, Canteen, and Adjunct Associate Professor, Cancer Nursing Research Unit, The University of Sydney, NSW and Visiting Professor, Faculty of Health and Life Sciences, Coventry University, UK; Suzanne Rumi, Consumer; Michael Sieders, Primary School Program Manager, Camp Quality.

We would also like to thank the health professionals, consumers, organisations and editorial teams who have worked on previous editions of this title, and we are grateful to the parents and young people whose real-life stories have added to the richness and relevance of this book.

We thank and acknowledge Dr Paula K. Rauch, MD, Founding Director, Marjorie E. Korff PACT (Parenting At a Challenging Time) Program and Associate Professor of Psychiatry, Harvard Medical School, whose research and writing on helping parents talk to their children about cancer was used as source material for this book and has been adapted in several sections: pages 8 -11, Different views of cancer; page 24, Answering key questions: Are you going to die?; pages 26 -27, Involving the school or preschool; pages 30 -31, Prepare for hospital and treatment centre visits; and page 37, Encouraging family time. We also thank the American Cancer Society for permission to use and adapt material on pages 8 -11 from its book Cancer in Our Family: Helping children cope with a parent’s illness (2013); Macmillan Cancer Support for permission to use its book Talking to Children and Teenagers When an Adult Has Cancer (2013) as a source of information; Jessica Watt, Oncology Social Worker, Children’s Hospital Westmead, for her contribution on page 18, When another child has cancer; Diane McGeachy, Hobart Counselling Centre, for contributing material for page 38, Spending one-on-one time; and Dr Ranjana Srivastava, and The Guardian for permission to adapt €œHow do you tell your children you have cancer? €_x009d_, on pages 21 and 47 – full story is available at https://www.theguardian.com/society/2015/nov/29/how-do-you-tell-your-children-you-have-cancer.