I have put off writing this article for 10 months, six days and three hours — since the moment I first learned that my daughter’s friend, Parker, had been diagnosed with terminal brain cancer.
Deep down, I recognized that at some point I would be forced to muster up the courage to begin stringing together the words, if only because they might be helpful to all of those who will be left behind: for my ultra-sensitive six-year-old girl and her kindergarten classmates, and for scores of friends and neighbors who just can’t fathom how to begin processing such a devastating reality.
But giving in to writing a story about helping young children grieve the death of one of their own always felt akin to surrendering hope. And I just wasn’t ready to abandon that.
But now Parker is in the final stages of the battle he has waged so valiantly against diffuse intrinsic pontine glioma (DIPG), a childhood brain stem cancer with a ghastly 0 percent survival rate. So as much as I have resisted, as vigorously as I have clung to hope and prayed for miracles, I can no longer postpone completing this task. There are just too many of us, myself included, who are desperate for practical advice as we struggle with how to share such heartbreaking news with our children.
“Every child is different in their cognitive understanding of the concept of death,” acknowledges Margaret Bouher, a San Diego-based licensed clinical social worker who has worked with children in private practice for more than 30 years. “For very young children, the finality of death is difficult to understand.”
And for many parents, communicating the topic to our kids is equally complex and complicated. What do I say? How will I reassure her? How can I possibly explain death to a six-year-old?
Parents know their children best, so above all else, be guided by your own intuition as you help navigate your child through the grief process. Beyond that, experts offer the following tips:
Because parents are likely to feel overwhelmed by their own grief, shock, and sadness when a child dies, it’s recommended that you take a little time to gather your composure and ensure you are calm before approaching your child about the loss.
When breaking the news, choose a quiet setting and a time when you won’t be rushed or interrupted. Experts advise against sharing explicit details of the child's death. Instead, Bouher suggests, use simple, direct phrases and avoid being too vague or euphemistic.
For instance, explaining that a friend “passed away” rather than died can cause children to misinterpret the explanation and believe that their friend might return.
Consider opening the conversation by saying something like, “I have some sad news about your friend Charlie. He was very sick and he died yesterday.” You might follow up by explaining that sometimes a person becomes ill with a specific illness that makes their body stop working.
At first, children may not say much and can appear surprisingly unaffected by the news. Because young children grieve differently than adults, they often experience waves of understanding then cycle back to their normal activities. This doesn’t mean they don’t have feelings about the loss; rather, they just don’t know how to express them.
“Kindergarteners may not realize that someone is gone forever, so their grief can seem delayed as they gradually process that someone they care about has died,” Bouher explains.
As a result, parents often need to engage in subsequent conversations with kids, allowing them to ask more questions and validating their feelings and concerns. Children may also find it helpful to hear you share your own feelings about their friend’s death.
Anxiety and sadness are perfectly normal responses after a child loses a friend. You can provide comfort by emphasizing that it is very unusual for a child to die – also stressing that parents and doctors work hard to keep them safe and healthy. A child’s developing empathy makes them more vulnerable to recognizing their own fears about illness and death, so it’s important to use words and images that will help them understand that there are different types of illness.
For instance, pointing out that our bodies are usually strong and able to heal can help ease their worries. In our case, I will likely tell my daughter that Parker has a rare illness that is very hard to fight, even though he and his parents and doctors have done everything possible to try to make him better.
Experts caution that children tend to react more strongly to the death of another child, often experiencing intense feelings of helplessness, sadness, anxiety, anger, or confusion. Sensing that adults are more emotional, kids may not want to upset parents or teachers by asking questions or showing their feelings. Yet they don’t always know how else to seek comfort.
“When a peer dies, kids may be afraid that something similar could happen to them. Be honest with them and encourage questions,” Bouher emphasizes. “This can be hard because as parents, you may not have all the answers. But it’s important to create an atmosphere of comfort and openness, and to convey that there’s no single ‘right’ way to feel or grieve.”
Young children typically ask questions to help them understand if death can be prevented. As they get older, their inquiries tend to become more specific, such as what happens to someone’s body after they die.
“Families may provide some answers by sharing their spiritual beliefs about death,” Bouher says, adding that it is also okay to acknowledge that much about death is unknown.
Following the death of a friend, parents should watch for signs of grief in their child’s play or daily routine. It isn’t unusual for young kids to regress in previously mastered developmental stages or have intense moments of sadness. Children may study the adults in their life and react similarly to how they see others showing their feelings.
Over time, they may revisit the loss as they mature in their understanding of grief, a process that can generate increased feelings of anxiety and depression. Bouher adds that it is common for a grieving child to develop some signs of separation anxiety that may require additional nurturing from parents and teachers.
Rituals can serve as a powerful tool for children to feel connected to the friend they lost in a manner that is not too overwhelming. Drawing, writing stories or poems, and planting flowers or trees are all symbolic tokens that acknowledge the loss.
I anticipate that my daughter will likely ask if she can write a message to Parker on a balloon and release it into the sky, a gesture she found comfort in when her pet died.
“Families may want to create something on their own, like the balloon release, to help the child consolidate some of their feelings in an expressive action,” Bouher agrees, especially when children are too young to attend a memorial service. “Very young children can become overwhelmed or frightened at a funeral, but older children may find it helpful to be part of a formal service of closure,” she points out, adding that parents should assess kids individually to determine if they are ready to attend a service.
It can be normal for kids to have emotional reactions to the loss of a friend for several months and beyond. Parents should be watchful, reassuring, and available to talk as their child moves through their own grief process.
However, Bouher warns, if their reactions seem too stressful or are interrupting normal activities such as sleep, eating habits, or school, or if a child seems unusually tearful, angry, or withdrawn, then it may be wise to consult with a pediatrician or child therapist.