Difficult Conversations with Children :: When a Loved One is Dying

I’m a social worker.  A hospice social worker to be exact. I know, I know, sounds like loads of fun. Truly though, I love my job and each one of my patients.

Luckily, if you consider it luck, most of my patients are older. They may have grandchildren, but the people I engage with are adults. But, then there are the outliers: The people who are terminally ill who have small children. They are the most heartbreaking of my patients.

I remember, very clearly, the first patient I was assigned who had a small child (details have been changed to protect confidentiality). 

I walked into the home and I was surrounded by adults. All were sad, worried and overwhelmed. They told me that my patient, a 30 something year old single dad had never told his little girl that he was dying. Now, it was getting close so they asked me “what do we do? Can you tell her?”

So, I sat down with the little girl and her Godmother. I told her who I was and that I wanted to talk with her about her father. I said “tell me about what you think is going on right now with your dad’s health?” She said “He’s sick. I think he’s dying. Is he dying?” I said, “yes, sweetheart. He is. He’s very sick and we’re here to take care of him so he can spend his time here on Earth with you, being comfortable and happy.”

And then there was her cry. It was a sound that I wasn’t prepared for. A wailing of the soul.

It was all I could do to keep it together.

It all made me think. Are there any of us who are prepared to have this conversation? This deeply troubling and emotional conversation? My suspicion is no. And, why would we be prepared? As a society, we shy away from death. It’s seldom talked about among adults, let alone children. Birth is spoken about all of the time, but we rarely mention death unless we absolutely have to.

Death will happen for us all. I know that this isn’t a popular fact, but a fact nonetheless. For many people, small children are involved somewhere in their family system. How do we talk to them? Do we talk to them? What do we say? I do not suggest that I am an expert on this. Just a big hearted social worker who wants to help give children the opportunity to understand, process, and cope with grief in a more effective manor. 

Here are some suggestions on beginning the conversation surrounding grief:

Ask what the child knows before diving into your own explanation. 

Children are typically smarter than we give them credit for. They are often more aware of what is going on around them than we think. Starting the conversation with “Tell me about what you think is happening right now” is a good place to start. While they may be aware that their loved one is sick, there may be some details that are unnecessary for them to know. There is no use in offering painful and unnecessary information to a small child.

Say you don’t know when you don’t know.

Lying or making things up will only complicate things. If you don’t know they answer to a question they may have, say “I don’t know” and try to find someone who can answer that question for them. Or acknowledge “there isn’t an answer for that question.”

Use the child’s language. 

If they believe that when someone dies, they go live with the angels, then use that. Now is not the time to educate them on a new spiritual perspective or to impose your own beliefs on them. There are already so many questions that they will have. Don’t add to those questions unless absolutely necessary.

Don’t use misleading language. 

If you say “well, Maw-Maw went to sleep,” they may be fearful to go to sleep themselves. Phrases like “she is passing away” or “moving on” mean very little to small children and may only confuse them.

Always tell the truth – but age appropriately so. 

All children react a little differently, so it is important to respect the unique nature of each child’s reaction.

Let them say goodbye.

If they want to. How they say goodbye may be different for each child. For some, it’s a hug at the hospital. For some, it’s attending the funeral. For some, it’s writing a letter and having it placed in the coffin. Offer the child options and see what they prefer.

Model healthy emotional expression. 

This means crying if you are sad. It means expressing that you will miss the deceased individual. It means acknowledging ways that you will memorialize the deceased individual. The most important thing that you can do is to not ignore your own feelings or pretend that you have no emotional reaction.

Reach out for help. 

This may be a therapist who specializes in work with children. A resource like 232-HELP in Acadiana or 211, can help you to find mental health resources. Or it may be your local grief center. Healing House in Lafayette offers assistance to any child in the local area who has experienced the death of a sibling or parent. They are also an excellent resource for questions about grief, no matter what the relationship is between the child and the deceased individual.


These conversations are, hands down, the most difficult conversations that I have had to have as a social worker. If I think about someone having to have that conversation with my little boy … my heart breaks in a million pieces. No one can love my little boy quite like I can. When I think of ever having to leave him, I have to shove the thought away. I begin to cry and I’m not even sick. But, if it ever were to happen, I hope that my loved ones would know how to speak to him about death. I want him to know that he can go on, and he will be okay.

The only way we help our children to begin the business of grieving is to have an open dialog. That is the only way to help them heal their hearts.

Amanda is a native of Kenner, LA and is now an honorary Cajun. She is married to a psychiatric nurse, Joe, and is a hospice social worker so don't come to her house unless you are ready to talk about your feelings! Amanda and Joe are parents to Kael and Remy and furry parents to Luna and Spiderman. Amanda is all about that #boymom life and is enjoying wrangling her two wild men while checking out the wonderful culture of Acadiana and all of Louisiana. Amanda is a fan of all things yummy and enjoys a good cocktail. Her motto is "if I can't wear yoga pants, I'm not going".