by CanTeen31/01/2019

How to Talk with Your Child when their Sibling Died of Cancer

Talking about death and dying is a sensitive subject. The following advice is based on my clinical experience as well as research findings. However, every child is unique and as a parent, you know your child and family best. Be sure to follow your own parental wisdom and modify and customize any presented strategies to best suit you and your child. The most important thing you can do to support your child is to love them and try your best. 

Get support for yourself. You will not be able to support your child effectively if you are not taking care of your own needs. Find a healthy balance in expressing your grief in front of your child. You should not hide your grief from your child. However, do not use your child as your emotional support. Adults need to seek support from other adults – friends, siblings, extended family, religious leaders, professional grief counsellors. Do not hesitate to seek out professional guidance and support from a counsellor or join our Parent Support Community. 

There is no way to protect a child from the pain of a person in their life dying. Accept that it is normal and natural for your child to experience this loss and give them permission and space to do so. You will not make the grief worse by talking about it.  

The first step to talking to your children about your child who has died, is to bring up the topic whenever appropriate. Do not be afraid to speak about the deceased. If speaking about them, do not change the subject if the child enters the room. Children are very perceptive. Anything they think is a secret or taboo will become marked as something shameful or “not ok”.  

Follow your child’s lead. As a rule of thumb, if a child asks a question, that means they are ready to hear the answer. If you are worried about providing too much detail or overwhelming your child, start off with a vague answer. If the child asks more questions, then provide further detail. It is ok to tell your child “I don’t know”. Your child may ask questions that you do not have an answer to, and it is ok to tell them that you do not know the answer. For example, your child may ask “Why did she have to die?” and it is ok to tell them that you do not know. 

In communicating the death, use simple, clear language. Avoid euphemisms (e.g., “Aiden went to heaven” “Marie is sleeping” “She passed away”) as these can be confusing for children. Use the words death, dying, and dead. Depending on the age of your child, you may also need to explain what death means.

Example script of telling a child about a child dying: 

  • “Your father has died. This means that his body has stopped working and he can no longer breathe, eat, sleep, talk, or do anything. Being dead means that your father cannot feel anything in his body, so he is not in any pain. Being dead does not hurt. Your father has died because he had cancer and that made his body stop working. It is not your fault he has died and there is nothing you or I could have done to stop him dying. Being dead is forever and he will not become alive again. Do you have any questions about Dad dying?” 

Let the child know that it is very uncommon for a child to die. Be sure they know that they and other children they know are not at risk of dying. Let your child know that the cancer their sibling had is not contagious, meaning they could not have caught it from them. 

The younger a child is, the more you may need to repeat to them that the loved one is dead and what that means. It is normal that a child may need to hear the explanation multiple times. 

When talking about death with your child, be careful to notice if the child may have any false beliefs about death. It is very common for children, especially young children, to think the death is their fault, or that the person who died did so because they were mad at them. Be sure you let them know this was not the case and that nothing they did or did not could have stopped the person from dying. You can check if you child has any false beliefs about dying by asking: 

  • Why do you think Mum died?
  • Do you think there is anything you could have done to prevent Dad from dying?

Children whose sibling has died may struggle with thoughts that it “should have been me who died” or worry that a parent may have preferred they died and their sibling lived. Let your child know that you love them as much as your child who has died and you are so glad they are alive and well.  

All children, no matter how young, grieve. Although grieving in children often looks very different from how adults grieve. You may notice the following signs of grieving: 

  • Crying and being more clingy, acting younger than their age.
  • Being irritable and showing more anger.
  • Trouble sleeping – including having nightmares, or trouble falling asleep.
  • Increasing anxiety – about who will take care of them now. Questions about routines and daily needs. Worry that others in their life may die.
  • Changes in eating.
  • Physical aches and pains – tummy aches, headaches.
  • Themes of death and dying in play. May draw or act out death and morbid themes.
  • Withdrawal – wanting to be alone.
  • Difficult concentrating on school work, being more forgetful.
  • Acting as if nothing is different

It is normal that children “dip” in and out of grief. This can be surprising to adults, but it is nothing to worry about if one moment the child is crying and the next happily playing as if nothing has happened.  

Children and adolescents may worry about “how” they grieve. They may wonder if they “should” be crying, or if it’s ok to have some fun with friends and play. Let your child know that everyone grieves in different ways and that grief is normal and ok. Tell them it is ok to cry, or not cry, it is ok to be angry, it is ok to “be ok”, it is ok to miss the person who has died. 

Keep to your routines as much as possible. Children are greatly comforted by routine and it will comfort them greatly to know that while the family member has died, there are aspects of their life that are constant. 

Comfort and support your child, but do not change your normal boundaries and discipline. A child can still be expected to do their chores and behave appropriately. If a child begins acting out inappropriately, address the behaviour, not the feeling. For example, if a child is more irritable and hits you in a tantrum. Let them know it is OK that they feel so angry, but it is never Okay to hit, and have consequences for inappropriate behaviour as normal. Give them other outlets for their anger, such as physical activity.  

Listen to and comfort your child. Offer comfort through hugs and cuddles. You can also help your child to name their feelings – like sadness, anger, guilt.  

Prepare your child in advance of any mourning rituals (e.g., wakes, funerals, memorial services, burials). You can prepare your child by explaining in simple language, what to expect at the event, and the appropriate ways they can react. 

Example of explaining about a burial: 

  • “Today, we are going to your mum’s burial service. This means that Mum’s body will be in a special box, called a coffin, and that box will be buried in the ground. This is where Mum’s body will stay forever. This special place is called a graveyard. This is a good place for Mum’s body to stay because it is in a park and there are trees and nature all around, which Mum loved. Burying Mum’s body is an important event, so we have invited other people to come and watch. Grandma and Uncle Teddy will be there. When we get to the graveyard, we will gather in a circle and the priest will speak and say a prayer. Then the coffin will be lowered into the ground and we will put some earth on the coffin to start burying it. This is a sad event, so it is OK if you cry. I and others may cry too. It is also OK if you do not cry. You do not need to say or do anything at the burial. All you need to do is come and watch and I will hold your hand, if you want. Do you have any questions?”

Coach your child with how to respond to others offering condolences. Let them know about the language they may hear, such as “I’m sorry for your loss” or “My condolences”. Many children and teenagers are confused by the wording of “I’m sorry”. Explain to your child that people are not saying this because they think it was their fault the deceased died, but that this is a different use of the word “sorry” and it just means the person cares about them and the person who died, and they are sad the person has died. Let them know that they can respond to this phrase by saying “thank you” or “thank you for coming” in the case of the funeral.  

It is usually helpful for children to be given the option to see the body of the person who has died. Seeing the body helps the child understand concretely that the person has died. Children who do not see the body are more likely to struggle with accepting the reality of the death and have persistent fantasies of the loved one being alive (e.g., they may fantasize that they are still alive and have just moved). If the child is unsure, reassure them that there is nothing to fear and gently encourage them to view the body. Of course, a child who does not want to see the body should not be forced against their will. If appropriate, a photo of the loved one may be taken that can be shared with your child at a later time. 

Before viewing the body, prepare the child for what the body looks like. You can explain that it will look like their loved one is sleeping. Let them know that the person may look different, more pale, and just “weird” and explain that this is normal. If viewing in the hospital, let them know that there may be medical equipment hooked up. An important message to convey is that the person is not in any pain and is not hurting. Also let the child know that it is ok to speak to the body and say goodbye, or to touch the body. Let them know that because the person has died, their body will feel cold. With older children and adolescents, give them the option if possible to have some moments alone with the body.  

Find ways to keep the loved one connected to the child. Death ends a life but not a relationship. Ideas may be having photographs of the deceased, or a journal where the child can write down things they want to tell the deceased. (link to section about Memories and Rituals for more ideas of maintaining connection).  

CanTeen has multiple support options for young people, including face to face and online counselling and peer support forums, which you can read about here.