Pediatrics - Good Grief Program at BMC

Pediatrics – Good Grief Program

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Talking With Children About Loss

Read an Excerpt from Chapter Two

Chapter 2
We Put Old Rover to Sleep:  The Task Of Understanding

We can't escape loss and death. Every bug, every plant, and every person that is born also dies. Whether we acknowledge it or not, loss surrounds us every day in the news, in our cities and communities, in our schools, or in our own back yards. Kids need to make sense of death or any loss just as much as they need food or warm clothes. We are responsible for their need to understand.

Understanding, the first task of mourning, means knowing what happened to the person who died and why. In the case of nondeath losses, understanding means knowing what situation caused the loss and why it happened. Children can't feel the pain of grief unless they have an honest understanding about what it means to die.

The need to understand is a cognitive and intellectual human need, so it's normal for kids to ask why. "What happened to Grandpa Henry? Why did he die? Where did he go?" Youngsters ask these questions and many others in order to make sense of death at a level appropriate to their age and developmental stage. Their preschool (ages 3 to 5), latency (ages 6 to 8), preadoles- cent (ages 9 to 12), and adolescent (ages 13 to 21) years span the four developmental stages of childhood.

So that kids aren't forgotten, isolated, and left to deal with their confusion and fears on their own as they strive to understand a loss, we must address three issues:

  1. The definition of death
  2. The way in which they use magical thinking to rationalize death and other losses
  3. The cognitive abilities that children possess to understand death and other losses, which depends on their age and developmental stage

Defining Death

As nurturing adults, we often want to soften our definition of death. This impulse is well intentioned, but it only inhibits our kids' understanding. We cringe and feel inadequate to explain this process of the life cycle. Parents wonder what causes them more anxiety, discussing death or sex-and kids sense our anxiety and discomfort.

Perhaps communicating about death is a painful process because of our experiences as kids. When you were a child, what were you told about death? Some adults remember that no one said anything when, for example, Grandpa Henry died. Sometimes Grandpa Henry went "away" or "to heaven." The veterinarian put our old dog Rover "to sleep." Also, we do a lot of "passing" in this country. As I give workshops around the United States, I hear people talk about "passing on, passing away, or passing over." Frequently adults say, "We lost Uncle Sam." Preschool child might reply, "Well, let's go find him." Medical professionals are fond of the word "expire." When I once asked a group of kids what expires, they said their "library cards."

We make ourselves uncomfortable, not our children, when we use euphemisms and confusing language as we talk with them about death. We need to be direct. Tell kids that Grandpa Henry died, that Rover the dog died. If Rover was "put to sleep," a child might fear that she too might "go to sleep" one night and never wake up, like Rover.

We also should convey what happens physically to the person who died by saying that a dead person's body totally stops working. A dead person can't breathe, eat, talk, walk, or got to the bathroom. A dead person can't do anything. Preschool and latency-age youngsters might find this definition odd and suggest that it's pretty boring to die! This is, however, an honest explanation of the physical facts of death.

Spirituality in Defining Death

How do our spiritual beliefs fit into this definition? I recall how Hollywood depicted death in a made-for-TV movie in the aftermath of the 1989 San Francisco earthquake, the Loma Prieta. One evening I saw a preview of the upcoming movie. A portion of a bridge had collapsed on top of a car in which a mom and her two kids were riding. Immediately the scene flashed to the hospital and showed dad coming into the room in which the two children lay. Mom had died and the youngsters, who were maybe six and eight, said: "Daddy, where's mommy? We want our mommy." Dad told them: "Well, the angels came down and took mommy." Have you ever heard this response or one similar to it? So the kids said: "Well just tell the angels to bring her back." Dad looked bewildered momentarily and then said: "Sorry, they are one-way angels. But, we must not feel sad because mommy is happier in heaven with God."

That was the end of the clip. Although the father's answers are gentle and kind, they're not truthful facts about death of the body and they might even terrify kids. His youngsters might misunderstand his meaning and blame God or angels for taking their mom from them. They might also be upset because mommy is happier in heaven with God rather than on earth with them. Honesty about a person's body at death can go hand in hand with our beliefs about the person's spirit. Neither need negate the other.

Once we explain the physical cause of a death, we can add what our family believes about the spirit or afterlife. Younger children can't understand what they can't concretely see or experience in their external world, so sharing our beliefs about the "spirit" can confuse them. However, these beliefs, and the rituals that accompany them, can make children of all ages secure as they open their hearts to their fears of the unknown and to the inexplicable power underlying all life--God, Buddha, Allah, Krishna, their Higher Power, Love.

A few years ago, I worked with five-year-old twins after their older brother died of hemophilia. Because their parents made heaven sound as alluring as Disney World, these little girls wanted to die so that they could be in this dreamy place with their big brother. I remember a child telling me, "Mommy said that, because my daddy was so smart, God needed his help with the big Hewlett-Packard in the sky." One four year old was told that her mommy was such a good mommy that God asked her to be the special mommy for babies in heaven.

Why would a child be happy knowing that his most cherished person in the world was taken from him to run a computer or care for other kids in heaven? These seemingly protective and comforting explanations might make youngsters (1) blame a higher power for taking their loved ones from them, as the TV movie also illustrated, (2) want to die because death sounds "glamorous" or irresistible, or (3) fear that angels or God will snatch them away too.

Although our spiritual beliefs can coexist with the physical facts about death, how can we honestly talk about our beliefs? Abstract spiritual reasons are not the cause of death. Rather, we should first explain that everyone dies, that "Grandpa Henry's heart was so bad that it caused his body to totally stop working." We can compare it with a machine that can't be fixed. After this factual explanation, we can relate what happens to the person's spirit. A Christian, for example, might say, "In our family, we believe that Grandpa Henry's spirit, the part inside of him that made him laugh and love us and be grumpy with us at times, is now in heaven with God forever." This kind of response is clear, loving, and truthful.

Even with this explanation, young kids might not be able to piece together how the body of a "dead person" can be buried in the ground while the "spirit lives" someplace that they can't see, but don't let this inhibit you from sharing your beliefs about the afterlife. If you say that Grandpa Henry's spirit is in heaven and you take your six year old to visit his grave, he will be confused; but as he grows older, he will learn to make sense of the more abstract concept of spirit.

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