Families often have difficulty dealing with an ill and dying child. Children who are trying to make sense of the death of a friend or family member may have particular difficulty (see also The Dying Patient).

Death of a child: Most often the death of a child happens in the hospital or emergency department. Death can occur after a prolonged illness, such as cancer, or suddenly and unexpectedly, such as following injury or sudden infant death. The death of a child can be difficult for families to comprehend and accept. For parents, the death of a child means that they must give up their dreams and hopes for their child. The grieving process may also mean that they are unable to attend to the needs of other family members, including other children. Health care practitioners can help in the process by being available to the family for consultation and to provide comfort whenever possible. In some circumstances, referral to specialists skilled in working with families who have experienced the death of a child is appropriate.

Death of a family member or friend: Many children experience the death of a loved one. The way children perceive the event (and hence the best response by parents and health care practitioners) is affected by their developmental level. Preschool children may have limited understanding of death. Relating the event to previous experience with a beloved pet may be helpful. Older children may be able to understand the event more easily. Death should never be equated with going to sleep and never waking up because children may become fearful of sleeping.

Parents should discuss with health care practitioners whether to have children visit severely ill children or adults. Some children may express a specific desire to visit family members or friends who are dying. Children should be adequately prepared for such a visit so they will know what to expect. In the same way, adults often wonder whether to bring children to a funeral. This decision should be made individually, in consultation with the children whenever possible. When children attend a funeral, a close friend or relative should accompany them to provide support throughout, and children should be allowed to leave if necessary.

Last full review/revision January 2010 by Rachel L. Chapman, MD; Eve R. Colson, MD

Content last modified February 2012