When Kids Talk About Death

Hello Barbara,  I have a question that has been bothering me a lot. I take care of kids battling cancer, most of them being on palliative care.  Is it okay to share some of the things the children tell me with their parents? One of my kids once told me that he kept seeing death, he said it repeatedly but I didn’t share and two weeks after, he got his angel wings. Another child whispered that he was sorry for letting me down, he said he was tired of treatment and wanted to go home (heavenly home) and two days after he was gone. Previously, one of the kids about twelve years old told me that she was going home and it was a different home because she had to use white stairs and again, just like that, she was gone a few days after she told me that. All these cases have left me feeling so guilty. I think I should have told someone or even the parents. My question is how would they respond, positively or negatively? Please advise me what is the right thing to do?

Before I start answering your question of "Should we tell parents that their child is talking about death?" I need to say I am not an expert on children as they approach the end of their life. My experience has been with adults and very few children. What I offer you is my opinion but not necessarily the Truth with a capital "T."

Each situation is unique. Some parents would want to hear what their child is saying, thinking and experiencing, others may not. For some, knowing will be comforting, for others upsetting ---- which puts you in a no win situation. BUT, really, our work is a no win situation. We are the bearer of sad, generally bad news. That is what we do.

My guess is there will be as many answers to your question as there are people you ask and I'm not sure there is a right or wrong to any of the responses. 

Here are my personal thoughts: as a parent I would want to know what my child is experiencing so I would want you to tell me my child is seeing angels. I would want to talk with them about their angels. They could teach me what the Other World is like. It would be very comforting for me (for other's, however, it may not be). 

As a professional, I would tell the family about their child's seeing and talking to, whatever the child is saying and describing, but I would not add that in other, similar cases the child has died shortly thereafter.

Part of our job in working with end of life situations is to prepare the family for approaching death. I would tell the family if I thought the child's condition was deteriorating, if they were showing signs of approaching death (conveying that information is part of our job), but seeing angels would not be the only signs of approaching death I would look for or use as an assessment tool. 

I would use seeing angels as a sign that death is on the horizon just as I use adults talking about angels (and many do) that death is coming closer. For adults it is in the weeks before death that the angels and loved ones that have died before begin to appear. I am not familiar enough with children at end of life to know their timeline. 

We, as a people, are never truly prepared for death but with guidance, honestly, and gentleness we, as caregivers for those people, can ease the fear and uncertainty most bring to the bedside. Preparing the family and significant others for the eventual expected death is what we do, that includes talking about angels.

Something more...   about When Kids Talk About Death 

Our booklets, The Tree of Life  and I Am Standing Upon The Seashore are end of life coloring books that can bring understanding and reassurance to us when we or a loved one is on hospice and journeying into the stages of death. The Tree of Life and I Am Standing Upon The Seashore are simple yet profound and consoling.
 

 

 

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4 comments

Misty, RN CHPN

In my experience as a hospice nurse I have found that asking the family and patients up front what kind and how detailed of information they would like better prepares me to recognize the things I should and should not share. Like Barbara said, some may not want to know all of the details but others may. I always ask this at the start of my admissions and care conferences and check in to see if they have changed their minds as end of life gets closer.

Diane

Not a nurse but a healthcare chaplain…if this was said to me in a confidential session, especially if the patient was a teen, not sure I would share with parent out of a desire to respect the patient’s privacy. Might ask if they had said this to parents but wouldn’t necessarily encourage them to unless they felt like it was a conversation they needed to have to be at peace…
Just a thought…

Sandra Stedinger

Thank you for sharing your insight into this delicate topic. My elderly father had dreams of spaceships and aliens coming to take him away, in the weeks before he left us. We never verified these reports, but I wouldn’t doubt him. He was a very smart guy, and a detailed observer.

Robin, RN CHPN

That is heavy stuff!! I have been a hospice nurse for over 9 years. My experience with dying children is minimal. I am a mom of a child with an immunodeficiency who had a near death experience. Again, that is a very heavy question! As a hospice nurse I would say that information should be shared with parents. As a parent, I’m not sure I would be prepared nor know how to process that information.
Those deep, incredible conversations we have the privilege of sharing with our patients is so very moving. It is so challenging for us to always know how to share what our patients have confided in us.
Certainly not an answer to the question, please take what is shared with you as a gift and use it to continue comfort the patients we are privileged to help.

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