How to Support Children and Young Family Members When a Loved One is in Hospice

Supporting children and young family members when a loved one is in hospice is a deeply emotional and often challenging task. Still, with compassionate guidance, it can also be an opportunity for growth and understanding.

Children may experience grief and confusion differently from adults, and it’s essential to create a safe space for them to express their emotions, answer their questions honestly, and involve them in ways that foster a sense of love and peace.

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Communicate Honestly and Age-Appropriately

Children need age-appropriate, truthful information about what’s happening. Though shielding them from brutal realities may be tempting, honest communication fosters trust and helps them process the situation more effectively.

  • Young Children (Ages 3-6): Young children may not fully grasp the concept of death but can sense changes in the household. Use simple, direct language, such as “Grandma is very sick, and the doctors are helping her feel comfortable.” Avoid euphemisms like “going to sleep,” which can create confusion or fear.
  • School-Aged Children (Ages 7-12): At this age, children begin to understand that death is permanent. Be open to questions, and answer them as truthfully as possible. Explaining that hospice is a special type of care focused on comfort rather than curing illness can help clarify why their loved one might be at home or in a hospice facility.
  • Teenagers (Ages 13+): Teens often have a better understanding of death but may struggle with the emotions and practicalities involved. They might want more detailed information about their loved one’s condition and the hospice process. Respect their need for privacy, but encourage them to express their thoughts and feelings, emphasizing that no emotion is “wrong.”

Encourage Emotional Expression

Children may express emotions through tears, play, behavior changes, or quiet withdrawal. Provide a safe environment where they feel encouraged to share their feelings in their own way. Be mindful of your emotions as well – sharing some of your sadness can validate their feelings, though it’s also essential to maintain stability.

  • Art and Creative Outlets: Art, music, and journaling can offer children an emotional outlet. Younger kids might draw pictures or play out scenarios with toys, while older kids and teens might write about their feelings or create memory books. These activities can help them process their emotions and develop a tangible connection to their loved one.
  • Open Dialogue: Use open-ended questions, such as “How are you feeling about spending time with Grandma lately?” or “Is there anything you’d like to share about how you’re feeling?” Listening attentively and without judgment allows them to explore and articulate their emotions.
  • Role Modeling: Show them that expressing emotions is normal by sharing some of your feelings calmly and age-appropriately. For example, you might say, “I feel sad too, and it’s okay to be sad when someone we love is very sick.”

Maintain Familiar Routines

When a loved one is in hospice, the household routine may shift significantly, which can be unsettling for children. As much as possible, try to maintain daily routines, like mealtimes, bedtimes, and school activities. Familiarity provides children with a sense of stability and security, especially during times of uncertainty.

  • School and Extracurricular Activities: Encouraging children to continue attending school, sports, or music classes can give them an essential sense of normalcy. If they feel comfortable, they might benefit from talking to their teachers or coaches, who can offer additional support.
  • Family Time and Rituals: Continue family rituals, whether reading a story before bed, having a weekly movie night, or eating dinner together. These routines offer comfort and reassurance, showing children that life continues even during hard times.

Involve Them in the Process as Appropriate

Involving children in the care process can help them feel connected and provide them with an opportunity to say goodbye in a meaningful way. This involvement can range from helping with small caregiving tasks to spending quiet time with their loved ones.

  • Reading and Storytelling: Reading stories from a book or sharing family memories can be a comforting and meaningful way for children to connect with their loved one. It allows them to participate in a peaceful activity and create lasting memories.
  • Creating Memory Projects Together: Encourage children to make a scrapbook, memory jar, or photo album of shared experiences with their loved one. This can be a therapeutic way for them to channel their emotions while celebrating the relationship they cherish.
  • Visiting and Saying Goodbye: If appropriate, let children visit their loved one to say goodbye. Explain in advance what they might see and encourage them to ask questions. If they feel uncomfortable, assure them that it’s okay and they can decide what feels right for them.

Address Questions and Curiosity Openly

Children may have questions about death and dying, and it’s essential to answer these questions as openly as possible, even when they’re difficult. Being prepared to answer their questions with gentle honesty can ease their anxiety and help them process what’s happening.

  • Answering Common Questions: Children might ask, “What happens after we die?” or “Why can’t the doctors make Grandma better?” Answer in ways that align with your family’s values and beliefs. If you don’t know an answer, it’s okay to say, “I’m not sure, but I wonder about that too.”
  • Responding to Misconceptions: Younger children may think they caused the illness or worry that other family members will also die soon. Reassure them that the illness is not anyone’s fault and that you are doing everything possible to stay healthy and safe.
  • Encouraging Questions Later: Let children know they can ask questions whenever they feel like it, even weeks or months later. Grief can be a long process, and children may revisit questions as they mature or their understanding deepens.

Provide Reassurance and Comfort

It’s natural for children to feel scared or worried during this time, and they need reassurance that they’re safe and loved. Be attentive to their fears and address them with kindness and patience.

  • Physical Comfort: Physical affection, like hugs or holding hands, can provide significant comfort. Small gestures of care can go a long way in helping children feel secure.
  • Reassuring Words: Remind them that it’s okay to feel however they’re feeling and that you support them. Let them know that they are loved no matter what happens and that the family will continue to support one another.
  • Modeling Coping Strategies: Children look to adults for cues on how to cope with difficult emotions. Model healthy coping strategies, such as taking deep breaths, walking, or talking to a trusted friend. Show them that taking breaks and finding joy even amidst sadness is okay.

Seek Support from External Resources

Sometimes, children may benefit from additional support, especially if they’re struggling to cope or have questions beyond what you feel prepared to answer. Seek professional help or outside resources if needed.

  • Therapists and Counselors: A therapist specializing in grief or child counseling can provide children with additional tools to process their emotions. Many hospice organizations offer grief counseling or can recommend therapists experienced in family bereavement.
  • Support Groups: Some children find comfort in meeting others who have gone through similar experiences. Look for support groups for young people experiencing grief in person or online through hospice organizations or community centers.
  • Books and Educational Resources: Many age-appropriate books on grief and death can help children understand and accept what’s happening. Some books are written specifically for children dealing with hospice or a family member’s terminal illness, offering gentle stories and activities that can be comforting.
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Final Thoughts

Supporting children when a loved one is in hospice is about providing honesty, comfort, and a sense of stability. By guiding them through the experience thoughtfully and compassionately, you’re helping them develop resilience and an understanding of life’s transitions.

Though it’s a difficult journey, it’s also a significant one, offering opportunities for bonding, growth, and creating memories that honor the love they share with their loved one.