Preparing the Children: Preteens and Teens

Patient & Family Teaching Sheet

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How Should Adults Prepare Preteens and Teens for Death?

Adults sometimes feel that children are too fragile to face the reality of death or too young to understand. Children experience the same emotions adults do; most are emotionally strong enough and want to know about death. The truth helps them understand what is real and what is not. It is important to remember that grieving is natural. Support for their unique grief processes helps children heal and learn to live with a painful loss. With help, a child may find grief a growing process. It is important to make sure that the help offered is age-appropriate.

Age affects how children understand death – Preteens and Teens ages 10 years and above

  • May have developed an understanding of death; that death is final but remains a mystery
  • While understanding death, he/she still may be careless with their own health and safety because they have a feeling that it will never happen to him/her
  • May want to talk about death and other abstract topics
  • May begin to question the family’s faith and other beliefs

How to Explain Death and Dying

  • Should be done by a person they know and trust
  • Know the facts and be honest. Make sure they understand that death could not be prevented, such as when a person dies of cancer
  • Provide needed structure, support, and guidance. He/she is no longer a child but not yet an adult. Allow him/her to express anger or guilt. He/she may try to hide his/her feelings, so let him/her know his/her emotions are okay and normal
  • Maintain family closeness, but respect their privacy

Signs and symptoms of Grieving/Mourning

  • Anger or guilt
  • Withdrawal or attempts to hide their feelings
  • Aggressive behavior
  • Resistant to help and may react by trying to take care of others
  • May have difficulty concentrating in school

What to report to the care team?

  • Any kind of extreme behavior

What can be done?

  • Refer to professional counseling, if needed
  • Access grief and bereavement support groups
  • Certain books may be a good tool to help the preteen/teen become aware of his/her feelings and talk about the The preteen/teen may identify with a character in a book, learning they have similar feelings, which helps the healing process. Ask the nurse about books
  • Allow him/her to participate in any family rituals such as funerals, wakes, and memorial services
  • Allow him/her to speak to someone other than a parent about his/her feelings may be best. Encourage him/her to seek another trusted adult, such as a counselor, teacher, pastor, or coach

Should children visit the dying?

  • This depends on the situation. If the child is old enough to understand what is happening and the dying person has played an important role in his or her life, then it may be good for both the child and the dying person
  • The preteen or teen needs to be prepared for what he/she will see and hear. A picture and description of the equipment in the room may help
  • The preteen or teen should never be forced to visit a dying patient, go to a funeral, or the funeral home, nor should he/she be made to feel guilty for not wanting to be involved

Should children attend funerals?

Yes, if a child wants to go and is old enough to understand the event. Rituals can be an important part of the grieving process. Prepare the child for the event by explaining what they will see and hear, especially if there will be a viewing. Give the child a choice, but try to understand the child’s reasons so you can address any fears or misconceptions and answer questions.

The grieving process is normal, and the process helps both adults and children heal from their pain. If you have questions or concerns, please contact the hospice or palliative care team, a bereavement group, a religious advisor, or a professional counselor.