A Child's Concept of Death
Every child, at any age, has his or her own unique concept of death. Past experiences
with death for the terminally ill child, as well as, his or her age, emotional development,
and surroundings are what most influence a child's own concept of death. Cartoons,
movies, television, video games, and even books are filled with images of death. The
child with a terminal condition may have previously experienced death by loss of a
family member, friend, or pet.
An adult's misconceptions and fear about death are often transferred to his or her
children. Treating death as a part of life is difficult, but may help ease some of
the fear and confusion associated with it. Dealing with death must be done within
the cultural beliefs and mores of the family.
Developmental age is a broad term used to describe the maturity of thought process
development. Children may be more or less mature in their thinking and processing
information, than others at a similar age. The following are children's concepts of
death, according to common developmental ages.
For an infant, death has no real concept. Infants do, however, react to separation
from parent(s), painful procedures, and any alteration in their routine. An infant
that is terminally ill will need as much care, physically and emotionally, to maintain
a comfortable environment as any age group. Maintaining a consistent routine is important
for the infant and his or her caregivers. Because infants cannot verbally communicate
their needs, fear is often expressed by crying.
For the toddler, death has very little meaning. He or she may receive the most anxiety
from the emotions of those around him or her. When a toddler's parents and loved ones
are sad, depressed, scared, or angry, he or she senses these emotions and become upset
or afraid. The terms "death" or "forever" or "permanent" may not have real value to
children of this age group. Even with previous experiences with death, the child may
not understand the relationship between life and death. Death is not a permanent condition
Preschool-aged children may begin to understand that death is something feared by
adults. This age group may view death as temporary or reversible, as in cartoons.
Death is often explained to this age group as "went to heaven." Most children in this
age group do not understand that death is permanent, that everyone and every living
thing will eventually die, and that dead things do not eat, sleep, or breathe. Death
should not be explained as "sleep."
Their experience with death is influenced by those around them. They may ask questions
about "why?" and "how?" death happens. The preschool child may feel that his or her
thoughts or actions have caused the death and/or sadness of those around. The preschool
child may have feelings of guilt and shame.
When children in this age group become seriously ill, they may believe it is punishment
for something they did or thought about. They do not understand how their parents
could not have protected them from this illness.
This idea may make preschool-age siblings of a dying child feel as if they are the
cause of the illness and death. Young siblings of dying children need reassurance
and comforting during this time period, as well.
School-aged children are developing a more realistic understanding of death. Although
death may be personified as an angel, skeleton, or ghost, this age group is beginning
to understand death as permanent, universal, and inevitable. They may be very curious
about the physical process of death and what happens after a person dies. They may
fear their own death because of uncertainty of what happens to them after they die.
Fear of the unknown, loss of control, and separation from family and friends can be
the school-aged child's main sources of anxiety and fear related to death.
As with people of all ages, past experiences and emotional development greatly influence
an adolescent's concept of death. Most adolescents understand the concept that death
is permanent, universal, and inevitable. They may or may not have had past experiences
with death of a family member, friend, or pet.
Adolescents, similar to adults, may want to have their religious or cultural rituals
Most adolescents are beginning to establish their identity, independence, and relationship
to peer groups. A predominant theme in adolescence is feelings of immortality or being
exempt from death. Their realization of their own death threatens all of these objectives.
Denial and defiant attitudes may suddenly change the personality of a teenager facing
death. Adolescents may feel as if they no longer belong or fit in with their peers.
In addition, they may feel as if they are unable to communicate with their parents.
Another important concept among adolescents is self-image. A terminal illness and/or
the effects of treatment may cause many physical changes that they must endure. Adolescents
may feel alone in their struggle, and scared, and angry.
It is important for parents to realize that children of all ages respond to death
in unique ways. Children need support and, in particular, someone who will listen
to their thoughts, and provide reassurance to ease their fears.