• Arrange to talk to the child in a private, comfortable location. For example, have your child sit on your lap, or talk to your child on his or her bed. Having your child’s favorite comfort item available (a blanket, a stuffed animal or favorite toy) can also help.  Turn off your cell phone, TV, or other background distractions.

• Long before we realize it, children become aware of death and when bad news is approaching.  It may be tempting to withhold bad news. It’s important to be honest with your kids and not to be afraid of their reactions. When we aren’t honest about what is going on, children make up their own explanation for the tense environment.  What they imagine is often worse than the truth.  Foreshadow the bad news, “I’m sorry, but I have bad news.”

• When you meet with the child ask what they already know and understand. Be prepared to provide basic information about prognosis and treatment options if there are any available.  Give information according to your child’s age. Younger children will require less information than older teenagers.

• Speak frankly but compassionately. Avoid euphemisms and medical jargon. Use the words cancer or death rather than “going to sleep” or giving false hope.  Offer realistic hope. Even if a cure is not realistic, offer hope and encouragement about what options are available such as hospice or medications which will help the person or pet have the best quality of life as possible until they die.

• Have the child tell you his or her understanding of what you have said, use repetition and corrections as needed. Encourage them to ask questions if they have any now or in the future and be sure to follow up often to see if any new questions have arose.

• Allow silence and tears, and avoid the urge to talk to overcome your own discomfort. Proceed at the child’s pace. Be empathetic; it is appropriate to say “I’m sorry” or “I don’t know.”

• Talk about what the bad news means for them personally. Be as clear as possible about how the bad news will make their life change—or not change. “Mom won’t be able to take you to school anymore so our neighbor will bring you instead.”  Older kids will want to know more details about this than younger kids.

• Reassure your kids. When bad things happen, they need to hear that you love them and that you’re there for them. If you’re uncertain how long you can be there for your children (such as when you receive a terminal prognosis), make sure they know of other caring, trusted adults who will also be there for them.

• Don’t be surprised if your child tries to blame you or someone else for the bad news. It’s hard for children and teens to understand that sometimes bad things just happen.

• Do something special with your child. You can say that when bad things happen, it often helps to do something you enjoy to try to feel better. For example, ask your child what he or she would like to do with you. Maybe your child will want to go the playground or play a board game.  It is important that children know it is okay to still want to have fun and to enjoy life.  They should not feel guilty about wanting to be happy.

• Model the grief process.  It helps children and teens to see that there are hard times and that people can get through these tough situations by making positive coping choices. For example, even if you don’t feel like exercising, you notice that exercise helps you feel a bit better. Explain that even though you may be tempted to eat badly, you notice that you feel better when you eat healthy. Talking about the ups and downs (while modeling positive coping strategies) will help your child be more intentional about the choices he or she makes and they are grieving.

• Keep in mind, although older teenagers may seem like they can take on more hardship than younger kids, remember that they still don’t have the life experience that you have. Hearing bad news can be extremely difficult on a teenager, and it can sometimes trigger risky behaviors, particularly if they were struggling before the bad news hit or they’re feeling extremely vulnerable.

• Talk to other significant adults in your child’s life. For example, talk to your child’s teacher, coach, or club leader. Sometimes a child will talk to another adult, and it helps if everyone knows the same information.

Parents, remember this:

• Attend to your own needs during and following the delivery of bad news.  Find a few people who are good listeners and can help with practical things such as taking kids to after school activities.

• Allow yourself to accept help.

It can be challenging to be the bearer of bad news, but keep in mind that there are others who can assist with this.  Asking for help from a social worker, counselor, a trusted friend, or spiritual adviser can help to facilitate this conversation, as well as connect families to resources in the community.

Amy Keiper-Shaw, LCSW