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When a loved one is admitted to hospice care, the family faces not only the pain of loss, but also the need to support the youngest members of the family. A child who sees their grandfather or grandmother fading away experiences disturbing emotions that they are often unable to comprehend or express.
Parents often do not know how to properly explain to a child what a hospice is and what the death of a relative means. Some resort to euphemisms “went to sleep,” “went far away” while others avoid the topic altogether. But silence or distortion of the truth does not protect the child on the contrary, it deepens their anxiety and feelings of loneliness.
A sincere, age-appropriate explanation, regular emotional support, and presence in the moment are what will help a child get through the loss without deep psychological wounds.
And most importantly, don’t try to deal with it alone: involving specialists, educators, and the hospice team can make the journey easier for the whole family.
How children perceive death. Age-related characteristics
A child’s reaction to the death of a loved one depends largely on their age, emotional maturity, and previous experience of loss. Common to all age groups is the need for truth, security, and the opportunity to express their feelings. But the form of this support must be adapted to how the child perceives the concept of death.
Preschool age (3–5 years)
At this age, death is not usually perceived as something irreversible. Children may believe that the person will “come back,” “wake up,” or “get better.” They have vivid imaginations and often fill in the gaps in their knowledge with fantasies that can be scarier than reality.
Typical reactions:
- Frequent question: “When will he come back?”
- Fears before bedtime or separation
- Reenacting the scene of loss in a game
Due to:
- Avoid metaphors such as “fell asleep” or “went away.” Say directly that grandpa or grandma died, meaning that their body no longer works and they will not return.
- Explain that death is not a punishment and that the child is not to blame. Allow space for questions, even if the answer is repeated many times.
Early school age (6–9 years)
At this age, children already understand the irreversibility of death, but they can still fantasize about a “magical return.” They often look for logic: “Why did this happen? Who is to blame? How can it be stopped?”
Typical reactions:
- anxiety, sleep disturbances
- feelings of guilt or obsessive thoughts
- questions about technical details (how exactly did he die, what will happen to the body)
Due to:
- Give clear answers, avoiding details that may be traumatic.
- Ensure consistency in everyday life (routine, habits, school).
- Tell them that it is okay to feel sad, cry, or get angry.
Teenagers (10–16 years old)
Teenagers already understand death as part of life, but at the same time they can experience it very deeply and emotionally. They tend to withdraw, philosophize, or rebel.
Typical reactions:
- Detachment, indifference, or aggression
- Emotional swings
- Increased anxiety or depressive moods
Due to:
- Let them talk or remain silent; the main thing is to be there for them and available.
- Ask if your child wants to talk to a psychologist.
- Emphasize that their emotions are normal and natural.
How to properly explain to a child what a hospice is
Explaining what hospice is can be one of the most delicate moments in communicating with a child. For most children, this word is new, and its connection with death causes fear, anxiety, or confusion. Therefore, it is important not only to give a definition, but also to present it in a form that is appropriate for the child’s age and emotional state.
Don’t hide the truth, but present it gently
Even the youngest children can sense when adults are hiding something. Attempts to “protect” a child by keeping quiet can cause even greater anxiety. It is better to tell the truth sincerely, but without excessive emotion or frightening details.
“A hospice is a place or special home care service where people who don’t have long to live are looked after. They are helped there so that they don’t feel pain and can feel calm.”
Avoid metaphors that may cause confusion
Words such as “went to sleep,” “fell asleep forever,” “flew away into the sky” can cause fear of falling asleep or disturbing fantasies. Children should be spoken to in simple, concrete terms:
“Grandma was very sick, and medicine could no longer help her. She died — that means her heart is no longer beating, and she no longer feels any pain.”
Add accents of care and love
When explaining what a hospice is, emphasize that it is not a place of “death,” but a place of love, care, and peace. This will help dispel any frightening notions about a “scary hospital.”
“At the hospice, they help Grandpa feel comfortable. He is not alone there; he has nurses and doctors, and we will visit him. It is a place where they care for him with great love.”
Allow me to ask questions and return to the topic
Don’t expect your child to understand everything after just one conversation. Allow them to return to the topic, ask questions, and talk about their emotions. This is a natural part of the acceptance process.
How to support your child when a loved one is in hospice care
The period when a grandparent is in hospice care is often the most emotionally difficult stage for a child. It is a time of waiting, tension, and saying goodbye. It is the parents’ job to create conditions in which the child can go through this experience as safely as possible and with emotional support.
Create an emotionally safe space
Children need to know that all their feelings are normal. Sadness, anger, fear, even joy in ordinary situations are all natural. It is important not to “correct” children’s emotions, but to accept them:
“I can see that you are sad. That’s okay. I am sad too.”
Don’t force your child to be silent or “hold back.” On the contrary, send the message that emotions are good, that they don’t ruin relationships, but help us to be closer.
Organize visits whenever possible
Seeing that a loved one is still alive, talking to them, holding their hand is very important for a child. Even a short visit accompanied by parents can calm and reduce fear.
If visits are not possible, try to arrange:
- video or audio calls
- recorded video or voice messages
- drawings or letters from children that can be passed on to patients
This gives the child a sense of belonging and an opportunity to say goodbye.
Don’t avoid traditional holidays or family gatherings
You want to shield your child from pain, but complete isolation raises even more questions. Shared family events, even in hospice care, can be a source of memories, warmth, and closure. Explain that grandma or grandpa are happy to see her, even if they can’t speak.
Involve other adults
During this period, the child may change their behavior, become withdrawn, or, conversely, start to “act out.” This is natural. It is very important to inform teachers, educators, or nannies about the situation. They can:
- Be more attentive to the child’s emotions.
- Temporarily reduce the academic workload.
- Recommend a psychologist or support resources.
Signs that a child needs additional psychological support
Even with the utmost care from the family, a child may not be able to cope with their inner feelings. It is important to notice the signs that indicate that they need professional help in time.
1. A sudden change in behavior
If a child has become aggressive, withdrawn, or overly obedient, this may be a defensive reaction to stress. Behavioral “swings” are also a common symptom of deep internal conflict.
Examples:
- a child who used to be active becomes silent or vice versa;
- refusal to play or communicate with other children;
- outbursts of anger for no apparent reason.
2. Sleep problems or physical symptoms
Recurring nightmares, difficulty falling asleep, and frequent awakenings may indicate subconscious grief. Complaints of stomachaches, headaches, loss of appetite, or overeating, as well as enuresis (bedwetting) in children who no longer wet the bed, are also possible.
3. Excessive anxiety or guilt
Children may believe that they are “bad” or that the death happened “because of them.” This is especially common among younger children.
“I didn’t say goodbye to my grandmother, and she died because of it.”
This requires immediate correction; the child should not bear the burden of guilt.
4. Isolation, indifference, or excessive “maturity”
Teenagers may pretend that they “don’t care,” but behind this mask often lies a deep sense of loss. Or, conversely, they become “caregivers,” taking on the emotional burden of adults. In such cases, it is worth gently, without pressure, suggesting a conversation with a child psychologist.
When to consult a specialist:
- if symptoms persist for more than 2–3 weeks;
- if the child says that they “don’t want to live” or that “nothing makes sense”;
- if the child avoids contact or shuts themselves off from everyone.
Don’t be afraid to ask for help. A psychologist will not “break” your child; he or she will help your child find a path to inner balance.
How schools and educators can help
When a close relative is in hospice care, a child spends a significant part of the day away from home, at school, kindergarten, or clubs. That is why the educational environment has a huge impact on their psychological state. Partnership between parents and teachers can be a decisive factor in maintaining a child’s emotional balance.
Inform teachers or educators about the situation
Don’t be shy or wait until “problems arise.” A brief, calm conversation with the homeroom teacher, counselor, or school psychologist will allow you to:
- identify changes in behavior in advance;
- avoid misunderstandings if a child behaves “unusually”;
- get recommendations or support.
“Our grandmother is currently in hospice care, and we have noticed that this is affecting our child’s mood. If you notice any changes in their behavior, please let us know.”
Avoid pressure regarding education
When a child is emotionally overwhelmed, their ability to concentrate and absorb new information decreases. Therefore, it is important not to force them to perform perfectly on their homework or achieve academic success during this period.
It is worth discussing with the teacher the possibility of:
- reducing the volume of tasks;
- extending deadlines;
- participating in psychological support groups, if available.
Ask for additional emotional support
Educational institutions can offer individual meetings with a psychologist; participation in emotional intelligence training; inclusion in a friendly environment where the child will not be judged for crying or being withdrawn.
Psychological support at school does not replace family support, but it helps to avoid emotional isolation.
How Golden Age Hospice supports families with children
At Golden Age Hospice, we understand that hospice care is not just about the patient. It is about supporting the entire family, including its youngest members, who are experiencing difficult emotions and often cannot express them in words.
Our team in Los Angeles provides comprehensive care that takes into account the needs of children when their grandparents are in the final stages of life.
Emotional support for the family as a whole
We do not separate the physical condition of the patient from the emotional state of their loved ones. Our palliative care team, nurses, social workers, and spiritual counselors work not only with the patient, but also with those around them.
Our approach is centered on human dignity, open dialogue, and empathy for every generation.
Advice for parents on communicating with children
Many parents don’t know how to talk to their child about death. We help you find the right words, suggest age-appropriate phrasing, and explain how to have a conversation without pressure.
Our specialists will help you prepare for your first conversation with your child about hospice care; recognize signs of childhood anxiety; and organize a gentle farewell, if the family so desires.
Support during visits
We create an atmosphere in which children are not afraid to enter their grandfather or grandmother’s room. Our staff explains what is happening and answers questions without downplaying the child’s emotions. If necessary, we organize separate visits for children accompanied by parents or a specialist; a place for shared memories: drawing, music, reading; recommendations on how to prepare a child for saying goodbye.
Spiritual and psychological support
We work with qualified psychologists, spiritual advisors, and chaplains who have experience working with children and adolescents. The approach is individualized, taking into account the child’s religion, family culture, and emotional state.
Explaining to a child that their grandfather or grandmother is in hospice care is one of the most difficult moments in a parent’s life. But silence or oversimplification does not lessen the pain; it only creates confusion and anxiety. Instead, honesty, openness, and sincere support can make this period less traumatic for the child.
Every child experiences loss in their own way. Some through tears, others through silence or irritation. Your presence, attention, and willingness to be there are the strongest support you can give.
Golden Age Hospice in Los Angeles works not only with patients but also with families, helping them navigate this journey with dignity, without fear or loneliness. We are here to support not only bodies but also hearts.
Contact Golden Age Hospice to learn more about our personalized hospice services for the whole family, including emotional support for children.
