Preparing Children and Teens for a Grandparent or Parent in Home Hospice
When a family member enters home hospice care, adults often wonder how to involve children and teenagers in the process. There's a natural instinct to shield younger family members from difficult experiences, yet research consistently shows that with appropriate preparation and support, children and teens can benefit from being included in this important family transition.
Including younger family members in the hospice journey honors their place in the family, helps them process grief in healthy ways, and provides opportunities for meaningful connection and closure. The key lies in providing information and involvement that matches their developmental stage and individual temperament.
Children and teens are remarkably perceptive. Even when adults attempt to shield them from difficult realities, they typically sense that something significant is happening within the family. Without accurate, age-appropriate information, young people often imagine scenarios that are more frightening than reality or blame themselves for changes they observe in family dynamics. Research indicates that children who are appropriately included in end-of-life care experiences typically show greater resilience and healthier grief processes than those who are excluded.
When supporting children through this experience, honesty is essential, though it should be delivered in age-appropriate ways. Use clear, simple language, avoiding euphemisms that create confusion. With preschoolers (ages 3-5), focus on concrete explanations about the body wearing out and reassurance about their own security. These young children understand illness very literally and may not fully grasp the permanence of death. They benefit from short, frequent visits and simple ways to help, like bringing a blanket or creating artwork.
School-age children (ages 6-12) develop a more mature understanding of death and often have practical questions about illness. They appreciate more detailed explanations about the illness and the goals of hospice care. These children often find comfort in practical involvement like reading to their loved one, helping with simple comfort care, or working on memory projects together. Their developing sense of empathy allows for meaningful participation, though they still need guidance about appropriate expectations.
Teenagers understand death similarly to adults but may struggle more with existential questions while simultaneously balancing their need for independence with family responsibilities. They benefit from comprehensive information and inclusion in family discussions about care. Many teens appreciate having specific responsibilities that utilize their strengths, whether that's documenting memories using technology, providing companionship, or helping with direct care tasks if they express interest.
Across all age groups, maintaining routines provides security during times of change. While some disruption is inevitable, keeping core routines around meals, school, and bedtime helps children feel more stable. Similarly, preparing young people for physical changes they might observe in their loved one reduces fear and helps set appropriate expectations. Before visits, gently explain changes they might notice in appearance, breathing, or communication ability in terms they can understand.
Creating specific opportunities for participation gives children and teens a sense of purpose and connection. Depending on their age and comfort level, they might select music or photos for their loved one's room, share in reading favorite books, apply lotion to hands, or simply sit quietly holding hands. These experiences often become cherished memories later. Memory-making activities like recording stories, creating artwork together, or making keepsakes provide both immediate connection and lasting comfort.
As death approaches, children and teens benefit from clear, gentle communication about what to expect. Use direct language appropriate to their age, explain common end-of-life symptoms they might observe, and give them choices about their level of involvement. Research indicates that having the opportunity to say goodbye, whether through a final visit, a letter, or a special ritual, is important for healthy grief processing.
There are also many support groups and resources designed specifically for young people, such as Actively Moving Forward, a network designed to help teens experiencing grief. The Hospice Foundation of America has a full list of other programs designed for children and teens here.
While most children navigate the hospice experience successfully with family support, certain signs indicate the need for additional professional guidance. These include prolonged sleep or appetite disturbances, significant behavioral changes, withdrawal from previously enjoyed activities, or expressions of wanting to join the deceased person. Resources like school counselors, hospice bereavement specialists, and therapists specializing in childhood grief can provide valuable support.
The hospice team—particularly social workers, chaplains, and bereavement specialists—can provide guidance tailored to your family's specific situation. They can help you navigate conversations, suggest age-appropriate resources, and address concerns specific to your child's needs. Remember that there is no perfect approach; what matters most is moving forward with honesty, compassion, and a commitment to supporting the important children and teens in your family through this significant life transition.