TABLE 3.1 General Suggestions for Age-Appropriate Communication for Dying Children


AgesMain concept of deathCommunication approach

0-2NoneProvide maximum physical relief and comfort
2-7Death is reversible, a temporary restriction, departure, or sleepMinimize child's separation from parents. If parents unavailable, provide reliabe and consistent substitute.
Correct misperceptions of illness as punishment for bad thoughts or actions. Evaluate for feelings of guilt, resentment.
7-11/12Death is irreversible but capriciousEvaluate for fears of abandonment, destruction, or body mutilation. Be truthful and open. Provide details about treatment. Reassure that treatments are not punishments. Maintain access to peers. Foster child's sense of control, mastery.
12+Death is irreversible, universal, personal, but distantReinforce comfortable body image, self-esteem. Allow ventilation of anger. Provide privacy. Support reasonable measures for independence. Be clear, honest, and direct. Maintain access to peers.Consider mutual support groups.

SOURCE: Adapted from Wass, 1984. Used with permission.


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