Grief-Sensitive Communication: Patients, Families, and Care Partners
Communicating With Children About Grief
Talking with children about death and grief can feel challenging. Adults may feel that avoiding difficult topics, withholding information, or redirecting conversations is the best way to protect a child.
While this impulse is understandable, the discomfort of discussing a death or loss may stem as much from adult distress as from concerns about the child.
Without opportunities for discussion, children may be left with unanswered questions and greater confusion.
Grief-Sensitive Strategies and Language
Grief-sensitive communication can help children better understand a loss and feel supported as they navigate their grief.
The strategies below offer practical approaches for communicating with children in ways that promote understanding, emotional safety, and connection
Adapt Communication to the Child's Developmental Level
A child's developmental level can influence how they understand death and how they express grief. While individual experiences vary, understanding common developmental stages can provide a useful framework for tailoring grief-sensitive communication.
The following overview highlights general considerations that may help guide conversations following a loss.
Use Concrete Language
Euphemisms such as “passed away”, “went to sleep”, or “we lost them” can be confusing or frightening, and may make it harder for children to understand what has happened.
In this video, shared courtesy of WPSU, Julie Kaplow, PhD, ABPP, Executive Vice President of the Trauma and Grief Center at the Meadows Mental Health Policy Institute, explains why concrete language can help children better understand death and reduce confusion that may arise from euphemisms.
Being direct about death can help children understand what has happened and can reduce unnecessary confusion or anxiety.
Grief-sensitive language:
- “Death means the body stops working, so the person doesn’t breathe, eat, or feel any pain anymore.”
- “When someone dies, it means their body stopped working and they aren’t alive anymore.”
- “They died, which means they won’t be with us physically, and it’s okay to have lots of different feelings about that.”
Let Them Guide the Conversation
Talking with children about the circumstances of a death can feel overwhelming for caregivers. Many adults worry about saying too much or too little.
In this video, shared courtesy of WPSU, Dr. Julie Kaplow explains how allowing a child's questions to guide the conversation can help ensure they receive the information they need without becoming overwhelmed.
Following a child's questions can help caregivers provide information at a pace the child can understand and process.
Stay Curious About What’s Beneath the Words
Children’s questions can carry deeper emotional meaning. In this video, Dakota Becker, MSW, LCSW, Clinical Instructor of Social Work at the Yale Child Study Center, describes the importance of listening for the "question beneath the question" and responding with curiosity, honesty, and emotional attunement.
The examples below illustrate how curiosity can help healthcare professionals explore the possible meaning beneath a child’s question while avoiding assumptions about what the child is thinking or feeling.
"Have you ever had someone die?"
What might be beneath the question?
The child may be wondering whether anyone understands what they are experiencing or whether other people have gone through something similar.
Grief-sensitive response:
- "Yes, someone important to me has died. I wonder what made you think about that today?"
"Do you ever cry when you think about them?"
What might be beneath the question?
The child may be wondering whether it is okay to express strong emotions or whether other people experience feelings similar to their own.
Grief-sensitive response:
- "Sometimes. I’m curious if you asked that because maybe you’re wondering whether other people continue to have feelings about someone they miss.”
"Is it wrong to be mad at someone for dying?"
What might be beneath the question?
The child may be wondering whether their feelings are acceptable or whether something is wrong with them for feeling angry.
Grief-sensitive response:
- "Many people feel angry after a loss, even when they love and miss the person who died. I wonder what made you think about that."
"If Harry Potter is such a powerful wizard, why couldn't he save his parents?"
What might be beneath the question?
The child may be wondering whether someone could have prevented the death, wishing things had happened differently, or thinking about what it is like to lose a parent at a young age.
Grief-sensitive response:
- "That's an interesting question. I wonder what you're thinking about when you ask that."
A child’s question about death, another person's experience, or seemingly unrelated topic can sometimes provide clues about what a child is trying to express or make sense of.
It may also reflect a child's need for reassurance, connection, or validation.
Children do not always talk about grief directly. Questions about books, movies, superheroes, or other fictional characters may offer insight into a child's own thoughts, feelings, and experiences.
Grief educator and social worker Jill A. Harrington, DSW, LCSW, has explored how superhero origin stories and other fictional narratives can help people engage with grief and loss. Conversations about a character's experiences can sometimes feel safer than talking directly about personal experiences, creating opportunities to explore difficult topics with curiosity and connection.
When children raise questions about fictional characters, movies, books, or superheroes, it can be an opportunity to become curious about what the story may represent for them.
Check for Understanding
When sharing information or answering questions, pausing to check for understanding can help ensure the child is not left confused or overwhelmed and signals that questions are welcome.
Grief-sensitive language:
- “Does that make sense?”
- “Do you want me to explain more?”
- “Can you tell me what you heard me say?”
- “Do you want me to say that again in a different way?”
Respond With Honesty
When an answer isn’t clear, respond honestly and let the child know that some questions do not have clear answers or that adults may not know the answer. Authentic responses can help build trust and reinforce that communication remains open even when there are no simple answers.
“What happens after someone dies?”
Grief-sensitive language:
- “That’s a really good question. Different people believe different things, and I don’t know for sure. What I do know is that you can always ask questions, now or later, and we can talk about what you’re wondering.”
- "What do you think happens after someone dies? Have you thought about that?"
Avoid False Reassurance
When children ask about safety or future loss, it can be tempting to offer absolute reassurance. Grief-sensitive responses focus on what is true right now, while avoiding promises that cannot be guaranteed and still emphasizing care, support, and presence.
“Am I going to get cancer too?”
Grief-sensitive language:
- “Most children do not get cancer. Some people get cancer because of things happening inside their bodies, and doctors work hard to help keep people healthy. Right now, you are safe, and we can talk more if you’re worried.”
“Is my other parent going to die, too?”
Grief-sensitive language:
- "That’s an important question, and I’m glad you asked. Right now, your dad is healthy and plans to be with you for a long time. Everyone dies someday, but most people live for many years. And no matter what, you won’t be alone. There are people who love you and will take care of you.”
Normalize Curiosity
Naming curiosity as common and normal can reduce shame and help children feel more comfortable continuing to ask questions.
Grief-sensitive language:
- “A lot of kids wonder about that.”
- “It makes sense to be curious about this.”
- “These questions are normal and it’s okay to ask them.”
Grief-Sensitive Communication Around Stigmatized Loss
Stigmatized loss refers to grief that is dismissed, judged, or met with shame or silence, such as losses related to suicide, overdose, or homicide. In these situations, the instinct to protect children can feel especially strong, often leading adults to withhold or soften information out of concern for harm.
Before responding, it can be helpful for healthcare professionals and other caregivers to pause and consider their own thoughts, feelings, and intentions.
The desire to shield children from painful information is often rooted in care and concern. Some grief professionals describe withholding information as an "error of kindness" because it is intended to protect but can sometimes leave children confused or excluded.
This can be an opportunity to practice mentalizing—becoming curious about what may be happening in both one's own mind and the child's mind.
Before responding, pause and consider what thoughts, feelings, or worries may be influencing the urge to protect. It can also be helpful to consider what the child may already be noticing, wondering about, or trying to understand.
Taking a moment to reflect, or talking through concerns with a trusted support person, can help adults respond with greater clarity, honesty, and emotional presence.
Honest communication that is adapted to a child's developmental level can help children understand what has happened and support healthy adjustment following a loss.
Suicide
Age-appropriate explanations that focus on illness rather than intent can help children understand what happened without assigning blame. Reassurance that the child did not cause the death is essential for reducing guilt and fear.
“Did they die because they wanted to?”
Grief-sensitive language:
- "They died because their brain was very sick, and it affected how they thought and felt. That sickness can make people feel trapped or overwhelmed. It wasn’t because of anything you did, and you couldn’t have stopped it.”
Overdose
Language that avoids moral judgment and acknowledges struggle helps counter stigma and confusion.
“Why did they take drugs if they’re bad?”
Grief-sensitive language:
- “Some substances can make people feel better for a short time, especially when they’re hurting or struggling, but they can also make the body very sick. Sometimes people don’t realize how dangerous it can be, or they can’t stop even when they want to.”
Homicide
Clear, direct language paired with reassurance about safety can help children feel grounded. Avoiding unnecessary details while affirming that the harm was not the child’s fault helps reduce fear and distress.
“Did someone hurt them?”
Grief-sensitive language:
“Yes. Another person caused their death. What happened was not okay, and it wasn’t your fault. Right now, you are safe, and there are adults working to keep people safe.”
Address Feelings of Responsibility
No matter the circumstances of the loss, children may wonder or assume that a death was their fault, even when it was not. Gently naming this possibility and clearly reassuring them that they did not cause the death can help reduce guilt and correct misunderstandings about responsibility.
Grief-sensitive language:
- “Sometimes kids wonder if they caused what happened. I want you to know this was not your fault.”
- “Nothing you did, said, or thought made this happen.”
- “Even if you were mad, wished something different, or didn’t get along sometimes, that did not cause the death.”
- “It’s common to have these thoughts, and it’s okay to talk about them. You didn’t do anything wrong.”
Supporting Children Through Non-Death Losses
Grief-sensitive communication remains important even when no death has occurred. Children can experience grief following many types of losses, including divorce, family separation, foster care placement, serious illness or injury, changes in ability, loss of a home, or the absence of an important relationship.
The same grief-sensitive principles can be beneficial for non-death losses: honest, age-appropriate communication, opportunities to ask questions, and the presence of trusted, caring adults.
Caregiver Illness or Injury
"Why can't my mom do the things she used to do?"
Grief-sensitive language:
- "The illness has changed some things for your mom, and some activities are harder right now."
- "It can be hard when someone you love isn't able to do the things they used to do."
"Will things ever go back to normal?"
Grief-sensitive language:
- "Some things may get better, and some things may stay different."
- "It's okay to miss how things used to be and to wonder about what comes next."
Changes in Ability
"Why can't I play soccer anymore?"
Grief-sensitive language:
- "Your body has been through a lot, and some things may need to change for now."
- "It's okay to feel disappointed, angry, or sad about losing something that was important to you."
Hospitalization or Separation from Family
"Why do I have to stay here?"
Grief-sensitive language:
- "The doctors and nurses are working to help your body heal and keep you safe."
- "Being away from home can be hard, and it's okay to miss the people and places that are important to you."
A Grief-Sensitive Example
In this episode from the podcast Good Inside offers a compassionate, practical framework for talking with young children about cancer. Through a real conversation with a parent, Dr. Becky Kennedy, PhD, a clinical psychologist, models how honesty, clear language, and emotional presence can help children feel less alone and less confused when facing serious illness in their family.
Normalize Different Expressions of Grief
Children may notice differences in how they and others respond to loss and may worry that their reactions are wrong. Grief-sensitive language helps normalize these differences and reassures children that there is no single “right” way to grieve.
“I didn’t cry when they died.”
Grief-sensitive language:
- "That’s okay. People show grief in different ways, and not crying doesn’t mean you didn’t care. You’re not doing anything wrong, and whatever feelings you have, now or later, are okay.”
“My brother likes to talk about my dad, but it makes me sad so I don’t like to.”
Grief-sensitive language:
- “That makes sense. People grieve in different ways. It’s okay that talking helps your brother and that you don’t want to right now. You’re not doing anything wrong, and you can choose what feels right for you.”
Creating Safety Through Grief-Sensitive Communication
Talking with children about grief does not require perfect words.
What matters most is age-appropriate honesty, responsiveness, and presence.
Clear language, openness to questions and feelings, and a willingness to follow the child's lead can help children make sense of loss in ways that feel manageable and safe.