Developmental Stages & Reactions to Death
Children Under Two Years of Age
 May sense that something is wrong
 Sense the emotions around them
 May react physically: change in sleeping, eating, bladder/bowel function, irritability
** Need physical reassurance, care, and affection; keep a routine
Three to Five Years of Age
 Escape into play for relief from the reality of the illness
 Increased aggression, acting out, fear of other illnesses
 Regressive behavior: bed-wetting, thumb-sucking, tantrums, etc
 May fear that someone else may become seriously ill
 May attach to substitute people- neighbor, teacher
 View changes as temporary
 Have difficulty understanding “the illness”
** Need honest answers, reassurance, love, daily routine, and structure.
Five to Ten Years Old
 Begin to understand the seriousness of “the illness”
 Fatality of illness seen as accidental and happening to others
 Increased fear of other loved ones becoming ill, possibly dying
 May feel angry or may wonder “Did I cause this to happen?”
 Difficulty expressing feelings in words
 Feelings are expressed through behavior – acting out, difficulty in school, poor concentration
 Ask concrete questions
** Need stability, honest, accurate information about circumstances, keep routine
Ten to Eighteen Years Old
 Recognize impending death as final and universal to all things
 Tend to hide feelings
 May attempt to take on role of the sick person
 Fears for the future
 Denial: Try not to think about it, don’t want to talk about it
 Peers are an important source of support
 May feel anger, repress sadness, feel depressed
 Religious belief may be questioned
 Fear their own immortality; and “test” it through risk-taking
** Need consistency from parents, encourage opportunities for expression, but
don’t push, provide teen with honest answers to questions
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