| Age | Usual Understanding of Death |
|---|---|
| Birth–1 yr | No concept. |
| 1–3 yr | Believes death is temporary and reversible. May believe his or her thoughts or unrelated actions caused another’s death. |
| 4–8 yr | Begins to understand permanence of death. May view death as separation. May worry about effect of own death on family. |
| 8 and older | Understands permanence of death and begins to face reality of own mortality. |
Nursing Considerations
The dying child should be allowed to ask questions regarding his or her condition. Before formulating specific answers, the nurse should determine the child’s understanding of his or her condition and his or her understanding of death, as well as his or her coping strategies and the family’s wishes.
Siblings as well as parents of the dying child often feel great guilt and may believe that they are responsible for the child’s condition. It is important for both siblings and parents to be allowed liberal visitation privileges.
The nurse should be certain that the family and the child have access to support from a member of the clergy of their religious preference and that the performance of religious activities not be hindered.