Baby

Babies have no concept of death. Babies do react to separation from a parent, painful procedures, and any change in their routine. A baby who is terminally ill will need as much physical and emotional care as any age group. Keeping a consistent routine is important for a baby and their caregivers. Babies can't talk about their needs. So they often express fear by crying.

Toddler

For the toddler, death has very little meaning. They may feel anxious and afraid because those around them are sad, depressed, scared, or angry. Toddlers may not understand the terms "death" or "forever" or "permanent." Even with past experiences with death, the child may not understand the relationship between life and death. To them, death is not permanent.

Preschool

Preschool-aged children may start to understand that adults fear death. This age group may view death as short-term or reversible, as in cartoons. Death is often explained to this age group as someone "went to Heaven." Most children in this age group don't understand that death is permanent. They don't know that everyone and every living thing will die. And they don't know that dead things don't eat, sleep, or breathe. Death should not be explained as "sleep." 

Young children's experience with death is influenced by those around them. They may ask questions about why and how death happens. The preschool child may feel that their thoughts or actions have caused the death, and the sadness of those around them. They may feel guilt and shame.

When children in this age group are seriously ill, they may think death is a punishment for something they did or thought. They don't understand how their parents couldn't have protected them from this illness.

Preschool-age siblings of a dying child may also feel they are the cause of the illness and death. Young siblings of dying children need reassurance and comforting during this time, too.

School-age

School-aged children have a more realistic view of death. They may see death as an angel, skeleton, or ghost. But this age group is starting to see death as permanent. They know that everyone dies. They may be very curious about the physical process of death and what happens after a person dies. They may fear their own death because they don't know what happens after they die. Fear of the unknown, loss of control, and separation from family and friends can be the main sources of anxiety and fear related to death.

Teen

As with people of all ages, past experiences and emotional development greatly influence a teen's concept of death. Most teens understand that death is permanent, and that everyone dies. Some may have experienced the death of a family member, friend, or pet.

Teens, like adults, may want to have their religious or cultural rituals observed.

Most teens are starting to establish their identity, independence, and relation to peers. A main theme in teens is feeling immortal or being exempt from death. Their realization of their own death threatens all of these objectives. Denial and defiant attitudes may suddenly change the personality of a teen facing death. Teens may feel they no longer belong or fit in with their peers. They may also feel that they can't talk with their parents.

Self-image is also important to teens. A terminal illness or the effects of treatment may cause many difficult physical changes. Teens may feel alone in their struggle, and scared, and angry.

It's important for parents to realize that children of all ages respond to death in unique ways. Children need support. They need someone who will listen to their thoughts, reassure them, and ease their fears.