Communication Vignettes: Telling a child that her dad is dying

Clinical skills
First published in this online journal
Declaration of interests: 
Vicky Robinson and Nathalie Asmall
Author profile (accurate when this article was originally published): 
Vicky Robinson, Consultant Nurse in Palliative Care, and Nathalie Asmall, Psychotherapist, Psycho-Oncology Support Team, Dimbleby Cancer Care, Guy’s and St Thomas’ NHS Foundation Trust, London. Emails: vicky.;

Traditionally, palliative care emergencies are associated with physical, often reversible, clinical signs (e.g. spinal cord compression and hypercalcaemia). However, palliative care practitioners can sometimes find themselves in a situation where there is an urgent need to communicate with a family member or friend of a terminally ill patient (Pickering and George, 2007). Nurses working in hospitals, care homes and community settings are often involved in end-of-life conversations and thereby play an important role supporting families facing loss (Jeffreys, 2005). There is a paucity of information in the palliative care literature on how to talk to children when a parent is dying. According to Chowns (2009), healthcare professionals are often reluctant to engage in such conversations because:

  • The forthcoming death of a parent challenges the perception that childhood is a time of innocence and their instinct is to protect children from painful experiences
  • They lack confidence when it comes to relating to a child’s conception of the world
  • They worry that talking to a child about death will potentially cause more harm to the child.

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