How to talk to teenagers about Grandpa dying, and what to tell the younger kids about Grandma's decline
Short scripts, by age, for three different conversations: a grandparent who is declining, a grandparent with dementia, and a grandparent who is dying. Plus the questions your kids will ask and which of them belong to the care team, not to you.
Nobody teaches you how to talk to teenagers about Grandpa dying, or what to tell the kids about Grandma's decline, and by the time you need the words you are usually standing in a kitchen at 9pm having just gotten off the phone with a nurse. So here are the words. They are short because kids stop listening after the second sentence, and they are honest because kids can tell when they are not. Adjust them for your family and your faith. Do not adjust them toward comfort at the expense of the truth, because a teenager who catches you softening one thing will assume you softened everything.
Three rules before any script
- Tell the truth at their size. A twelve-year-old needs to know what is happening this week. An eighteen-year-old can hold the whole arc. The facts do not change. The amount does.
- Do not promise outcomes. Not she will be fine, not he has months, not this will not happen to me. Every one of those is a promise you cannot keep, and the Alzheimer's Association's guidance for families says learning about a grandparent's condition in an age-appropriate way can help children understand what to expect. What to expect is not the same as a promise.
- The how-long and what-will-it-look-like questions go to the care team. You can carry a question to a doctor or a hospice nurse. You should not answer it yourself.
At 12
At 15
At 18
An eighteen-year-old gets the adult version, with one exception: you still do not make them the adult. They are leaving for college or a job or a gap year, and the guilt of leaving while a grandparent declines is its own thing. Say plainly that the timing is bad and that leaving is still right. Then give them the arc: what the doctor has said, what hospice is if hospice is involved, and what you expect the next semester to look like. Tell them who is covering Grandma's afternoons so they do not quietly decide it has to be them.
The words for dementia
Use the real word once your kid is old enough to look it up, which is about eleven. The National Institute on Aging says dementia is more common with age, that about one-third of all people age 85 or older may have some form of dementia, and, in the same breath, that it is not a normal part of aging. Both halves matter to a teenager: it is common enough that their friends' grandparents have it too, and it is an illness, not just Grandma getting old. The Alzheimer's Association suggests activities they can still do together, cards, a walk, music, and the point is not the activity. The point is that the kid stays a grandchild instead of becoming a visitor.
The words for hospice
Kids hear hospice and think it means today. It does not. Under Medicare, hospice is care for a person whose hospice doctor and regular doctor certify is terminally ill with a life expectancy of 6 months or less, who has chosen comfort care instead of care to cure the illness. The National Institute on Aging says the same thing in plainer words: hospice is for a person whose doctor believes he or she has 6 months or less to live if the illness runs its natural course. Tell a teenager that hospice is a team that comes to the house so Grandpa can be comfortable there instead of in a hospital, and that months is the frame, not days. Then tell them the nurse is the one who will know when that changes. If you are trying to keep a parent at home through hospice, Hospice at Home Help is a sibling desk written for exactly that stretch.
The questions they will ask, and where each one goes
Is Grandpa going to die?
If hospice is involved, yes, and say so. His doctors think so, and the team's job is to keep him comfortable at home. If nobody has said that yet, the answer is that you do not know, that his doctors do, and that you will tell them what you learn when you learn it.
When is it going to happen?
This one does not belong to you. Do not guess. Offer to ask the hospice nurse or the doctor, and offer to bring the teenager along if they want to hear it firsthand.
Is it my fault, or will this happen to you?
Not their fault, ever, and say it flat. Nothing they did or skipped caused it. Whether it will happen to you is a doctor's question, and the honest answer is that you do not know and will not pretend to. Do not promise it will not. Do not hint that it will.
Can I still see her, and do I have to?
Yes, and no. Visiting is allowed, encouraged, and never required. A kid who cannot face Grandma this month is not failing her.
Grief starts before the death
The Hospice Foundation of America describes grief as a reaction to loss that, like a fingerprint, is different for everyone, notes that grieving can begin before a death as an illness progresses, and says that children and adolescents grieve too, from deaths and from losses that are not deaths. Your kid is already grieving the Grandma who remembered their birthday. Let them. And if Grandma's illness is dementia and you need a person at 2am, the Alzheimer's Association runs a 24/7 Helpline at 800.272.3900, free, around the clock, every day of the year.
What to do tonight
- Pick the script for the kid's age and say it before bed. Two sentences. Stop talking. Let them leave the room if they need to.
- Write down the two questions you could not answer. Those are the ones you carry to the doctor or the hospice nurse this week.
- Tell the eighteen-year-old who is covering the afternoons, so they do not decide it is them.
- If Grandma's illness is dementia and it is late, the Helpline is 800.272.3900.
When to ask the care team or the doctor
Everything about how long, what the next stage looks like, what a new symptom means, and whether anything can be done differently belongs to Grandpa's doctor or the hospice nurse, and they are used to teenagers in the room. If a younger kid's questions are outrunning what you know, ask the care team whether they can talk to the child directly. Nothing on this page is a prognosis. It is a way of repeating, at a kid's size, what the people who treat your parent have already told you.
A note on help in the house: if you want a person at Grandpa's or Grandma's home in the afternoons so that the kids' time there is time with her rather than chores for her, New Plan Care, the paid placement disclosed on this site's homepage, is one independently owned non-medical company in west county. It is not hospice and it is not a care team. Call (314) 405-0887.