Talking to Children About What’s Happening

“My seven-year-old asked me why Grandpa didn’t recognize her anymore. I told her the truth as simply as I could: that Grandpa’s brain was sick, that it made him forget things, that it wasn’t her fault, and that he still loved her even when he couldn’t show it the way he used to. She nodded and said, “Okay. Can I still hold his hand?” I said yes. She did. He smiled.” — Angela, 44 When a grandparent is aging or ill, the children in the family are also living through something. They see the changes. They feel the anxiety in the adults around them. They draw conclusions — often frightening, often inaccurate — from what they observe and from what they are not told. Children who are not given honest, age-appropriate explanations do not stop noticing or worrying. They simply do so without the context that would help them understand and cope. Research on children and grief consistently shows that children who are included in honest family communication about illness and death fare better than those who are excluded. They feel less anxious, less confused, and less alone. They are also better able to participate meaningfully in the relationship with the grandparent while it continues, which benefits the grandparent as much as the child. What Children at Different Ages Can Understand Very young children (roughly 3 to 6): Very young children understand the world primarily through what they can see and feel. They need reassurance and simple, truthful language — not detailed medical explanations and not elaborate euphemisms that obscure what is actually happening. “Grandma’s body is having trouble working the way it used to. Her brain sometimes gets confused. It’s not because of anything you did. We still love Grandma and she still loves us.” Answer the same questions patiently as many times as they ask. They are not failing to understand. They are processing something large, and repetition is how children process. Elementary-age children (roughly 7 to 11): Children in this range can understand more complex explanations and often want them. They are also highly attuned to what adults are feeling and will sense when they are being told less than the full story. Being honest with them is not just kind — it is a prerequisite for their trust. “Grandpa has a disease called Alzheimer’s. It affects his brain. It makes him forget things, sometimes even people he loves. It doesn’t mean he doesn’t love you. The disease is going to keep getting worse, and eventually it will be what causes Grandpa to die. But we’re going to keep visiting. We’re going to keep being his family.” Alzheimer’s is not contagious. Children do not cause it. Answer specific questions directly. Teenagers: Teenagers can understand adult-level explanations and often appreciate being treated as capable of handling honest information. What they most resist is the pretense that nothing is wrong — the performance of normalcy that they can see through and that makes them feel excluded and alone with their own feelings. Including teenagers in honest family conversations, even difficult ones, tends to produce more support and more engagement than keeping them on the periphery. Teenagers who are given a meaningful role in the caregiving family — a specific responsibility, a genuine contribution — often look back on it as one of the most formative experiences of their adolescence. Keeping the Relationship Going Children — particularly young children — are often remarkably natural with grandparents who have dementia, less frightened by the changes than adults, less caught up in what has been lost, more able to simply be present in the current moment. A grandmother with advanced Alzheimer’s who no longer consistently recognizes her adult daughter may still light up when a five-year-old grandchild comes in with a drawing. Simple activities work beautifully in this context: looking at old photographs together (which can stimulate memory and connection even in people with significant cognitive decline), listening to familiar music, holding hands, doing a simple craft, just sitting together in shared quiet. These activities do not require sustained cognitive engagement. They provide real human connection. And the child who experiences them is being given something irreplaceable: a relationship with their grandparent as they actually are, not only as they once were. Angela and Sophie: being glad for the ordinary visits Sophie was seven when my father’s dementia reached the point where he no longer recognized her consistently. I dreaded the visits. I thought they would be too hard for her. But Sophie kept asking to go. She’d bring him drawings — pictures of their dog, pictures of the house, pictures of things she thought he would like to see. He didn’t always know her name, but he always smiled at the pictures. The last visit before he died, she climbed onto the bed next to him and told him about her week, matter-of-factly, as if he understood every word. Maybe he did. When he died, she was sad but she wasn’t afraid. She said to me: “I’m glad I got to tell him about my week.” So am I. PART SIX Taking Care of Yourself Because none of this works if you don’t