After a parent passes away, tell the child the truth and support attending farewells

Children who lose a father or mother before age 18 have a mortality rate in early adulthood that is roughly 50% higher than those who have not experienced such a loss. If the death was due to unnatural causes such as accidents or suicide, the risk rises by about 80%. If it was due to illness or other natural causes, the risk is about 30% higher. This is not something a child simply forgets after a few days; the effects can last many years. The American Academy of Pediatrics recommends explaining what happened truthfully, dispelling misunderstandings, and supporting the child to attend funerals or memorial services.

There is no monetary cost. The difficulty lies in the fact that you yourself are grieving, yet you must still explain things clearly to your child.

This data includes the entire populations born in Denmark from 1968 to 2008 and in Sweden from 1973 to 2006, plus 89.3% of those born in Finland from 1987 to 2007 — a total of over 7.3 million people. Among them, 189,094 lost one or both parents before age 18. Their overall mortality rate is 50% higher than that of peers who have not experienced such a loss (mortality ratio 1.50, 95% CI 1.43–1.58, roughly 1.5 times higher). For deaths caused by unnatural reasons, the ratio is 1.84 (1.71–2.00), an increase of about 80%. For deaths due to natural causes, it is 1.33 (1.24–1.41), a rise of about 30%. The risk is highest when the child’s cause of death matches that of the parent.

When speaking to your child, do not make up stories such as “Mom or Dad has gone away on a trip.” Any arrangements regarding guardianship and upbringing must be put in writing. Whether to transfer schools or send the child to live elsewhere has no direct trial or guideline literature; the author's assessment is that minimizing unnecessary upheaval in the child's daily routine is generally advisable. This recommendation is graded B not because the figures lack solidity; these statistics come from longitudinal studies of entire populations in three countries, which would merit an A rating on their own. The lower grade reflects the absence of direct experimental evidence linking these mortality figures to specific ways of communicating with children or involving them in funerals. The authors also point out that data on parent-child relationships and children’s lifestyles after such a loss are lacking. Both genetic factors and long-term effects of bereavement contribute to these elevated mortality rates. Details on designated guardians and property arrangements can be found in Section 17, while information on child support and schooling is covered in Section 18.

Li J, et al. (2014). Mortality after parental death in childhood: a nationwide cohort study from three Nordic countries. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1001679；Schonfeld DJ, Demaria T, Committee on Psychosocial Aspects of Child and Family Health, Disaster Preparedness Advisory Council (2016). Supporting the Grieving Child and Family. Pediatrics, 138(3), e20162147. https://doi.org/10.1542/peds.2016-2147