How to Teach Adults to Talk to Their Children About Advanced Disease and Impending Death.

As part of Palliative Care McGill’s speaker lineup for National Palliative Care Week 2025, social worker Vivian Myron (MSW, TS) taught participants how to approach this difficult subject in her talk, “Mommy is Very Very Very Sick . . . How to Teach Adults to Talk to Their Children About Advanced Disease and Impending Death.”

Lexa Frail (LF): Can you tell us a bit about your National Palliative Care Week talk?

Vivian Myron (VM): I work in the palliative care unit at the Jewish General Hospital, and I feel privileged to support young families navigating end-of-life care. Many of our patients are parents with children under 18, and sadly, it seems that this population is growing. Far too often, these children haven’t been told about their parent’s illness until just days—or even hours—before their death.

Because we are in an acute care hospital, hospitalizations are usually brief. Families often arrive in crisis, with little time to adjust. And when we ask what the children have been told, we often find that they’ve been kept in the dark. Understandably, this can be devastating for them.

My goal with this talk is to demystify the process of teaching adults how to talk to their children about serious illness and impending death. Yes, it feels difficult—but it isn’t complicated.

There are simple, effective techniques that can help guide these conversations, and I want to share those tools. More importantly, I want to explain why it matters to speak with children early and honestly.

Research clearly shows that children—especially young ones—who lose a parent are at heightened risk for trauma. The loss stays with them for life. If the information they receive is poorly managed, that trauma can deepen. But when we communicate thoughtfully, we can reduce some of that burden. We can help children make sense of what’s happening in a way that supports their healing, rather than adding confusion and fear.

When a patient has a potentially terminal diagnosis and young children at home, the medical team has a role to play. It’s not about telling parents what they “have to do,” but about offering gentle, common-sense guidance that resonates. We need to meet families where they are—acknowledging their deep love and desire to protect their children.

Most often, the decision not to tell a child comes from a place of love. Our job is to support that love while helping them understand why openness, at the right time and in the right way, is also a profound act of protection.

LF: I can see parents getting that impression, given how taboo a subject death is. I also imagine that a one-size-fits-all approach to this subject doesn’t work.

VM: No, there’s no one-size-fits-all approach.

Every person brings their own cultural lens, belief system, and emotional response to the table. At the same time, we share some core human truths—love for our children, our shared humanity, the fact that we all have a soul.

These commonalities give us a foundation to start from, even when the topic is difficult.

Talking about death doesn’t become easier just because we know it’s important. But when people begin to understand why it matters to be honest with children, it starts to make sense. Respect is crucial—parents know their children best. If we approach them with judgment or rigid rules, we’ll lose them.

Everyone grieves in their own way. And in palliative care, by the time families arrive, they’ve already started grieving. We call it anticipatory grief. It begins, for example, with a cancer diagnosis—you start mourning the healthy self you believed you were. That diagnosis inevitably brings the thought of death, even if it’s just a flicker.

That doesn’t mean you should scare your child or immediately talk about dying. But it does mean you should be brutally honest—something like, “Mommy has an illness, and she’s getting treatment.” Because when kids hear the truth from someone in the schoolyard, it’s not only shocking—it’s damaging. I’ve seen children blindsided like that, and it’s heartbreaking.

Children learn from how we navigate hard truths. If you’re the kind of parent who tells them the truth—gently, but honestly—you’re teaching them to trust you. But if we treat big things like secrets, they learn to hide things, too. It’s common sense, but we don’t always think about it.

I’m constantly struck by adults who lost a parent when they were young. Many validate what I teach—especially those who were left in the dark. One woman shared that growing up with secrets made her deeply distrustful of everything she was told. That’s a heavy burden to carry through life.

LF: Is there anything that you want your audience to know about youth grief specifically?

VM: That it’s not the same as adult grief. Children process through play. Their grief can look like puddle-jumping—fine one moment, devastated the next. Every child grieves differently, just like adults. But adults often misunderstand this. At funerals, for example, kids might be outside running around, laughing, playing—and some parents worry, “What’s wrong with them? Their father just died.” But that’s healthy. That’s a child coping. The red flag isn’t laughter—it’s when a child can’t climb out of their sadness. That’s when they may need professional support.

LF: Is there anything else you want to add?

VM: I hope this message reaches beyond those who already understand. I want it to resonate with the people who could benefit to hear it. I’d especially love to see more residents from oncology, cardiology, pulmonary, and neurology take part in these conversations. Many of their patients are young adults with families, facing serious illness—and those providers and the interdisciplinary team play a very important role. They need to know how to help guide families through these conversations.

Vivian Myron’s talk took place on Friday, May 9, at the Jewish General Hospital and on Zoom.