How can children be taught about death and serious illness?

Arnsberg, Germany – The children at Kita Entenhausen Bruchhausen, a kindergarten in Arnsberg, West Germany, are playing on the swings.

When they are called back inside, some protest, but they perk up when they realise that it is reading time.

Anni Kunkenrenken, a 75-year-old volunteer at the kindergarten, welcomes them inside with a picture book which she reads about opa (grandpa in German), who visits an island and does not return. 

The book subtly portrays the death of a grandparent in a story about travel, which the four to six-year-olds listen to attentively until the end.

“Do you know where opa is?” Kunkenrenken asks in German, closing the book.

“Yes,” one of them answers.

“Is he okay?” she says.

“Yes,” comes the reply.

Unlike adults, children do not process information in one go, says Kunkenrenken, who has been volunteering with the kindergarten for about 10 years. 

“Perhaps when they listen to the story the second or third time, they might ask why grandpa didn’t return,” she says.

When parents failed to explain death to their children, they rushed to the kindergarten for help.

by Ulla Huser, head of the Kita Entenhausen Bruchhausen kindergarten

She picked the book from Kita Entenhausen Bruchhausen’s library, which has 200 children’s titles on ageing, dying and dementia. 

Two decades ago, when Arnsberg started bracing itself for demographic changes, Ulla Huser, the head of the kindergarten, opened the library with a modest offering of 10 books. Apart from parents, books can be borrowed by other kindergartens and primary schools, professionals who work on intergenerational projects and anyone else in the city.

Arnsberg – like all of Germany – has a large and growing elderly population. 

In 2012, for every 100 people between 20 and 64 years there were about 37 people over 65. By 2030, about 55 seniors are expected in the city for every 100 younger people.

One in 11 citizens in Arnsberg also has dementia.

When children’s grandparents died, Huser said they often sought support at the kindergarten.

“When parents failed to explain death to their children, they rushed to the kindergarten for help.”

For the most part, the children’s literature she had come across relied on tired stereotypes, “with grandma making marmalade in the kitchen and grandpa working in the cellar”.

“Children’s books need to keep up with the changing times and portray modern, realistic characters.”

Ten years ago, after the city launched its Fachstelle Zukunft Alter, or the department of Future of Ageing, the kindergarten received funding to add books that tackled the topic of dementia.

“Children feel for people in need,” says Professor Dr Andreas Kruse, director of Gerontology at the University of Heidelberg. “They can emotionally support them, with their special kind of sympathy.”

Introducing children to subjects including dementia and dying in school or even kindergarten can be a positive experience, he says.

Useful learning material, especially books, can prepare children sensitively, “as long as children are not overwhelmed emotionally and cognitively”, he adds.

At Kita Entenhausen Bruchhausen, children are introduced to stories about the death of a pet or dead worm on the wayside and are encouraged to talk about their own experiences.

“But they decide for themselves how they want to see things and how much they want to let themselves get involved, even if we adults have a different opinion about it,” says Huser.

“When sensitive situations arise, we provide appropriate input,” she says. 

For instance, when a four-year-old lost his father, the child neither cried nor spoke about it.

After a few weeks, he started drawing pictures of graves. 

“We could feel his restlessness and anger even as he played with other children,” says Huser.

Reading and talking to the child helped. 

“After a while, the child could identify his feelings as anger, because daddy didn’t go swimming with him any more, because he couldn’t play with him in the evening.”

The kindergarten has an open-door policy for seniors.

Karl Heinz Lorke, now 80, was stressed when he went into retirement.

“I didn’t want to sit at home and wondered what I could do to keep myself active,” he says.

He approached the Future of Ageing department, which suggested volunteering at the kindergarten. 

Whenever Lorke visits the kindergarten, he says he has fun because the children are so unapologetically outspoken.

“Once a little boy asked me my name and when I said I’m Karl Heinz, he replied: ‘Oh, what a sh***y name!’

“But they love me and often wrap their arms around my long legs to seek my attention,” he says. 

Studies have shown that three to four year olds who participated in intergenerational programmes displayed prosocial behaviour, like sharing, helping and cooperating with elderly people.

Huser reflects on an elderly contributor to her kindergarten, who has been around for over 10 years. 

“We have seen him develop dementia,” she says. 

Children have noticed that he often forgets the instructions he gave them, or sometimes repeats things several times.

Kids have now accepted this as his “forgetfulness” and still enjoy spending time with him. Some compare him to their grandparent who forgets what he ate for lunch as others have found people like him in books.

“They understand dementia, even though they don’t have a word for it,” Huser says. “I’m glad I have books that help them process what they observe.”

The reporting for this story was supported by a fellowship from the Robert Bosch Foundation.