How to Talk to Kids About a Grandparent's Declining Health

Your five-year-old might point out that Grandpa isn’t as fast as before. Your ten-year-old might notice the same things that Grandma asks them to repeat herself. Or, your teenager might say nothing during a visit home or afterward.

You are often left wondering what to say next. You might feel the urge to guard against their sadness but realize they might not want that. You don’t want them to worry. But there is no point in denying what has been happening for them to guess. Because they probably have a sense something is off about the grandparent they know and love already. They do not need a shield from the truth, they need your kind, truthful words, and the assurance that loving someone doesn’t just stop when their body or their mind becomes slow.

This article will explore how you can talk to your kids about a grandparent’s failing health and how it can look at any age, what you can or cannot say, and how you can keep the bond between grandchild and grandparent even when it feels shaky or impossible.

Why Honesty Matters More Than Protection

We naturally want to shield our kids from the hard, unvarnished facts. However, according to the American Academy of Pediatrics, children who receive accurate and age-appropriate responses to a loved one’s poor health are better equipped to cope than kids who are kept in the dark.

Kids pick up on a lot of things. When Grandma stops driving or Grandpa moves to a new building, the children know something is different. Without an explanation, they tend to assume the worst. Perhaps there’s something they did to hurt Grandma, or Grandpa is contagious, or perhaps they’ll get sick too.

“The reality of what death and life mean, and learning to grieve well, can help to decrease the likelihood of developing anxiety, depression, and other mental health conditions that are often exacerbated by traumatic life events,” Dr. Monica Guirguis, a pediatrician at Arnold Palmer Hospital, said.

Talking to them opens the door for them to understand what’s going on but also lets them know that big feelings are okay and they have their family behind them through it all.

What to Say at Every Age

Every family situation is different, but your child’s age will give you an indication of how detailed a response they want to have and what type of words to choose from.

Toddlers and Preschoolers (Ages 2-5)

Kids this young understand in a very literal and concrete way. Keep your answers direct and succinct. And avoid phrases that don’t translate easily like “Grandpa is going away” or “Grandma is losing her mind.”

You can say:

• “Grandpa’s body is getting older, and now there are a lot of things that are harder to do for him. He’s no longer able to play with you the way he used to, and he can’t run or pick you up. But he still loves playing with you.”
• “Grandma’s brain has a sickness that makes it harder to remember things sometimes. She might not remember who you are, but she is always really happy to see you.”

What to expect: They will ask for clarification. Repeat what you’ve said and ask them what they think about it. A toddler may respond by wetting the bed, or become overly clingy. These are normal responses to stress in toddlers.

Grade-Schoolers (Ages 6-10)

Kids this age start to reason logically. They like the facts and will sometimes ask you difficult or direct questions (prepare for, “Will Grandma die?”) without flinching.

What to say:

• “Grandpa has arthritis. It means his joints hurt, especially the ones in his hands and knees. That is why he is using a walker now, but doctors can help to make those joints feel better.”
• “Grandma has dementia. This means that the part of her brain where memories are stored isn’t working right anymore. It can mean that she will ask you the same question three times, or not know what day it is, or even not recognize you. It isn’t because she doesn’t love you. Her brain just doesn’t work like it did before.”

What to expect: School-age children can also play the role of “helper.” If they know about Grandpa’s condition, they can research the condition, make Grandma a card, or visit more often. This is positive. They also may worry about Mom or Dad getting the same illness, so be ready to be calm and reassuring in that way.

Tweens and Teens (Ages 11-17)

Older kids can take more detail. They can also withdraw or pretend they do not care more often. This is less about disliking Grandma than the way they are coping with it.

What to say:

• “I want to be honest with you about Grandpa. His Parkinson’s is progressing, and you’ll probably notice more changes when we visit. He may shake more or have trouble speaking. That can be hard to see, and it’s okay to feel however you feel about it.”
• “Grandma’s memory is getting worse. There may come a time when she doesn’t recognize us. That does not change how much you love her, or how much she loved you. Right now, when you call her, she is very happy to hear you on the phone.”

What to expect: Teens may process through silence, journaling, or talking to friends rather than parents. Give them space, but check in regularly. Some teenagers feel a deep sense of urgency to spend time with their grandparent once they understand the situation. If you’re struggling with what to talk about during visits with aging parents, your teen likely is too — sharing your own conversation strategies can help.

How to Explain Memory Loss and Dementia

Dementia deserves its own conversation because it’s one of the most confusing conditions for children to witness. A grandparent who doesn’t remember your child’s name, repeats the same story five times, or becomes agitated during a visit can be frightening.

Frame it as a brain condition, not a choice

Children need to know that Grandma is not making a choice to forget. Tell them that the brain has different parts responsible for different things, and the part that stores memories is getting sick. The part that has feelings and makes love? That’s one of the last to go.

Prepare them before each visit

If your child does not see their grandparent regularly, the changes between visits can be jarring. Before each visit, give a brief update: “Grandma may not know that you started middle school. You can tell her again — she’ll be happy to hear it, even if she heard it last time.”

Give them tools for the moment

Teach kids a few simple strategies:

• Don’t correct. If Grandma calls them by the wrong name, it’s okay to gently say, “It’s me, Emma,” without making it a big deal.
• Go with the flow. If Grandpa tells the same story, listen like it’s the first time.
• Use touch. Holding hands, sitting close, or giving a hug communicates love even when words fail.

According to the Alzheimer’s Association, children who are prepared and supported through a grandparent’s dementia tend to develop greater empathy and emotional resilience.

What Not to Say

Just as important as finding the right words is avoiding the wrong ones. Here are phrases that can confuse or frighten children:

Avoid	Why	Say Instead
”Grandpa is going away”	Implies abandonment or choice	”Grandpa is moving to a place where nurses can help him every day"
"Grandma is losing her mind”	Terrifying mental image	”Grandma’s brain has a sickness that makes it hard to remember"
"Don’t worry about it”	Dismisses real feelings	”It’s okay to feel worried. I feel that way sometimes too"
"Be strong for Grandpa”	Teaches emotional suppression	”It’s okay to feel sad. Grandpa would want you to be yourself"
"You’ll understand when you’re older”	Excludes and frustrates	”Let me explain it in a way that makes sense”

When Your Child Doesn’t See Grandparents Often

This question is often asked when families are separated geographically. If you and your children can only see their grandparent two or three times a year, then the child may not understand the difference in their grandparent’s behavior between visits. The differences can be huge from December to July. At Christmas, the grandparent might be tending to his flowers, and in the summer he is sitting in his wheelchair watching television. Here’s what you can do:

• Share updates gradually. Don’t wait until the next visit to explain all the changes at once. Explain them along the way. Weave brief updates into everyday conversation: “I talked to Grandpa today. He’s using a walker now, which is helping him get around more safely.”
• Use photos and video calls. Regular visual contact helps children adjust to gradual changes instead of facing a sudden shock. Even short calls where Grandpa just waves and smiles keep the connection alive.
• Send and receive letters. Writing to a grandparent gives children a way to maintain the relationship on their own terms. A monthly update with drawings, school stories, and photos becomes something the grandparent can hold onto. Services like Hug Letters make it easy to send a printed family newspaper to grandparents each month, keeping them connected to everyday moments they might otherwise miss.
• Prepare before in-person visits. A week before a visit, show recent photos of the grandparent and remind your child of any changes. This reduces the shock of seeing someone who looks or acts differently than they remember.

If you’re looking for more strategies for staying connected across the miles, our guide to long-distance grandparenting has additional ideas.

Keeping the Bond Strong During Decline

A grandparent’s physical and mental deterioration does not necessarily mean that their relationship with their family will deteriorate. Some of the best connections happen when families lean in rather than pull away.

Adapt activities to current abilities

Activities that you or the child and grandparents once enjoyed may not fit the bill anymore. That’s okay. You can find new shared activities that match the grandparent’s current abilities:

• Limited mobility: Board games, puzzles, reading together, looking at photo albums
• Memory loss: Singing familiar songs, gentle sensory activities, hand massage
• Low energy: Short visits during the grandparent’s best time of day, watching a favorite show together
• In assisted living: Bringing a simple craft, sharing a meal, walking the hallways together

For more activity ideas, see our list of fun activities for grandparents and grandchildren.

Let children contribute meaningfully

Children cope better when they feel useful. Give them age-appropriate ways to help:

• Young kids: Draw pictures, pick flowers, choose a book to read aloud
• School-age: Write letters, help organize photo albums, learn to play a card game Grandpa likes
• Teens: Help with technology, record Grandpa’s stories, assist with visits

These contributions aren’t just good for the child. They give the grandparent a sense of connection and purpose that can genuinely improve their quality of life.

Model healthy emotions

Your children are watching how you handle this. If you feel like shedding some tears after a particularly hard visit, let the kids know you’re sad too. Say, “I feel sad because I miss how things used to be with Grandma. It’s okay to feel sad about changes.” This teaches your child that grief is normal and doesn’t need to be hidden.

Judith Myers-Walls, Associate Professor of Child Development at Purdue University, recommends offering realistic reassurance rather than false promises. Instead of “Grandpa will be fine,” try “We’re doing everything we can to help Grandpa feel comfortable, and we’ll get through this together.”

If you’re navigating caregiver guilt about an assisted living decision, know that your own emotional health directly shapes how well you can support your children through these conversations.

When to Seek Professional Support

There will be times when your parenting alone isn’t enough. Consider reaching out to a child therapist or school counselor if your child:

• Shows persistent changes in behavior (withdrawal, aggression, declining grades) lasting more than a few weeks
• Develops new fears around illness, hospitals, or death that interfere with daily life
• Refuses to visit or talk about their grandparent entirely
• Experiences nightmares or sleep disruptions related to the grandparent’s condition
• Shows signs of regression that don’t improve with reassurance

The Family Caregiver Alliance offers free resources for families navigating these conversations, and your pediatrician can recommend age-appropriate counseling if needed.

You might also find it helpful to read about how to help your child bond with grandparents, which covers building connection at every age, including during challenging times.

Books That Help Kids Understand

Books can be a starting point for discussions that would otherwise be too difficult to jump into on your own. A few that families recommend:

• “The Sunshine Home” by Eve Bunting — A boy visits his grandmother in a nursing home and learns that love adapts.
• “Wilfrid Gordon McDonald Partridge” by Mem Fox — A child helps an elderly friend find her lost memories.
• “Still My Grandma” by Véronique Van den Abeele — A girl navigates her grandmother’s Alzheimer’s with honesty and love.
• “The Remember Balloons” by Jessie Oliveros — A boy watches his grandpa’s memory balloons float away, and discovers he can hold onto them.
• “Grandpa’s Great Escape” by David Walliams — For older children, a funny and moving story about a grandfather with Alzheimer’s.

Read the book first yourself so you’re prepared for any questions it might raise. Then read it together and let your child’s reactions guide the conversation.

FAQ

How do I explain to my child why Grandpa can’t play like he used to?

Keep it simple and physical: “Grandpa’s body is getting older, which means his legs get tired faster and his hands don’t grip as well. It’s not that he doesn’t want to play with you — his body just needs different kinds of activities now. Maybe you could read a book together or play a card game instead.”

Should I bring my child to visit a grandparent in assisted living?

Yes, in most cases. Children who visit grandparents in assisted living develop a more realistic understanding of aging and often bring genuine joy to the facility. Prepare your child for what the environment looks like, keep visits short (30-45 minutes is plenty for young children), and bring an activity to do together. For more tips, see our guide to making visits with aging parents meaningful.

What if my child doesn’t want to talk about it?

Respect their pace. Some children process internally before they’re ready to talk. Let them know the door is open: “Whenever you have questions about Grandma, I’m here. There’s no wrong question to ask.” You can also try indirect approaches, like reading a relevant book together or mentioning your own feelings casually: “I was thinking about Grandpa today and feeling a little sad. Do you ever feel that way?”

At what age should I start these conversations?

As soon as your child notices changes, which is often earlier than you’d expect. Children as young as three can sense when a grandparent is different. You don’t need to wait for a major health event. Brief, simple explanations woven into everyday life (“Grandma goes to the doctor a lot because her body needs extra help”) build a foundation of understanding that makes bigger conversations easier later.

You Don’t Have to Have All the Answers

There’s no perfect script for telling your child that someone they love is changing. You’ll stumble over words. You’ll wonder if you said too much or too little. That’s okay.

What your child needs most isn’t a flawless explanation. They need to see that you’re willing to sit with hard feelings alongside them, that you’re honest even when it’s uncomfortable, and that the family shows up for each other no matter what.

The grandparent-grandchild bond is one of the most resilient relationships in a family. With your support, it can endure and even deepen through the hardest chapters.