Discussions of End of Life care and death can be difficult at any developmental stage in family life. Parents can be uncertain about how to approach these discussions with children. That uncertainty and the desire to protect their children from the pain of loss can amplify emotional distress when considering how to introduce this discussion to children. Clinicians need to be prepared to support parents in developing language to use in these difficult discussions. A foundational knowledge of children's development is a crucial element of the clinicians skill set when facilitating these discussions with parents. This knowledge would include an understanding about how the presence of mental illness in the family unit may influence the discussion. This presentation will focus on child development and the understanding of dying and death. Additional information will be included which reflects on the presence of mental, emotional and behavioral factors which may impact a child's or family member's ability to cope with the death of a family member.