I watched Mad Men since the first episode aired, so as the series came to an end this year, I had some thoughts on where the characters were likely to wind up in the last few episodes. The penultimate episode, which aired on May 10, confirmed one of my suspicions about the fate of Betty Francis (the former Betty Draper) and it also, in a very tertiary way, examined the issue of kids and grief.

Before I go forward, let me warn you that this is full of spoilers, if you haven’t seen the series since it ended. That’s right, you’ve been duly warned.




Stop reading now, or forever hold your peace.




Last chance.




You have been adequately warned. On the finale of Mad Men, Betty is winded while climbing a set of stairs at school. She falls, breaks her rib, and an ensuing x-ray reveals advanced lung cancer that has metastasized to her bones and lymph nodes. She has less than a year to live. Many fans assumed this fate would befall one major character on the show considering how much the characters smoke and the associated prevalence of the disease in the show’s time period, the 1960s and early 70s.

While her husband Henry and doctor debate how best to prolong her life, Betty decides to live out the end of her time on her own terms and specifically requests that her children not be told. In an effort to convince her not to do this, her husband visits her daughter Sally at college, informs her of her mother’s terminal diagnosis and brings her home.

At the time of her diagnosis her three children range in age from six to seventeen years and obviously, a six-year-old will handle information that a parent is dying much differently than a seventeen-year-old will. On this show it’s written, as in real life, that children of different ages are at completely different developmental stages in their lives and will understand and process the gravity and finality of death differently.

According to the American Academy of Pediatrics (AAP) to truly understand what death means, children need to understand that death:

  • is permanent and irreversible;
  • means the person or creature stops living (functioning) when they die;
  • is inevitable, and all living things, including themselves, will eventually die;
  • is caused by something (ie: an illness or accident)
Betty explains to Sally why she's decided to not enter treatment for her cancer, and entrusts her daughter with her last wishes.

Betty explains to Sally why she’s decided to not enter treatment for her cancer, and entrusts her daughter with her last wishes.

The youngest of the Draper children, six-year-old Gene, likely would not have the emotional or intellectual capacity to understand all of the concepts of death (though perhaps some), however, his older brother and sister (ages 12 and 17) do.  For example, when Henry’s character tells Sally about her mother’s diagnosis and prognosis, she covers her ears and she says she can’t hear him because her ears are ringing. Sally knows what cancer is, what death is, and knows what this means for her mother.

Yet, because a child doesn’t fully understand the concept of death, does not mean that they shouldn’t be told about a parent’s diagnosis. It’s important to tell children when a parent has a terminal illnesses, not hide it, and to talk to them in language that’s age appropriate and after you have dealt with your own emotions.The death of a parent will forever upend their world, and children need to know as much as possible to help them process and grieve. For a child Gene’s age, The American Cancer Society recommends using language that explains that the terminal illness is causing the parent’s body to stop working and that the parent may die.

That recommendation might seem incredibly difficult and potentially harmful, but both the AAP and the American Cancer Society warn that while parents think that not telling children of a terminal diagnosis will protect the child, it actually tends to increase the child’s feelings of hurt, pain and isolation when the parent does die. Children who are not informed of their parent’s illness may feel their parent’s death is their fault, it may make them feel isolated and that they are not an important member of the family.

Having this discussion with a child is difficult for both parent and child, which is why both the AAP and The American Cancer Society recommends that parents involving another supportive person the child trusts in the discussion with the child, like their other parent, a favorite relative or family friend.  They also recommend using the words “die” and “death” instead of metaphors that may be misunderstood by the child such as “go to sleep,” “go home,” or “pass away” as they may unintentionally confuse the child.

Betty's daughter, Sally, cries after reading her mother's last wishes and her words of reconciliation.

Betty’s daughter, Sally, cries after reading her mother’s last wishes and her words of reconciliation.

I can speak to this first hand, when as a child our minister suddenly died of a heart attack when I was about five or six. Everyone said he “passed away” which I took to mean the same thing as “passed out.”  I was corrected by an adult several days later and I remember feeling grief for the first time in my life and also confusion.  Had he died because he passed out?  Why didn’t everybody just say he had died? And of course, I was hit with the now new-to-me news that our beloved minister was dead.

Considering what we know now, neither Betty nor Henry handle the situation ideally for the children involved. Betty’s decision to not tell her children sets them up for a life-altering shock, with little time and resources to cope with her sudden death. By going against Betty’s wishes and asking Sally to be involved in her mother’s health care, Henry makes Sally an adult in a situation she isn’t emotionally mature enough to deal with yet.

In the end, Betty knows that when she dies, both her current and ex-husbands won’t be emotionally able to deal with the decisions that need to be made. Betty writes out her instructions for funeral and burial and gives them to Sally to be carried out once she’s died. While this is an enormously adult task for a seventeen-year-old (who will be forced to grow up quickly anyway as she’s about to lose a parent), it serves as a vehicle for an ultimate moment of reconciliation between mother and daughter on the show. Betty knows that her headstrong daughter is the only one who will be able to carry out her wishes, and Sally knows that her mother trusts her above all others, a gift in the tragedy of death.




HealthyChildren.org. How Children Understand Death and What You Should Say. American Academy of Pediatrics. Last Updated 5.5.15. Retrieved 5.12.15

Cancer.org Helping Children When A Family Member Has Cancer: Dealing With A Parent’s Terminal Illness. The American Cancer Society. Last update 3.20.15. Retrieved 5.12.15

University of Rochester Medical Center Medical Library. A Child’s Concept of Death. Retrieved 5.12.15

Cancer.gov. Smoking Prevalence and Lung Cancer Death Rates. The National Cancer Institute. Retrieved 5.12.15


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Categories: Ages + Stages, Mental, Emotional, + Behavioral Health, Newborns + Infants, Toddlers + Preschoolers, Tweens + Teens