If you or another member of your family is coping with a serious illness,
you know the impact it can have on your children as they confront the anger
and anxiety that can come with changing roles and routines.
As a psychiatrist with a background in primary care, I’ve worked with
families who are dealing with a wide variety of diagnoses and illnesses –
from cancer to neurological problems to serious heart disease. While each
family’s situation is unique, I’ve found that there are some common
strategies that can be helpful for kids when another family member is very
sick and undergoing treatment.
Communication Is Key
Breaking the news is the most difficult part for many parents. The most
important thing is that you’re open and honest with your child about what’s
going on. Don’t try to ignore or avoid it because most kids notice that
something is off – and many have questions and concerns.
Do keep in mind that there’s a fine balance between providing kids with
important details and scaring them unnecessarily. A general rule of thumb
is to start by explaining in simple terms. I recommend planning for an
uninterrupted conversation ahead of time in a place that’s familiar to your
child. The calmer you are, the calmer he or she will be when you have the
talk. You may want to include another family member who is important in
your lives so that person can comfort him or her as you explain the
situation, particularly if it’s you who has the illness.
Once you’ve had the initial conversation, continue with open communication.
How you go about talking to your child about such a serious issue depends
on his or her age and developmental stage. Keep in mind that you are the
expert on your child, and what works for one child may not necessarily work
for another. So trust yourself and your instincts!
- Babies and toddlers younger than 3 won’t understand much. They may
know something is wrong and notice that you (or your partner) are
not around to do familiar things like cook dinner, read before
bedtime or play outside. You can say things like, “Mommy is not
feeling well today,” or, “You have to play quietly for a while so
Mommy can get some rest.”
- Children ages 3 to 5, they take things very literally. Use words
they understand and provide brief explanations. It’s important to
separate the illness from the family member. Help children
understand that it’s not the family member’s desire to be
unavailable: it’s the illness that’s making Mom or Dad take a sick
day in bed. If the sick family member feels up to it, you can bring
the child to the loved one’s bedside a few times a day to play with
toys or read a story. Being in their family member’s presence is
often reassuring.
- For children 6 and older, you can tell them the name of the illness
and what may happen as it progresses. For example, you can say,
“Mom/Dad/brother/sister has a sickness called lupus that may make
him or her feel tired and weak at times.” The bottom line is to
follow your child’s lead. If the conversation seems to be upsetting
your child, steer it in another direction.
Offer Reassurance
Overall, children, especially younger ones, need to be reassured that the
illness is not their fault. I’ve had young patients in the past who feel
some fear and resentment when a sick family member is not able to help with
homework or leave the house for activities, like soccer games or Girl
Scouts. If your children are angry, acknowledge their feelings and let them
know it is OK to feel this way. You can explain that you (or whoever is
sick) do want to do things with them. Then try to plan something
fun but low-key on another day when the sick person has more energy.
Maintain a Sense of Normalcy
When it comes to the everyday, try to keep routines as normal as possible.
Let children continue with their out-of-school activities if possible. If
you do need to make changes, let your children know ahead of time. Try not
to let treatment become so consuming that your children feel overlooked.
When possible, continue having family dinners or spending time before bed
reading a book together. Maintaining some sense of normalcy is key to the
well-being of everyone in the family.
I like to remind adult patients in this situation that no matter who is
sick, they should make a conscious effort to express their love and
affection to their kids as often as possible. I often recommend setting
aside time when the attention is focused only on their kids, even if that
doesn’t involve the sick family member. This might mean arranging playdates
with family friends or sleepovers with their cousins so your children can
continue to be kids and have fun. The time apart also allows the adult to
focus on his or her own needs for a while without feeling guilty.
An illness in the family isn’t confined to home life, so make sure someone
at your child’s school knows a bit about the situation, whether it’s a
teacher or a guidance counselor. You don’t need to go into great detail,
but because the effects of the sickness or treatment may influence your
child’s behavior, it will help to stay in communication.
Check In
Set aside time to check in with your children regularly so they know they
have supportive adults in their lives they can trust. Ask them how they are
doing and listen to them. Encourage them to ask questions, and be prepared
to provide honest responses that make sense for their age. Make sure not to
falsely reassure them by saying that everything will be fine. This will
cause them to lose trust in you if things do not go well.
Validate the emotions they experience. Children will likely express a range
of feelings, including sadness, confusion, frustration and anger. Try to be
open with them about your own feelings so they are aware that others have
feelings, too. There will be days when you (or whoever is sick) may feel
poorly. Often, children will want to help, so allow them to be included and
provide comfort on a bad day.
Ask for Help if You Need It
One of the most important things I tell my adult patients is that if you
need help, ask for it. Don’t hesitate to reach out to others if you need
to. It’s important not to put too much responsibility on children, so that
they can still be kids, not caretakers. If other adults are helping care
for your children, try to limit the number of different people who keep the
kids feeling safe and calm.
You may also want to talk to a professional about how you’re handling
things. Consider finding a counselor or therapist who specializes in
helping those with chronic or terminal illnesses. Try the American
Psychiatric Association’s Psychologist Locator (locator.apa.org) if you
need a place to start.
For more information on how to talk to your kids about serious illness in
the family, I recommend reading “Raising an Emotionally Healthy Child When
a Parent Is Sick” by Paula K. Rauch and Anne C. Muriel, or “How to Help
Children Through a Parent’s Serious Illness” by Kathleen McCue.
Children’s Books for Explaining and Coping with Serious Illness
If you’re looking for a bit of help talking to your kids about a serious
illness in the family, consider reading some of the following with them:
- “You Are the Best Medicine” by Julia Aigner Clark
- “The Invisible String” by Patrice Karst
- “Whimsy’s Heavy Things” by Julie Kraulis
- “My Yellow Balloon” by Tiffany Papageorge
- “When Dinosaurs Die” by Laurie Krasny Brown and Marc Brown
