Helping Children When a Family Member Has Cancer: Dealing With a Parent`s Terminal Illness

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How do I talk to my children about dying?

You’ll want to have some uninterrupted time and a quiet place. Consider having your spouse, partner, or another adult who is close to the child with you. If you don’t have someone to help you, ask your social worker, nurse, or doctor who might help you explain things to your child.

Some general tips are shared here, but what you say and how you talk to your child should be based on the child’s age and stage of development. The section called “How do children differ by age in dealing with illness and death?” gives you suggestions for each stage of development.

Start by talking about what your kids think is happening

It helps to get an idea of how your kids think things are going. An open-ended question like “How do you think I’m doing now?” is a good way to start. Often children sense that things are becoming more serious just by the way you’re acting, by the way you look, or by how much or little you’re able to take part in normal family activities. This usually is a gradual process. They may notice relatives or friends are helping out more, or family life seems to revolve around trips to the hospital and there’s less time for the family to enjoy their usual routine.

Ask your child what changes they’ve noticed, and what they think these changes mean. Are they worried that you might die? Most children sense that things are worse, but they’re often too scared to talk about what they fear the most.

Keep in mind that children think in a very concrete way. One little boy, when asked if he worried about his dad dying, said that he knew this wouldn’t happen because his dad’s feeding tube was helping him eat. Don’t assume that you know what’s going on in your child’s mind. You must ask.

Talk about treatment

Children need to understand that there’s been a change in your response to treatment. Kids who have been told that the treatments are supposed to control or get rid of the cancer need to be told that this is no longer happening. You might say something like, “The treatment the doctors have been giving me isn’t working any more. The cancer has come back (or is getting worse). And as it gets worse, my body can’t work like it’s supposed to and will stop working. When my body stops working, I will die.”

You can tell your children that what everyone hoped for is no longer possible – the cancer is still there. It’s growing and spreading. This means that you probably won’t live much longer. Sometimes people die from cancer in spite of the treatment, and it looks like this is going to happen to you.

Use the right words

It’s tempting to avoid them, but it’s important to use the words “die” and “death” rather than “pass on,” “go away,” “go home,” “go to sleep,” or other terms that make death sound nicer. Children often don’t understand what these nicer-sounding words really mean and may not fully understand what you’re trying so hard to say.

Since a child’s understanding is based on what they can directly experience, death should be explained in terms such as these.

    · Death means that we’ll no longer see the person we love except in our hearts and minds.

    · Death means the person will no longer be physically there in our lives.

    · They’ll no longer be with us as they were before, but we’ll still have memories of them.

    · Be sure to explain that when a person dies, they don’t feel anymore; the heart doesn’t beat anymore; the person doesn’t breathe.

    · Since young children don’t understand the finality of death, be sure to say that death is not like a trip; you don’t come back from being dead. Also, make it clear that death is not like sleeping.

    · Using a simple story book is a good way to help explain this. Talk to your health care team, ask a local librarian, or check the resources in the “To learn more” section to get recommendations.

Know what reactions to expect

Depending on their age and many other factors, some children may not be able to really grasp that a parent is dying, and their first reaction is often one of disbelief. This is normal. And it’s often a reaction shared by the parent who’s thinking, “How can this be happening to me?” Another normal response is anger, sometimes directed at the parent who is sick. Give your child time to absorb what you’ve said. Be sure to check in later to find out what your child really understood and be prepared to say it again.

The immediate and most pressing issue for the child is “Who will take care of me?” Parents need to tell their children what arrangements have been made to provide the care and security the sick parent can no longer provide. All children depend on their parents to provide security and love and to make sense of life. Children have fears about being abandoned by the people they depend on the most to keep them safe. Since young children are rarely able to talk about these feelings, it’s up to you to tell them about changes the family has thought about and the plans that have been made to keep the child’s world as safe as possible.

Be prepared to repeat this conversation

Young children will probably not understand what death is and what it really means the first time they hear it. You may have to repeat this discussion many times for them to fully understand. If a child doesn’t want to believe what you’ve told to them, they may ask the same questions over and over again, often as if the conversation had never happened. They do this hoping that the answer will be different the next time, hoping that somehow what they’ve been told isn’t true.

Although this is painful for the adult, it’s a key part of preparing the child. In time, the child will accept the reality. This process is how the child comes to accept the painful truth that life can and will go on without the parent.


Last Medical Review: 01/14/2015
Last Revised: 03/20/2015