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

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Children age 3 to 5

Generally children younger than 5 are not yet able to understand that death is permanent, and that it happens to everyone. Children at this age may expect that someone who has died will come back. They can’t understand the finality of death. It often takes time and growing up for them to realize that the parent they loved will not return. So when a child asks if they can draw a picture to “give Mommy for Christmas,” they are only expressing what they cannot understand. Do your best to try to give them accurate information which they can build on as they get older.

When death is very close, the child should know that at some point the parent will die and the body will be taken away soon after. If you say things like “Mommy will go to sleep,” the child will realize at some point that Mommy didn’t wake up. Children told these kinds of stories can become afraid to go to bed at night, so it’s important to tell the truth and use the right words.

Some possible approaches for working with children at these ages include:

  • Keep explaining changes that are caused by cancer and its treatment (again, without being too optimistic or pessimistic). Remember that the child may be able to say back to you what they heard the first time or two, but this doesn’t mean they understand it.
  • The child will probably show more fear and anxiety when away from the main caregiver. The child will need a consistent substitute caregiver when the main one cannot be there, and will need to be assured that they will always be cared for.
  • Get your relatives, nanny, or day care providers to help maintain the child’s routine and provide daily care. Be sure the caregivers know about the family situation.
  • Have a parent or trusted adult who is a regular part of the child’s life spend time with the child every day.
  • If a parent is in the hospital, plan short visits with fun activities that include the parent. Be sure that the child has toys and understands which of the usual things that the parent cannot do. Explain any differences in how the parent looks before you go.
  • Use play and artwork to show a child the complicated things that are happening in the family.
  • Set up a regular time when you are not rushed each day, so the child can ask questions and share feelings.
  • Long emotional displays from a parent can frighten a child at this age. But assure the child that it’s OK to express intense feelings for short times. After such feelings are expressed, it’s common for the child to change the subject or go off to play.
  • Arrange for one family member or trusted friend to take a special interest in each child.
  • You can use examples of animals or insects that have died to show the child that there is no movement, and that living creatures don’t come back after death. You can also point out that the animal doesn’t feel pain after death.

Describe the funeral or memorial ritual for the child and tell them what others will do and how they may feel. The child may want to give something to the parent, by placing it in the casket, the ground, or the cremation urn. If the child wants to do something like this, explain how this would work. You may also want to assign a caretaker to take the child outside for a break during the service, since it’s likely to be too long for most pre-school children to sit through.

After death, the child may feel upset that the parent doesn’t come home day after day. They may ask the same questions over and over, like, “Where did he go?” Offer the child things that seem important from the parent who died, such as special belongings, clothes, or gifts they may have left for the child. Be prepared for trouble sleeping, and the child being clingy and not wanting to sleep alone. These usually get better over the course of a few months. If available, it may help the child to go to bereavement groups with other children.

Last Medical Review: 07/20/2012
Last Revised: 07/20/2012