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

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Children age 3 to 5

Children age 6 to 8

Children this age are better able to understand death, including that death is permanent. Some children may see it as a monster, ghost, bogey-man, or some other such creature. Death often takes the form of an outside person who can come to catch them and if they run fast enough, they can escape. Children in this age group worry about monsters under the bed, witches, or devils, and it can be hard to reassure them that such creatures don’t exist. They may also think that the other parent or another loved one could have prevented the illness or death from happening.

Children at this age may come up with their own explanations of things, like why a sick parent won’t play with them (“Mommy doesn’t love me anymore because I told her I hated her.”) It’s important to explain changes right away. (“Mommy can’t play with you because she’s sick. She loves you a lot and still wants you to have fun.”) Once children believe their own interpretation, it can be hard to change their minds, and it requires lots of repetition and reinforcement.

Be patient trying to convince a child that a parent has really died. Don’t be hard on yourself if it seems like you can’t get through a child’s normal defense against such a difficult reality.

Here are some tips that may help:

  • Keep the child up to date about the parent’s illness and treatment, and be sure to explain what the child sees and hears. You may need to keep repeating this information.
  • Prepare the children for bedside visits and explain what they will see. Give more information and offer time for questions after.
  • Answer all questions honestly, including, “Will Mom (or Dad) die?” Get help from the social worker and cancer care team if needed.
  • Listen for unasked questions, and pay attention when the child talks about fears and concerns.
  • Encourage and help youngsters to identify and name feelings.
  • Encourage expressing and talking about feelings, especially anger, and safe ways to do it.
  • Teach the child about feeling and managing anxiety.
  • Assure the child that it’s OK to be upset, sad, anxious, or angry and that their parent still loves and cares for them.
  • Tell the child when death is getting close and let the child visit and be with the parent. Describe the parent’s condition and make suggestions as to what the child might say or do. Just touching the parent can mean a lot to the child. Tell the child to focus on an area of the body that looks the same (such as hands). Tell the child to talk to the parent and tell the parent about his/her day.
  • Find out if the cancer center has special group for kids with cancer in the family.
  • It’s OK for the child to see the parent cry or be angry as long as the child understands that they’re not to blame for these feelings. Try to help them understand that it’s normal to have strong feelings and it’s good to express them.
  • At least one adult should give the child permission to ask them questions and express feelings that the child thinks might upset others.
  • If parents have trouble listening to the child’s distress because of their own, get family, friends, social workers, or other professionals to help talk with and listen to the child.
  • If a child is having trouble in school, explain that it’s normal for school performance to suffer a bit when a parent is in the hospital, and you are not upset with them.
  • Tell the child that it’s hard for everyone in the family, but that you are there for them.
  • Assure the children that this is not their fault, they didn’t cause the cancer or the death.
  • Tell the child’s teachers, coaches, and other school staff about the family’s cancer situation.
  • Arrange for the child to stay in school and keep other activities on schedule as much as possible.
  • Support the child’s having fun, despite the parent’s illness or death. Make sure they don’t feel guilty about it.
  • Set up regular substitute caregiving when the parent is away or unavailable.
  • Remind the child that it’s normal for them to need play time and time to be with their friends for games, sports, and other activities that they enjoy. It’s OK to still be a kid!
  • Arrange for one family member or trusted friend to take a special interest in the child.

If the child shows severe anxiety, becomes fearful, is afraid to go to school, blames himself or herself, acts depressed, or shows low self-esteem, consider an evaluation by a mental health professional.

Children in this age range want to know that their parent loves them. Some want to hug the parent or hold their hand. Some are comforted by exchanging gifts or cards with the parent. These small gestures can become treasured memories for the child.


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