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, but they may see it as a monster, ghost, bogey-man or some other such creature. Death 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 range worry about monsters under the bed, witches, or devils, and it’s often 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. They may blame themselves that the parent died.

Children at this age may come up with their own explanation 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. It can be very frustrating and even painful to try to even persuade a child that a parent has really died. Be patient with yourself in these discussions—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.

  • Keep the child up to date about the parent’s illness, and be sure to explain what the child sees and hears. You may need to keep repeating this information.
  • Prepare the children for hospital 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.
  • Tell the child when death is getting close if the child can visit one more time. Describe the patient’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.
  • Find out if the cancer center has special group for kids with cancer in the family or kids who have lost a parent to cancer.
  • Children this age are likely to be upset by a parent who has a prolonged show of sadness or strong anger. The parents need to have their emotions fairly well controlled for talks with the child, but they should expect that the child might become highly emotional. Assure the child that it’s OK to be upset, sad, or angry, and that you still love and care for them.
  • Give the children permission to ask you questions and express feelings they think 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 the children are having trouble with 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 each child.
  • If the child shows severe anxiety, becomes fearful or school phobic, 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 loved 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.

After death, it often helps to give the child something that belonged to the parent to help them feel connected. Some children may want to write a letter or select a special item to send off with the parent.

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