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

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Why should I tell my children I’m dying?

Children need to be told of a parent’s terminal illness so they can prepare themselves for what will happen next. The pain of losing you is likely to be worse if they are not prepared, and they may feel confused, hurt, and angry that something so important was not shared with them. Children rely on their parents to bring order and security into their lives. Although children may not be able to say this, parents help them understand the world around them and their place in it. That’s what being a parent is all about.

Think about how you prepared your child for his or her first day in school. You were probably very aware of how they might react when being separated from you, their anxiety about meeting new children and the teacher, and just not knowing what to expect. You probably talked about all of the new things to learn, the fun in making new friends, and how going to school is a normal part of growing up. Your child might have had trouble knowing exactly what this would really mean, but he or she looked to you to help them deal with this new phase in life. The first day away from the home routine was made a little less scary because of this preparation. Children depend on their parents to interpret their world and help them deal with the uncertainty of the future.

Clearly, preparing a child for the death of a parent is a much more important and traumatic event than the first day of school. But not preparing children for a parent’s death may send the message that they are not an important part of the family. It may also give the impression that death is so terrible that they will not be able to cope with it. Some children may even believe they were not told because it’s actually their fault that their parent died. No parent intends this, but because children often cannot explain what they think and how they feel, not preparing them leaves them alone to make sense out of this critical event in their lives.

Why would a child feel they caused the death of a parent?

Children often feel responsible for whatever happens in their young lives. This is called magical thinking and while it’s not logical, it is, in fact, a big difference between how adults and children think. Children are egocentric, which means they see themselves as the center of the world. They are often unable to see beyond themselves. As children grow up they start to understand that they are not really the center of the universe and all kinds of things cause and affect events in their lives. It’s human nature to look for the answer to why things happen to us, and children have a harder time than adults trying to answer these questions.

Sometimes children can’t ask why things happen. They may not even be aware that they blame themselves for their parent’s cancer and that the parent might not survive. Even if they do wonder about this, it’s very scary to ask, “Did I make Mommy sick?” For this reason, we have suggested that parents bring up the subject themselves, and say something like “...and the doctors have told us it’s nobody’s fault that Mom (or Dad) has cancer.” That way, if the child is so worried that they can’t bring themselves to ask this question, it gets addressed in a way that does not cause the child too much anxiety. But it may need to be repeated more than once. After a child has made up their mind that something is true, it can be very hard to change it.

Think about some of the things you have probably heard your children say when they’ve been upset or angry, like “I hate you,” “I wish you were dead,” “I wish I was dead,” “I’m going to run away,” “I wish I had a different Mommy,” “I wish you were like Tommy’s daddy—he got a new bike,” “I don’t love you anymore!” and so on. Often in their anger they do not mean what they say, but these statements express what they are feeling at the moment. Once spoken, these words are usually quickly forgotten when they calm down. But when a parent gets sick, a child might remember saying these words and wonder if they caused the parent’s illness. The younger a child is, the more trouble they have separating what’s going on in their minds and hearts from what’s actually going on in their day-to-day lives. For this reason, parents need to think ahead about such thoughts, as irrational as they are, and address them. If you wait for your child to ask you if something they said or did is about to cause something awful to happen, it may never come up. It’s just too scary for them to ask, “Did that day I told you I hated you make you get cancer?” or worse yet, “...make you leave me?”

It’s very painful to think that what’s happening to you will upset your children. Parents wish that they could spare their kids from pain, but that’s not always possible. Life can seem so unfair and it seems especially wrong that you may not be there to see your children safely into adulthood. The best you can do is give them whatever tools they will need to succeed and lay a firm foundation that will see them through life’s trials and troubles. It may seem impossible to believe that your children will one day be OK. It’s certainly not easy, but experience and research have shown that children can and do cope with the loss of significant relationships if they are loved and given enough help by those close to them.

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