Helping Children When A Family Member Has Cancer: Dealing With Recurrence or Progressive Illness

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What is a child’s greatest worry if a parent’s illness progresses?

Clearly, children worry about what will happen to them if a parent dies. In a one-parent family, this concern can be even greater. Depending on the age of the children, the “Who will take care of me?” question can be the most critical. This question must be addressed whether the child actually asks it or not, at least for children who are school age and older. We all fear being abandoned. Children are not able to survive without someone to take care of them, so this question is basic and critical. Dealing with this question is probably one of the most painful things a parent can do. Some parents and caretakers get help from a mental health professional, both to deal with their own feelings and to get ideas and tips for talking with the children about this sensitive topic.

Families come in many shapes and sizes. There may be many people involved in the discussions that take place about these issues. Extended family members, beloved friends, teachers, or spiritual leaders can all be invited into the family to help with decisions—both making them and talking about them.

In an ideal world, all parents will have made arrangements for their children to be cared for in the event something happens to them. Even with parents who are not sick, accidents can happen, life can change in an instant, and children can find themselves in a very different world. Regardless of how your illness is expected to progress, you and your partner, or you and your close family members may want to sit down and discuss the best plan for your child’s living situation. A lawyer can draw up a will or legal document that will outline your wishes if you die. You should also explain to your children the decisions you have made and why you made them. Questions should be encouraged and answered as honestly and directly as possible. Make it clear to your children that you are making the best plan for them, but that you do not expect to have to put this plan into action right away. This is a just-in-case plan, a back-up plan.

For example, Linda is an adoptive parent with one son and no partner. Her son needs to know that she has already talked to her sister, Sara, about plans for him if something happens. She may say something like, “As sad as your Aunt Sara would be if I died, she would be thrilled to have you as part of her family. She loves you very much, and I know you love her, too. We have talked about it and it’s all settled.”

For a 2-parent family, changes need to be discussed because things will never be the same if one is lost. For example, a mother whose husband is being treated for cancer might say to her 3 children:

“Your dad’s doing very well with treatment right now, and we expect he will keep doing well. But we have talked about what might happen if treatment stops working. Your dad has a life insurance policy that would give us some money to help us live here in the house. But just to make sure we would be OK, I would probably go back to school and become a teacher, like I’ve always wanted. Later on I would probably go to work, but not right away. Your dad thinks this is a good idea too. What do you guys think?”

Talking to your children about this is important, but it’s even more crucial if the child has only one parent. The child knows that you provide all or most of their care, and may not know who would do it if you weren’t around. Again, what the child imagines may be much worse than reality.

If you do not have relatives or friends who are logical choices as caregivers, there are social service agencies that can help designate possible caregivers. This is a painful issue to think about when you learn you have cancer, but it’s something that must be done. It’s one way you can be sure that your children know that they will always be cared for. If your children are older, get their input on who might become their caregiver. But do not put this off. It’s important to make these arrangements, let your children know about them, and do the legal paperwork that’s needed.

This is a tough talk to have with your child, and you may have to rehearse before you can do it without getting very emotional yourself. When you are ready, give yourself some uninterrupted quiet time with your child. You can open the subject by saying that you know that children often worry about who would care for them if a parent couldn’t, or if their parent died. This lets the child know that you won’t be shocked or upset with them if they ask questions. You can see how the child responds to this statement before you explain your back-up plans.

You can expect that with any change children will have questions. They may even have some resistance to the change, as well as feelings of sadness and loss. It’s unrealistic to expect them to “get behind the plan” right away. But at least you are giving them information and structure to make them feel safe and secure should the worst happen. Even though cancer may change everything in the family, they will still be taken care of. Making a plan and talking to them about it lets them know how important they are to you. That’s a great message for children to get. So give yourself a pat on the back for getting this accomplished.

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