Helping Children When A Family Member Has Cancer: Dealing With Treatment

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TOPICS

What helps, by age of the child:

Infants or very young children

  • Keep the baby or child near the parents or a trusted adult who is a consistent part of the child’s life, if possible.
  • Have a parent or trusted adult who is a consistent part of the child’s life spend time with the baby or child daily.
  • Get your relatives, nanny, or day care providers to help maintain the baby or child’s routine.
  • Record lullabies, stories, and messages when the parent with cancer cannot be at home.
  • Offer frequent reassurance to toddlers when a parent is away for short times that Mommy or Daddy will soon be back.
  • Cuddle and hug them often.
  • Set up visits to the parent while in the hospital, preferably at times the parent has more energy and can hold and play with the child.

Children age 3 to 5

The child this age will likely 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. Simple, consistent messages work best, and keeping to the usual routines as much as possible make the child feel safer.

  • Give a simple explanation that Mommy or Daddy is sick and that the doctors are helping.
  • Arrange for reliable daily care, and stick to usual routines.
  • Keep all caregivers informed about the family situation.
  • Have a parent or trusted adult who is a consistent part of the child’s life spend time with the child daily, if possible.
  • Reassure the kids that the parents’ distress and sadness is because of the cancer, not anything they’ve done; and that the family will get through this difficult time.
  • Use play and artwork to show a child the complicated things that are happening in the family.
  • Set up a consistent time each day, like bedtime, when 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 brief 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.
  • Consult with cancer team professionals about any concerns or changes in the child’s behavior.

Children age 6 to 8

Children at this age may come up with their own explanation of things, like why their 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 right now. She loves you a lot and still wants you to have fun. Mommy will be feeling better when her treatment is finished.”) Once the child believes their own interpretation, it can be hard to change their minds and requires lots of repetition and reinforcement.

  • Tell the child about the illness and keep the child up to date about the parent’s treatment, in words they can understand. Be sure to explain what the child sees and hears.
  • Set up consistent substitute caregiving when the parent is away or unavailable.
  • Let the children tour the clinic, meet the medical team, and ask questions, if possible.
  • Find out if the cancer center has a special group for kids with cancer in the family.
  • Answer all questions honestly, including, “Will Mom (or Dad) die?” If needed, get help from the social worker and cancer care team.
  • Listen for unasked questions, especially about the child’s own health and well-being.
  • Tell the child’s teachers, coaches, and other school staff about the family’s cancer situation.
  • Repeatedly reassure the child that they did not cause the cancer.
  • Arrange for the child to stay in school and other activities as much as possible.
  • Support the child’s having fun, despite the parent’s illness—make sure they don’t feel guilty about it.
  • Plan for daily time with a parent or trusted adult who is a consistent part of the child’s life.
  • Give the children permission to ask you questions and express feelings that they think might upset others.
  • Accept the child’s unwillingness to talk about feelings if they don’t want to talk.
  • Explain that even though the parents have less time for the kids during treatment, they are still loved and valued.
  • Suggest the child write or phone, and send drawings, text messages, or voice messages to the parent when the parent is away.
  • Explain that the parents’ distress, sadness, or crying is OK.
  • Ask a 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, acts depressed, or shows low self-esteem, consider an evaluation by a mental health professional.

Children age 9 to 11

Usually after the age of about 9, children are able to understand more about serious illness and may have many questions about it.

  • Give fairly detailed information about the parent’s diagnosis: name of the disease, specifics, symptoms, and as much as possible about what to expect. Explain what the child sees. Answer questions honestly.
  • Assure children the illness is not their fault, and that it is not contagious.
  • Tell the child that the uncertainty is stressful for everyone, and remind him or her that the family is strong and will get through this painful time together.
  • Have the child visit the parent in the hospital. Suggest topics to discuss; explain the parent’s condition and treatment. Children this age are helped by meeting medical and nursing staff, and exploring the hospital a bit. Tell the child about and explain any differences in how the parent looks before you go.
  • Help the child stay involved in after school activities and sports, and keep them in contact with friends. Remind the child that it’s OK to still have fun.
  • Tell the child’s teachers, coaches, and other school staff about the family situation
  • Remember that parents can’t show special preferences within the family without distressing or upsetting children this age.
  • Encourage children’s interest in reading or writing about cancer or its treatment and their responses to the parent’s illness if they want to do this.
  • Arrange for one family member or trusted friend to take a special interest in each child.

Teens

Teenagers often behave in opposite and unpredictable ways—one day they feel independent and the next they retreat into the safety of childhood. As every parent of a teenager knows, it can be a delicate balancing act between giving a teenager enough independence to learn and experience the world while protecting them from what they are not yet mature enough to handle. With older teens, it can be tempting to give them too much responsibility while the parent is in treatment. And teens may try to protect parents by trying to hide their sadness, anger, or fears, so it’s important to check in with them regularly.

  • Arrange to let the teen tour the clinic or hospital and ask the cancer team questions, if they wish to do so.
  • Give detailed information about the parent’s diagnosis such as the name of the cancer, symptoms, possible side effects of treatment, what they might expect, and other information, if they are interested.
  • Keep the teen up to date with what’s happening with the parent’s treatment. Answer all questions honestly.
  • Find out if the cancer center has special group for teens with cancer in the family.
  • Reassure them that cancer is not contagious.
  • Assure them that nothing they did or said caused the cancer.
  • Tell the teen’s teachers, coaches, and other school staff about the family situation.
  • Discuss spiritual concerns related to the parent’s diagnosis.
  • Encourage sharing of feelings and talk about what’s normal.
  • Explain that even though the parents have less time for the kids during treatment, they are still loved and valued.
  • Arrange to keep a normal daily life at home, as close to the usual routine as possible.
  • Let the teen help choose where to go after school and have a voice in whose care they prefer when a parent can’t be there, when possible.
  • Assure them that the family will be able to handle the crisis.
  • Encourage teens to keep up their usual involvement in school and other activities.
  • Be sure that the teen knows parents are aware that having fun and spending time with friends are important parts of their lives, so there’s no need to feel guilty about it.
  • Don’t expect the teen to take on caregiving and other difficult tasks. Talk with the cancer care team about your family situation and see if you can get other help.
  • Check in with your teens often and let them know that everyone has feelings that can be confusing and overwhelming. Tell the teen it’s OK to ask you questions and express feelings that they think might upset others.
  • Ask a relative or trusted friend to take a special interest in each teen.

Last Medical Review: 08/07/2012
Last Revised: 08/07/2012