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 regular part of the child’s life, if possible.
  • Have a parent or trusted adult who is a regular part of the child’s life spend time with the baby or child daily.
  • When the parent must be in the hospital, caregivers can use video, phone, and other means so the child can see and hear their parent in real time.
  • Get your relatives, nanny, or day care providers to help keep the baby or child’s routine.
  • Record lullabies, stories, and messages when the parent with cancer can’t 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.
  • Arrange visits to the ill parent while in the hospital, preferably at times the parent has more energy and can hold and play with the child.
  • Talk with the team social worker or nurse about your own emotions in dealing with your child’s distress.

Children age 3 to 5

The child this age will likely show more fear and anxiety when away from the main caregiver. If possible, arrange a consistent substitute caregiver when the main one can’t be there. Assure the child that they will always be cared for. Simple, consistent messages work best, and keeping to the usual routines as much as possible helps the child feel safer.

  • Give a simple explanation that Mommy or Daddy is sick and that the doctors are helping.
  • Check on your child’s understanding of what’s happening. Remember that the child may be able to say back to you what they heard the first time or so, but this doesn’t mean they understand it.
  • 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 regular 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 explain what is happening, and also encourage the child to play out what’s going on. That way, you can see what your child understands through his play.
  • Set up a consistent time each day, like bedtime, when the child can ask questions and share feelings.
  • If you’ve cried or had angry outbursts in front of your child, you’ll need to explain what happened. Assure the child that it’s OK to express intense feelings. After such feelings are expressed, it’s common for the child to change the subject or go off to play.
  • Do not try to persuade your child using reason or logic.
  • Offer choices when possible.
  • Do not tolerate biting, hitting, kicking, or other aggressive behavior. Teach your child how to express feelings in healthy ways (things that don’t hurt the child or other people).
  • Teach acceptable expressions of angry feelings such as talking, drawing, or pounding a pillow.
  • Create opportunities for physical activity.
  • When the parent in the hospital, caregivers can use video, phone, and other means so the child can see and hear their parent in real time. Arrange in-person visits when possible.
  • 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 this requires lots of repetition and reinforcement.

  • Tell the child about the illness and keep them up to date about the parent’s treatment, and be sure to explain what the child sees and hears. Be prepared to repeat the explanation.
  • 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. It’s OK to still be a kid!
  • Plan for daily time with a parent or trusted adult who is a regular part of the child’s life.
  • Give the children permission to ask you questions and express feelings that they think might upset others.
  • Encourage and help youngsters identify and name feelings. Talk with them about safe ways to manage feelings such as anger and anxiety.
  • Accept that a child may not want to talk about feelings, and some are hard to have. But, be sure that the child is expressing their feelings to someone, if not you. Explain that even though the parents have less time for the kids during treatment, they are still loved and valued.
  • 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.
  • Suggest the child write or phone, and send drawings, text messages, or voice messages to the parent when the parent is away.
  • Ask one family member or trusted friend to take a special interest in the child.
  • If the child shows severe anxiety, is afraid to go to school, 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 more details about the parent’s diagnosis, such as the name of the cancer, what the cancer does to the body, what the child might see happening, and what the parent may be feeling. Explain where the cancer is in the body if the child does not already know. Use pictures from children’s books about cancer, and for older children, science books about the human body. Tell the child as much as possible about what to expect. Explain what the child sees, and answer questions honestly.
  • Assure children the illness is not their fault, and that cancer 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, its treatment, and/or their responses to the parent’s illness if they want to do this.
  • Assure the child that it’s OK to be upset, sad, anxious, or angry and that their parent still loves and cares for them.
  • Encourage expressing and talking about feelings, but allow your child to keep their feelings private if that’s what they prefer.
  • Arrange for one family member or trusted friend to take a special interest in the child.

Teens

Teenagers 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 condition, symptoms, possible side effects of treatment, what they might expect, and other information, if they’re 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.
  • Teens can step up to the plate and help with some tasks at home, such as cooking meals. You don’t want the teen to be overwhelmed, but helping is part of becoming an adult. Be sure you balance what you ask of the teen with their needs. If you realize they’re doing too much, 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.
  • Address feelings of anger and frustration (even if they are unspoken).
  • Be willing to tolerate some reluctance to share thoughts and feelings.
  • Encourage your teen to keep a journal or log.
  • Ask a relative or trusted friend to take a special interest in each teen.

Last Medical Review: 01/29/2015
Last Revised: 04/27/2015