What helps kids with cancer and their brothers and sisters?
Here are some ideas for helping children with cancer according to their age group. In the second part of each age group, there are ideas for helping siblings in that age group.
Infants and very young children (birth to age 3)
For the infant or very young child with cancer
- Soothe and comfort by being with your child, holding, touching, rocking, and singing or playing music.
- Cuddle and hug toddlers often.
- Stay with your baby or child during tests and procedures.
- Distract with toys and colorful things.
- Keep a favorite stuffed animal, blanket, or other special object near your child.
- Use a stuffed animal to let your baby know when a staff member or visitor entering the room isn’t going to do anything that causes pain. The stuffed animal can be a cue that this person is “safe,” to help the infant stay calm.
- Try to establish the crib as a safe, treatment-free place. Take your baby out of the crib for any treatment, test, etc., that may cause discomfort or pain.
- Limit the number of visitors.
- Have siblings visit as often as feels comfortable for the situation (based on the health and the need of each child to socialize).
- Create a cheerful hospital room with good lighting, art, and bright colors.
- Stick to your usual schedule as much as possible, including nap times and meals.
- Set aside time for play.
- Use video, phone, and other means so your child can see and hear parents in real time.
- Record lullabies, stories, or messages when a parent can’t be with the baby or child.
- Get ideas from a recreation therapist or child life worker on other ways to help.
- Talk with other parents of very young children with cancer to see what works for them.
- Talk with the team social worker or nurse about your own emotions in dealing with your child’s distress.
For infants or very young siblings of a child with cancer
- Keep your baby or child near parents, if possible.
- Get relatives or day care providers to help maintain your baby’s or child’s routine as much as possible.
- Have a parent or trusted adult who’s a consistent part of your child’s life spend time with them daily.
- Use video, phone, and other means so your child can see and hear parents in real time.
- Record lullabies, stories, and messages when a parent can’t be at home.
- Remind toddlers often that mommy or daddy will be back soon.
- Cuddle and hug them often.
- Arrange visits to sick brother or sister.
Toddlers or pre-schoolers (ages 3 to 5)
For the toddler or pre-school child with cancer
- Give very simple explanations of what’s happening and repeat them often.
- Comfort your child when he or she is upset or scared.
- Check on your child’s understanding of what’s happening.
- 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.
- Encourage doll play and other play to rehearse or repeat worrisome or painful experiences.
- Create opportunities for physical activities.
- Try to stick to a schedule for meals, naps, and play.
- Teach staff how to get your child’s cooperation.
- Talk with the child life expert or social worker about how to reward good behavior when your child cooperates with tests and procedures.
- Make use of experts on the cancer team to help you with your child or teach you useful strategies.
- Give simple explanations for a parent’s crying and sadness. For example, “I just feel a little sad and a little tired today. It makes me feel better to cry and get it all out of my system. Now I feel better.”
- Don’t forget to have fun; laugh together when possible.
For toddler and pre-school siblings of a child with cancer
- Give a simple explanation that brother or sister is sick and that the doctors are helping.
- Offer comfort and reassurance about the parent’s absence.
- Arrange for reliable daily care, and keep usual routines.
- Keep caregivers informed about your family situation.
- Have a parent or trusted adult who’s a consistent part of the child’s life spend time with them daily, if possible.
- Have siblings nearby (for example, use a local Ronald McDonald House during hospitalization or treatment).
- Be alert to changes in behavior.
- Give simple explanations for a parent’s crying and sadness, as noted in the list above.
- Talk to your cancer care team about any concerns.
- Talk with the child life expert or social worker about ways to provide positive reinforcement for your child’s newfound independence and supportive role in the family.
School-age children (ages 6 to 12)
School-age children are especially sensitive to parental feedback during an illness.
For the school-age child with cancer
- Explain the diagnosis and treatment plan in words your child can understand.
- Include your child as much as possible in talks about diagnosis and treatment.
- Answer all questions honestly and in understandable language, including “Am I going to die?” (Discuss ways to answer these difficult questions with the cancer care team.)
- Listen for unasked questions, and pay attention when your child talks about fears and concerns.
- Offer repeated reassurance that the child did not cause the cancer.
- Encourage and help youngsters to identify and name feelings.
- Teach that sadness, anger, and guilt are normal feelings and that it’s OK to talk about them.
- Teach about feeling and managing anxiety.
- Relieve anxiety about missing school by sharing with your child’s teacher and classmates about what’s happening, and encourage your child to share as well.
- Console your child over missed sports events, parties, and other activities.
- Encourage expressing feelings, especially anger, and safe ways to do it.
- Use cancer team professionals to intervene or suggest strategies for parents to use.
- Allow your child to keep feelings private, if that’s preferred.
- Offer art activities (writing, drawing, painting, collage) that will encourage expression of personal thoughts and feelings Make sure there’s fun and pleasure in each day.
- Arrange for daily physical activity, if possible.
- Help your child stay in touch with siblings, friends, and classmates by using things like cards, phone calls, text messages, video games, social media, and e-mail.
- Make plans with team members and teachers to keep up with schoolwork, which can include classes on speakerphone or the computer, recordings of class discussion, and visits from classmates (if possible).
- Plan your child’s return to school when the cancer care team can estimate a date.
- Use humor to distract.
- Arrange for your child to meet other patients their age to see how they have dealt with cancer.
For school-age siblings of a child with cancer
- Let the sibling tour the clinic, meet the medical team, and ask questions if possible. Provide understandable information about diagnosis and treatment, and keep the sibling up to date on what’s happening. Find out if the cancer center has special group for siblings.
- Take your child to an educational or support program or a camp for siblings if available.
- Answer all questions honestly, including, “Will he (or she) die?” Get help from the social worker and cancer care team, if needed.
- Listen for unasked questions, especially about the their own health.
- Tell the sibling’s teachers, coaches, and other school staff about your family’s cancer situation.
- Offer repeated reassurance that the sibling did not cause the cancer.
- Arrange for your child to stay in school and do other usual activities as much as possible.
- Support having fun, despite brother or sister’s illness – make sure they don’t feel guilty about it.
- Arrange for good child care; if possible, let the sibling help choose where they go after school, and whose care they prefer when a parent can’t be there.
- Plan for daily contact with a parent or trusted adult who’s a consistent part of the child’s life.
- Teach about normal feelings, such as fear, anxiety, sadness, guilt, and anger.
- Encourage the sibling to share their feelings, taking the time to attend to emotional concerns as well as physical needs.
- Accept the sibling’s unwillingness to talk about feelings if they don’t want to talk to you, but be sure that the child is expressing feelings to another trusted adult.
- Explain that even though the parents have less time for the siblings during treatment, they are still loved and valued just as much as the sick child.
- Suggest siblings write or phone, and send drawings, pictures, text messages, email, or voice messages to the patient.
- Offer reassurance that the family will be OK.
- Explain that the parents’ distress, sadness, or crying is OK.
- Arrange for one family member or trusted friend to take a special interest in each sibling.
Teens (ages 13 to 18)
The teenage years are challenging as teens are learning to separate from their parents and be more independent. Illness forces some of the task of separation to be put on hold.
For the teen with cancer
- Offer comfort and empathy.
- Include your teen in all discussions about diagnosis and treatment planning.
- Encourage your teen to ask questions (parents should listen for unasked questions).
- Give information on normal emotional reactions to a cancer diagnosis.
- Repeat reassurances that they did not cause the cancer.
- Address spiritual concerns or questions such as “Why me?” (Or encourage others to address them.)
- Encourage your teen to share feelings with someone: parents, family, friends, the cancer team, or other staff.
- Be willing to tolerate some reluctance to share thoughts and feelings.
- Encourage your teen to keep a journal or log.
- Allow time for your teen to talk privately with team professionals.
- Offer assurance that all of you – the patient, parents, and other family members – will be able to manage this crisis and help each other through it.
- Address feelings of anger and frustration (even if they are unspoken).
- Use team professionals to teach new coping strategies.
- Encourage your teen to share news of their diagnosis with friends and classmates, and stay in touch with them.
- Arrange for visits of siblings and friends.
- Develop a plan with team members and teachers at school for keeping up with classes, as well as a plan to return to school and deal with any restrictions that might apply.
- Make sure there’s some fun and pleasure in each day.
- Use humor to deal with frustration.
- Help your child make contact with other teen patients, if desired.
- Take your child to a teen support group and stress the importance of learning from other teens (if available in your area).
- Look for a childhood cancer camp that your teen can attend.
For teen siblings of a child with cancer
- Arrange for the teen sibling to tour the clinic and ask questions of the cancer team if they wish.
- Keep the sibling up to date with what’s happening during treatment.
- Find out if the cancer center has a special group for siblings.
- Answer all questions honestly.
- Reassure that cancer is not contagious.
- Offer assurance that nothing they did or said caused the cancer.
- Tell your teen’s teachers, coaches, and other school staff about the family situation.
- Discuss spiritual concerns related to diagnosis.
- Encourage sharing of feelings and talk about what’s normal.
- Explain that even though parents have less time for the siblings during treatment, they are still loved and valued just as much as the sick child.
- Try to keep daily life at home as normal as possible.
- When possible, let the sibling help choose where to go after school and have a voice in who they prefer to care for them when a parent can’t be there.
- Provide assurance that the family will be able to handle the crisis.
- Encourage teens to keep up their usual involvement in school and other activities.
- Ask your teen to help out at home, but don’t expect your teen to take on all the caregiving, housekeeping, and other difficult tasks that need to be managed. Talk with the cancer care team about your family situation and see if you can get other help.
- Ask a relative or trusted friend to take a special interest in each teen sibling.
Ask for help
Like parents, patients and their siblings will find that with the help and support of those who love them they’ll be able to handle this cancer crisis. Cancer care teams can refer you to skilled experts to help your family as needed, offering teaching, counseling, support, information, and other resources to make the task easier. Don’t hesitate to ask for help.
- When a child has cancer, it’s a crisis for the whole family.
- How do parents usually react to a child’s cancer diagnosis?
- Ways to improve coping
- How can parents be sure their child gets the best treatment?
- What if parents want a second opinion?
- How do children with cancer and their siblings react to a cancer diagnosis?
- What helps kids with cancer and their brothers and sisters?
- Keeping up with schoolwork during a child’s illness
- Will the child and family ever return to normal after a cancer diagnosis?
- To learn more