1.   Prepare in advance what you want to say to your child. If you have more than one child, you may want to talk with each child individually first, especially if there are wide age differences, and then talk as a family. 

    Talking with each child individually has the advantage of making it easier for you to customize your message for him/her, as well as make it easier for your child to ask questions without sibling distractions. It is important to meet as a family to review the message, share information and concerns, and provide opportunities to ask questions.

2.   Your goal is to tell your child the truth in a way he/she can understand.

3.   Your child will be paying special attention to your non-verbal communication, so you want to be as calming as possible. Share your feelings, but also emphasize how disease and illness are a natural part of life. You may want to talk about the range of emotions you feel, e.g., sad, angry, confused, guilty, anxious, curious, positive, hopeful, to make it easier for your child to express his/her emotions.

4.   Before you talk with your child, you may want to find out from the person with the disease or illness if he/she has some preferences about what gets communicated about his/her situation and his/her thoughts about having visitors and/or involvement with your child.

5.   Here is a suggested format to follow in your communication with your child:

·      Opening: “We have some family news we want to share with you. We’ll explain what’s going on and then answer any questions you might have.”

·      The situation / diagnosis: “Grandma has learned from her doctors that…”

·      Explanation of the diagnosis:

                                              i.     Use medically correct terminology, e.g., cancer, congestive heart failure, and then explain the disease or illness in language they can understand.

                                             ii.     Show them by pointing to your own body where the disease is located and/or use illustrations from books or pamphlets or hand drawn pictures.

·      Explanation of the treatment, its duration and possible side effects.

·      Prognosis or what the medical team is saying the likely or possible outcomes will be.

6.   If your child asks you something and you’re not sure or don’t know the answer, write it down on a piece of paper in front of him/her and say you’ll find out. Explain how you’ll get the answer and then follow through as soon as possible.

7.   Encourage your child to ask questions; empathize with them as they express the full range of their feelings, concerns and anxieties.

8.   Your child’s main questions and concerns may have to do with death: “Will Grandma die?” “Will you die?” “Will I die?”

When talking with a child about whether someone will die from cancer (or any life-threatening medical condition) The American Cancer Society has examples of what might be said (in these examples I use “Grandma” as the person diagnosed):

·       “Sometimes people do die from cancer. We’re not expecting that to happen because the doctors have told us they have very good treatments these days, and Grandma’s type of cancer usually does go away with treatment.”

·       “The doctors have told us that Grandma’s chances of being cured are very good. We’re going to believe that until we have reason to believe something else. We hope you can believe that too. We’ll tell you if we find out anything new or different.”

·       “There is no way to know right now what's going to happen. We’ll know more after the first treatments are finished. When we know more, we’ll be sure to tell you.”

·       “Right now there's not a lot known about the kind of cancer Grandma has. But Grandma is going to give it her best shot and do everything she can to get well.”

·       “Grandma’s cancer is a hard one to treat but she’s going to do everything she can to get better. No one can know right now what will happen down the road. What you can be sure of is that we’ll be honest with you about what is going on. If you can't stop worrying, please tell me so that we can work on that together.”

9.   Help your child figure out ways he/she can show his/her love and support, e.g., draw a picture, make a thinking-of-you card, talk on the phone, Skype, play cards or a game when visiting, watch TV together, change the water in the vase with flowers.

10.  Based on your child’s needs and personality, let him/her know  when you will update him/her on how the family member is doing, e.g., whenever you learn anything, every Friday after doctors’ appointments. One child may need to get updates whenever they’re available. Another child may handle things better with a set day and time to talk about the situation and what’s changed.

11.  Let your child know whether it’s okay for him/her to talk about this news and with whom, e.g., cousins, friends, teachers. Help him/her figure out what to say when talking about it with others.

12. Most important: Most children like routine and structure, so you’ll want to be ready to talk about changes affecting the child and the family that may/will happen as a result of the loved one’s illness or disease. Examples:

·      “Because Grandma will be tired from her treatments and will need lots of rest, she won’t be able to take you to your swim lessons like she’s been doing.”

·      “Grandma will be having her treatments during the summer, so she won’t be going with us to the cabin for vacation.” 

·      “I will be taking Grandma to her doctors’ appointments three days a week, so I will not be with you on those afternoons, but Aunt Susan will be with you.” 

13. Equally important, talk with your child about changes he/she may see as a result of your loved one’s treatments and/or operations. These changes may include visible side effects, new people in the picture, e.g., caretakers; use of devices and equipment.

·      “Grandma will be taking some very strong medicines to help fight the disease; one side effect of the medicine is that she may lose some or all of her hair, eyebrows and eyelashes. Sometimes she may wear a wig or scarf on her head, and other times you may see her ‘looking bald.’ Her hair should grow back later.”

·      “When we visit Grandma at her home, she may have a nurse or nurse’s aide staying with her to help take care of her.”

·      “Grandma will have to take some of her medicine intravenously. Here is a picture of what this will look like and this is what it means…”

14. Your child will probably need lots of reassurances that:

·      He/she did not in any way cause the family member’s medical condition.

·      The family member’s medical condition is not contagious and they don’t have to worry that they or anyone else in the family will catch it.

·      Yes, there may be changes as a result of the diagnosis, but everyone will continue to love each other and help each other as much as possible.

The key is to give your children truthful information when they need it to help them cope as well as possible from day to day. 

Copyright © 2014 by Karen L. Rancourt, Ph.D. All rights reserved.

This document may be used without permission by acknowledging credit to Karen L. Rancourt, Ph.D.