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
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
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
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?”
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
“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
14. Your child will probably need lots of reassurances
He/she did not in any way cause the family member’s
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
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.