Trying to protect children from difficult news, worry and distress is natural. You may have concerns that delay or stop you explaining what is happening.
You may feel it will bring home the reality of the situation, when you are still struggling to come to terms with it yourself. But not explaining what is happening may make them feel more vulnerable.
Children often know when something serious is affecting the family and people they are close to. It is important to give them the chance to talk openly about their fears and worries.
There are many benefits to being open and involving children and teenagers:
- Knowing what is going on may make them feel more secure and less anxious.
- It gives them permission to talk – they can ask questions, say how they feel and talk openly to you.
- It shows you trust them and that you do not feel you need to guard what you say all the time.
- It can make you all feel closer – your children can help support you, and you can help support them.
- It might help them cope better with difficult situations in life.
The effects of not talking
Wanting to protect children from difficult news is natural. But if you do not talk to them, they may:
- feel frightened because they do not know what is going on
- feel alone with lots of worries and no one to talk to
- worry that something they have done or thought has caused the cancer
- think they are not important enough to be included
- imagine something worse than the reality
- misunderstand situations and get the wrong idea about what is happening.
You will probably need time to cope with your own feelings before talking to your children. You might want to speak to your nurse specialist or a psychologist or counsellor before talking to your children. Try to talk to them before they pick up on things and start to worry.
Be as prepared as you can. Make sure you have all the information you need and that you understand it. You may want to think about the questions a child might ask and the words you will use to explain things.
Who should tell them?
If you are a two-parent family, it is usually best to tell your children with the other parent. But this can depend on how you usually talk as a family.
If you are a single parent, you may feel able to, and want to, do it on your own. Or you could do it with someone close who your child knows and trusts. You could also ask your nurse specialist or a psychologist or counsellor to be there.
Even if you are not doing the telling, you may want to be there so you know what is being said and how the child has reacted. However, some parents do prefer not to be there themselves. You should do whatever feels right to you.
Choosing the right time and place
There may be places where you and your children feel more able to talk. Make sure it is somewhere they will feel able to express their feelings.
If you have more than one child, it is best to tell them together if you can. This prevents them feeling like their siblings know more than them. If you are telling them separately, do it as close together as possible. Some children may wonder why they were told last.
Try to avoid only telling the older children, as this can place a burden on them.
As a parent, you are the expert when it comes to your child. You know the best way of communicating with them, how they might react and what support they will need. Here are some things to think about:
- See the first conversation as a starting point – it is the beginning of an ongoing process of gradually giving your children small, relevant pieces of information and reassurance.
- Allow the conversation to be directed by your children’s reactions and the questions they ask.
- Listen and keep it as open as you can.
- Try asking questions that encourage them to express what they are thinking, rather than a one word or two-word reply.
It is best to be honest with children. If they think you are being vague or hiding something, they may find it hard to believe they are being told the truth. Do not make things sound less serious than they are.
It is fine to say you don’t know if you cannot answer all their questions. Tell them you will try to find out and will tell them when you know.
Teenagers may react differently from younger children or adults when they are told a parent has cancer. They may ask for more information about the diagnosis and what it means for family life. They may also need more time to work through their feelings.
You will need to use words your children will understand. These will vary depending on their ages. Here are some tips to help you through the conversation:
- Find out what they know and explain anything they have misunderstood.
- Use simple, clear language and short sentences.
- Keep information relevant to the current situation, rather than things that may happen in the future.
- Be prepared for them to react in their own way, and ask them if there is anything else they want to know.
- Explain how their lives and routines may be affected.
- Repeat the information for younger children, especially those under seven, as they may not take it all in or understand.
Children need some information about the name of the cancer, where it is in the body and how it will be treated.
Teenagers in particular may look for information about cancer on the internet.
You could show them:
Riprap is a website for teenagers who have a parent with cancer.
Teenagers may know what cancer is from experience. They may have been taught about it at school or have a friend with cancer. You could talk to them about what they know if you think that would help.
Important points to tell them
Children, particularly those under 10 years old, often worry about things like causing the cancer or catching it. Children need reassurance that:
- nothing they did or thought caused the cancer
- cancer is not like a cold and you cannot catch it – it is okay to sit close, hug or kiss
- there will always be someone to take care of them
- they can always ask you questions and talk to you about how they feel
- you will listen to their worries and try to help them cope.
Children’s understanding and emotional reactions can depend on how old they are. They are usually able to understand more about illness as they get older, but this depends on the child.
We have more information about how children may react at different ages.
Children with learning disabilities
Children with learning disabilities can find change hard. Remember to explain any possible changes in routines and prepare them for any physical changes that you might go through. It is likely that they will cope better with the changes if you are honest with them.
The National Autistic Society has more information on helping children prepare for change.
You will usually want to tell your close family and other adults who your children know and trust.
It can be helpful to have a conversation with your children about who else needs to know, for example a teacher, club leaders or their friends’ parents. Older children may have strong feelings about who should or should not know.
It is a good idea to let nursery or school teachers and the school nurse know. It will mean that they can be sensitive to your child’s needs, and will help them understand any unusual or difficult behaviour.
At school, college or university
If you have an older child or teenager, they may not want to be seen as different from their friends. But it is important that certain people know and can be there to support them if they need it.
Teenagers may be facing exams or coursework at school, college or university. Teachers or staff can offer support, and they may notice issues or behaviours that are not always apparent at home.