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.
Babies and toddlers will not understand what is happening. They will be aware of changes to their routine, and especially changes to who is looking after them.
How to help
Try to create an environment that is as familiar and consistent as possible, especially for when you are not there.
If possible, choose someone to care for your child who knows them well. Keep to familiar routines when you can.
Young children do not really understand illness, but they pick up on tensions, changes in adults’ emotions and physical changes. They react to changes in their routine and to being separated from you.
They may also believe that wishing or hoping can make things happen. They might feel guilty that they have done something to cause the cancer. Or, if you are in hospital, they might worry that they have made you go away.
Older children in this group are beginning to understand what illness is, and they may worry that they will get cancer too.
This age group can become clingy and scared of being separated from their parents. They may start to do things they have outgrown, like thumb-sucking, bed-wetting, talking like a baby or having tantrums. They may become quieter than usual or have bad dreams.
How to help
- Let them know that the cancer is not their fault and they cannot catch it.
- Use a doll, teddy or simple drawing to explain where the cancer is, where you will have an operation, or both.
- Ask someone they know and trust to take care of them.
- Keep to everyday routines when you can.
- Set usual limits and boundaries, but do not be surprised if they start doing things they have outgrown.
At this age, children can understand more detailed explanations about the cancer and its effects on the body. They often have fears they may not mention to you. This includes worrying you are going to die, that they have caused the cancer, or that they can catch it.
They may try to be especially good, setting impossibly high standards for themselves. You may see changes in their behaviour, concentration, schoolwork or friendships.
How to help
The suggestions for children aged 3 to 5 still apply to many in this age group. You may find the following tips helpful too:
- Use books to explain the cancer and its treatment.
- Reassure them that many people with cancer get better.
- Make sure they keep up with school, other activities and friendships.
- Let them know it is okay to enjoy themselves.
- Give them little things to do to help out.
Teenagers usually understand what is going on in terms of the cancer, but they can be reluctant to talk about it. They may find it hard to talk to you, or show how they feel. It is important to encourage them to ask any questions they have and make sure they feel involved.
Some teenagers may be keen to help out. But they may find that at a time when they want to be more independent and spend less time in the house, they have more responsibilities at home.
This can make them feel angry and guilty at the same time. Sometimes their behaviour may seem hurtful to themselves or others.
How to help
- Tell them about sources of information that may help, such as riprap and Hope Support Services.
- Ask them what they think and include them in the same way as you would include an adult.
- Help them see that talking about feelings is a positive and mature way of coping. Encourage them to talk to someone close, such as their friends, a relative or a family friend.
- Make sure they keep up with friendships, activities and normal life as much as possible.
- Give them time and space to themselves when they want it.
- Keep to usual rules and limits – these can be even more important now than before.
- Explain that they might need to help out a bit more with things like cooking, tidying up or looking after younger siblings. Allowing them to help shows that you need and trust them. But reassure them you do not expect them to do everything.
- Show them you appreciate their help.
Children can have lots of different emotional reactions. They can show their feelings through anger or bad behaviour. Your child may react to your illness with behaviour you would not normally accept.
Some children may have problems with eating, sleeping or bed-wetting, or problems at school. They may seem sad and withdrawn, or have physical symptoms like going off their food, headaches or tummy aches.
These changes are not necessarily unusual, but if they carry on, or if there is anything worrying you about your child, you can ask for help.
People who can offer you and your child support are:
- your GP (family doctor)
- the school nurse
- social workers
- psychological services at your hospital
- local counselling services
- health visitors (for pre-school-aged children).
Your cancer doctor or nurse can give you advice about counselling or psychological services to help you support your child.
You may be able to get help from social workers. In England, Scotland and Wales, social workers are accessed through your local authority (council).