Being honest and providing information in simple terms can help children cope with illness and death
By Jane Doucet
It’s hard enough for an adult to handle the news that a loved one has a serious illness. Now imagine children who haven’t yet developed the coping tools to properly process the information receiving that news, and their ensuing feelings.
It’s important for parents to handle these situations sensitively, particularly if the sick relative is Mom or Dad. “Always provide information in clear language, simple terms and developmentally appropriate amounts based on the child’s age and capacity to understand,” says Dr. Pamela Mosher, a child psychiatrist at the IWK Health Centre.
Research shows that children who receive information in these types of stressful situations and talk about it with their parents experience less anxiety overall than those who don’t. But parents should be mindful of being too straightforward and honest. The goal is for children to get the information they’ll need to process what’s happening in healthy ways but not be overwhelmed (especially younger ones) with too much detail, which can be scary.
“It isn’t honest to say that Mommy isn’t going to die, because if she does die, the child will feel lied to,” Mosher says. “It’s truthful to say that Mommy is sick, and her body needs medicine and surgery to help it work better. And that Mommy and Daddy love you, and no matter what happens, there will be grown-ups to take care of you.”
For example, if Mom is having treatment for cancer, their son might tell Dad he’s upset and afraid she’ll die. Dad could say, “I’m upset, too, but Mommy’s doctors are using medicine to fight the cancer, and we hope that she’ll keep living. But sometimes cancer is too strong and even the best medicines don’t work. So I’m also upset that Mommy might die. If she does, we’ll all be sad and miss her so much, but I’ll be here to make sure you still go to school, see your friends and do the things that matter to you. And we’ll talk about Mommy together.”
If the sick relative isn’t a parent but lives nearby, visits can be helpful for both the family member who is ill and the child. “If they’re used to having regular visits, there’s no reason to stop this routine unless the parents and child discuss this and make a decision together,” says Mosher.
Hospital visits are fine as long as the child is prepared in advance for what he or she might see. For example, how Grandma will look, whether she’ll be in bed asleep or in a private or shared room. It’s a good idea to decide ahead of time on how long the visit will last.
If the relative is a sibling or young cousin, one question that might come up is, “Could I get sick like Cousin Lucy and die?” This is an understandable fear, says Mosher. You can address it by saying: “While it is possible that another person might get sick with the same disease, it isn’t very likely that you will become sick. But if you do, Mom and Dad will be here to care for you, no matter what.”
Regardless of the circumstances, and as difficult as it can be, parents should try not to alter their children’s routine. “Children should keep normal routines and schedules as much as possible,” says Mosher, “and meet basic expectations in terms of school performance.”
Support at school
Teachers are well equipped to observe their students’ behaviours and notice when something changes. While many parents will let teachers know when a loved one is seriously ill or has died, not all do. “In those cases, the teacher can have a conversation with the parents to find out what’s going on,” says Faye Trim, a Halifax-based registered psychologist and former school guidance counsellor.
Once the teacher has the necessary information, he or she can approach the student sensitively. But what if the child hesitates to open up? “It’s never a good idea to push a child to talk,” says Trim. “The teacher can say, ‘You seem to be more emotional than usual in class’ or ‘I’ve seen you crying—that’s not like you, what’s going on?’” If the student chooses to confide, the teacher can then respond, “How can I help you?”
Some teachers lead “caring circles” during which classmates discuss a certain topic. “The teacher could encourage the student to share his or her feelings, then listen to other students tell a story about someone they’ve lost and how it made them feel,” says Trim. “It can help them realize they’re not alone.”
After a student’s loved one has died, teachers need to be patient. “It can take one to three years before grief is resolved,” says Trim. “Each child is unique and will progress differently. Keep in mind that children are resilient. With the right support and coping skills and enough time, they will heal.”
If teachers still have concerns about worrisome behaviour such as frequent crying or angry outbursts, they can access the school’s psychologist, social worker or guidance counsellor. “The school can play a big role in helping students at times like this,” says Trim. “The more supports the child has, the better.”