For most families, a parent's diagnosis of cancer represents a
crisis. Family members find that they must adjust not only to the
diagnosis, but also to a prolonged period of treatment. This
presents a major challenge to both parents and children.
Supporting your children through this time is not easy, and no
one can do it perfectly. Here are some tips
and tools to help you help your children cope.
Most kids appreciate spending time with their parents,
especially during periods of stress. So to the extent possible,
spend as much time as you can with your children, either all
together or one-on-one. What you do is not so important. More
important is the message you send when you focus your energy on
Even everyday "normal" chores offer a chance for you
to be together. As you are able, drive the carpool, shop for
clothes, or make dinner with your kids. If you are tired or not
feeling well, watch a favorite movie or TV program together, listen
to music, snuggle on the couch to rest or read, or play a board
game. Find ways to have fun, laugh together, or play. One mother
told of bringing her wig home for the first time, and having
everyone in the family try it on – even the dog!
When you spend comfortable,
unstructured time together, your children may be more likely to
bring up their concerns and ask you questions about your health and
treatment. You also may find that you are better able to talk about
your cancer or give an update when you and your children are
quietly enjoying each other's company.
As much as possible, try to maintain your child's usual
mealtimes, bedtimes, and other activities. If people come into your
house to help, let them know about and ask them to follow these
routines whenever possible. Try to alert your children to any
upcoming changes, and ask for their thoughts about what they would
like to happen.
For instance, if you are going to be in the hospital for a few days and if you have a choice of caregivers, ask
your kids if they have any preferences about who will take care of
them. Honor their requests when you can, and try to explain your
reasons when you can't. If your choice of caregiver is more
limited, offer options for other, more flexible, arrangements
(e.g., when to have friends over, what to eat for dinner).
Don't overlook the importance of maintaining regular contact
with your children. If you plan to be hospitalized, talk with
your sons and daughters about how you will communicate: by phone,
through email, or in person, as well as when and how often.
When your children know they will speak to or see you at a specific
time, they may be less anxious about your absence. You are helping
them know what to expect, and including them in a positive way.
Like routines, limits provide predictability and order, helping
kids feel safe and supported. So even if you think you should ease
up on family rules for the time being, consider that your children
may not want you to. For example, if your children were required to finish homework
before watching TV, or were responsible for certain household
chores before you were diagnosed with cancer, keep these
expectations in place whenever you can.
Now that you have been diagnosed with cancer, you may find it
difficult to maintain regular discipline. This is not surprising:
when you don't feel well, are tired, or stressed, you simply may
not have the energy to struggle with your children. Ask for their
cooperation, and let them know that you hope they will be as caring
and understanding as possible during this difficult time. Let your
kids know what you expect from them, and that major breaking of the
family rules will have consequences, if not right now, then at some
time in the future. It is best to share what those consequences
would be, being as specific and clear as possible.
Talking with your partner or other involved family members is also an important step. Check to
see that you all are on the same wavelength about family rules and
expectations. Try to talk through differences of opinion and enlist
their support. And if other adults become part of your household
for some period of time, ask for their cooperation as well.
Consider asking your children how they might like to help out.
You may be pleasantly surprised by their ideas! You can also
identify some practical tasks that your children can do, such as
walking the dog or clearing the dishes. Invite them to take care of
you in small ways. You may all feel closer as a result.
Sometimes they may even resent the extra burden placed on them.
If this happens, try to empathize. Acknowledge that the cancer is a
burden for everyone, and that you understand their reactions. If it
is not crucial that they help, let them know that while you would
appreciate their lending a hand, they don't need to do so right
However, there may be times when you really need your children's
assistance, even if they object. If this happens, they may be more
cooperative if you explain why you need their help. Whenever
possible, give your kids a chance to resume their own activities
after they are finished helping you.
Even when a parent is ill, children need to have fun, enjoy
themselves, and keep up with their regular activities. Remember
that such involvement actually helps kids recharge and cope with
the disruptions that go along with your illness. Everyone needs
some time like this.
Let your kids know that while you will do your best, there may
be times when they're not able to invite their friends to your
home, or to take them places. On the other hand, if
you worked full-time before your diagnosis, and are now spending
more time at home, your children may find that they enjoy this
opportunity to be with you.
Despite all your careful planning and efforts, your children
still may need to adjust to some unfamiliar, and occasionally
upsetting, events or experiences. Your sons and daughters are more
likely to weather these changes smoothly if they know what to
expect. So, whenever possible let your kids know about any such
changes ahead of time.
For instance, before you start a new treatment, you might talk
to your medical team about possible side effects, and then describe
these to your children. If you will lose your hair, tell them. If
it is likely that you will feel sick for two days after each
chemotherapy treatment, let them know. When you plan for a friend or relative to
come into the household to help, give your kids advance notice.
When it is possible, let your children choose who will take care of
them, what meals the neighbors might bring, or other details of
Preteens and teens are especially worried about fitting in and
not being different from their friends. Ask your kids
if they are concerned about this. If so, talk with them about how
they might explain the situation to their friends. It may also be
helpful to talk about your diagnosis with the parents of your
children's closest friends. (If you do this, try to let your kids
know ahead of time.) This way, you can have some control over what
your children's peers hear, and your sons and daughters might be
relieved that their friends already know what is going on.
"Coping" includes everything we do to help manage stressful
events and feelings. Within the same family, each child is likely
to have a unique or different coping style. Consider the following
questions to help you to understand each child's coping
What does your daughter do that helps her feel confident? What
is she good at? Does she usually want to talk, need time by herself
to "think things through," or work things out through sports? Does
she use writing, art, or music to express her reactions? Does she
feel better when she has lots of planned activities, or does she
need more unstructured time?
Does he withdraw, seek attention by whining or misbehaving, come
to you for a hug, or tell you directly that he's sad or worried?
Does he talk more readily when he's riding with you in the car,
making a batch of brownies together, or snuggling at bedtime?
Does your daughter feel better staying close to you, or spending
time with friends or siblings? Who is your child most likely to
confide in, and under what circumstances? Who does he turn to in
the family – maybe an older brother or sister? Does joking or
gentle humor help to lift her bad mood? Does your daughter have a
comfort object, such as a blanket or stuffed animal, or find relief
in listening to music?
Many young – and sometimes older – children also are afraid that
they caused the cancer or can catch it from the ill parent.
Try not to be surprised if these issues come up. In fact, you might consider raising them even
if your children don't. Opening the door to this conversation may
help some kids find words for their fears or talk openly about
their worries. Children can have incorrect ideas or beliefs about
cancer, and you can help set them straight on certain key facts and
help reduce some unnecessary worry.
In preparing for these conversations, you might think about how
you would say, given your situation and the ages of your
But be careful: if you bring up a subject and your child tells
you it is not of concern or they don't want to talk right now, try
not to push. It's often enough to introduce the topic. Give your
son or daughter a chance to decide if and when to return to the
You may want to let them know that their worries are normal.
("Of course you're worried right now. That's only natural.") At the
same time, remind your children of any positive changes in your
illness or treatment. And reassure your kids that you love them,
and that you and others who care about them will be there to help,
no matter what happens.
Many parents with cancer find it hard to accept that their kids
do not always maintain a concerned, sympathetic response to the
illness. While some children may be empathetic and generally
helpful, many children feel anxious or resentful when something
interferes with their usual experience of life. Frustrating as this can be, try to
remember that it is normal.
For instance, your 6-year-old might get agitated or throw a
tantrum if you spend part of Christmas day in bed, instead of
playing with her and her new toys. When you feel your sickest, your
13-year-old may be angry that no one can drive him to his friend's
house after school.
When these situations come up, try to stay calm. Acknowledge to your children that the situation
is unfair for everyone, including them, and that you, too, wish it
were different. When you can, think together about how to solve the
It may help your 6-year-old if you suggest that she bring her
presents into your room and play there quietly. Your 13-year-old
might ask you to call his friend's mother for a ride or you might ask
a friend of your own to give your son a lift.
Be prepared for your kids to react with anxiety or
irritation, even when you do a terrific job of predicting and
informing them of any necessary changes.
One mother tells of her children's resentment when their ordinarily beloved grandmother
came to stay with them during their mom's surgery. Her
oldest explained angrily, "She's not you, and besides we don't want
anyone else in our house!" After their mom patiently accepted their
dissatisfaction, carefully explained (again) why grandma was
needed, and reassured them that the household would get back to
normal as soon as possible, her children settled down. The visit
went relatively smoothly after that, demonstrating that when
children are kept informed, their resentment is usually
short-lived, and they can adapt to changes.
Children rarely come out and say, "I'm upset because dad has
cancer." More typically they show their feelings through changes in
their mood or behavior, or in how they treat family members or
friends. For instance, you may notice that your son or daughter is
more clingy than normal, is agitated, worried or sad, or loses his
or her temper much more easily than usual-or you may notice nothing
For instance, an independent 11-year-old is suddenly afraid to
spend the night at her friend's house, or a 7-year-old searches
for his old baby blanket. Getting into trouble at school by
disrupting the class or doing poorly on homework and tests are
other common reactions.
Try to watch for such changes. Also ask teachers and others who
see your child frequently to let you know of anything unusual.
Try not to judge or criticize
your kids' reactions, but do ask about them. Saying, "I notice that
you seem really mad at your sister. Want to talk about it?" opens
the door for conversation in an emotionally neutral (no one is
being blamed) but caring way.
Acknowledge the possibility that your illness may
contribute to your children's behavior, too. ("I know
things have been a bit crazy since I learned I had cancer. It's
been hard on everyone, don't you think?")
When your kids act out of the ordinary, consider asking them
what's going on, and if it might have anything to do with your
cancer diagnosis. If your children seem frustrated with your
response, ask them to explain how your illness affects them, and
how they would like you to react.
A patient recently offered an excellent example. After observing
her young son's unusually sarcastic and angry behavior, a mother of
four repeatedly asked him if anything was wrong. He continually
said no, but several days later, confided that he had overheard a
neighbor saying that his mother had "four months left." This young
mother realized that her neighbor had been discussing her
chemotherapy, not her prognosis. When she told her son that she had
four months left of treatment, not that she had four months left to
live, he was visibly relieved. His behavior improved dramatically
And when you have a diagnosis of cancer, your life gets harder,
not easier. So try to become more comfortable asking for help – from
your partner, your friends, and your relatives.
Most people have a hard time asking others to lend a hand. You
might find it easier if you can make specific requests that fit
into helpers' daily lives and schedules. For example, ask your
stay-at-home neighbor if she could baby-sit while you go to the
medical center. Ask your brother if he could pick up groceries for
you. Ask the parent of your son's teammate if he would drive him to
and from soccer practice.
Instead, practice saying, "Yes, thank you." If you have help
when you need it, you will be more available to your kids when they
Encourage your children to see friends and continue with outside
activities. (If you don't have the energy to arrange play dates for
your younger kids, or drive to and from after-school lessons, ask a
friend to help, as described above.) Ask friends and relatives to
invite your child to play or to join their family for the
afternoon. If you are comfortable doing so, let the parents of your
children's close friends know of your situation. This way, these
adults may offer support to your child and, perhaps, to you,
Children often benefit when they realize they are not the only
ones with an ill parent, and may gain a lot of comfort from talking
to others who really "get it." Groups specifically organized around
the needs of children may be particularly helpful. Your children's
school counselor, a hospital social worker, or resource room may
have information on such groups.
And if you are concerned that your child is having an unusually
hard time coping, you might consider taking him or her to an
individual therapist. And even some children who do not appear to
be struggling may appreciate the chance to talk with an objective
person like a therapist or school counselor or hospital social
worker. Again, you can consult with your medical team or school for
Your children's teachers, guidance counselors, and school nurse
can play a very important role in supporting your children during
your illness. After all, they see your kids every day, and may be
the first to notice changes in behavior or mood. They may be able
to support your children by providing extra help or special
attention when times are difficult.
Consider contacting the school principal or another staff person
to tell him or her what is going on, and to ask for suggestions on
how best to inform other staff, if appropriate. Together, you can
develop a way to maintain ongoing contact, so that the school can
alert you to changes in your children's behavior or performance;
and you can update key personnel on any changes in your health or
Your children may know and interact with several adults outside
the family, including coaches, friends' parents, neighbors, and
religious schoolteachers. Think about whether it would be helpful
to let them know what is going on at home. If you do contact any of
these adults, consider asking them to tell you if they notice
anything unusual or concerning about your children.
Suggest ways in
which they could support your children, such as taking them to a
movie, inviting them for an over-night, or lending a sympathetic
ear. You might also choose to tell these adults what you have
already shared with your children about the illness, so they can
reinforce your message. Finally, let your children know that you've
talked with these adults, and that they are ready and able to
listen, support, and spend time with them.
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