Illness and death are as much a part of life as health and happiness. However, we often find these subjects tough to talk about with children.
Dr. Jennifer Wojciechowski, a clinical child psychologist at Sharp Mesa Vista Hospital, shares tips on how to talk with children about such a tough subject.
When should you first talk to a child about a loved one's illness?
Adjusting to a loved one's diagnosis and illness can be a difficult, ongoing process that generates many challenging emotions. Talk with your child as soon as possible about the events that are unfolding with your loved one's diagnosis, illness and treatment. Parents often withhold information in an attempt to shield children from worry or painful emotions. However, children are extremely perceptive — they can typically sense something is wrong or "off" very quickly. When not given information about a loved one's illness, children will often jump to their own conclusions about what is happening and imagination can often be worse than reality.
How much should children be told?
How much information you provide to a child will vary based on a child's age, developmental level and understanding of complex concepts. When people are facing complicated or life-threatening diagnoses, there are many unknowns. It is important to be truthful with children, provide simple answers to their questions and avoid making promises or guarantees about future outcomes.
Letting children know what they can expect during a loved one's treatment, hospital stay or recovery will help them be more prepared. For example, you may say, "When Grandma takes the medicine to fight her cancer, you will probably notice some changes. She won't have as much energy as she normally does. Her hair will fall out and she may lose weight."
If your child asks questions about death, it is important to provide honest responses. If you do not know the answer to their question, it is OK to say so. For example, if a child asks, "Is Grandma going to die?" You might respond by saying, "Everyone dies eventually. Nobody knows if Grandma will die from the cancer. She is taking medicine to help fight the cancer and the doctors are taking very good care of her."
How can parents help children cope with a loved one's illness?
Be honest and patient with your child's questions. Allow children to experience whatever emotions arise and assist them in coping with these feelings. If a child experiences worry or sadness related to the information, you can label your child's feelings and suggest appropriate ways to cope with these emotions. For example, they can make a card for an ill family member or draw a picture of a memory with the loved one.
Be aware that young children often lack the words to describe how they are feeling. As a result, they often act out their emotions through their behavior, perhaps with increased aggressive behavior, separation anxiety or bed-wetting. Be patient and tolerant with young children during this time and model appropriate ways to cope with emotions. Children find comfort in knowing what to expect. Try your best to maintain your child's schedule and routine. Remember that children are not able to grieve for long periods of time, so be sure to provide ample opportunities for fun, play and expression of positive emotions.
At what age is it appropriate to take a child to visit a loved one in the hospital or hospice?
There are no specific age requirements for visiting loved ones in hospitals or hospice. Some things to consider include:
- Take into account the age and behavior of the child and whether it is likely to interfere with medical equipment or the patient's comfort or treatment.
- Follow the child's preferences — Explain what the visit will entail, and give children a choice. Some children may want to come to the hospital but only go to the visiting room. Others may opt to instead provide parents with a card or drawing to give to a loved one.
- Explain to children in terms they can understand what they are likely to encounter when visiting loved ones and explain what emotions may arise. For example, you might say, "Grandma will be lying in a bed and her eyes will be closed. You will be able to talk with her, but she won't be able to talk back to you. It's OK if you feel sad or start to cry."
- Factor in your emotions and ability to cope with your child present. If you are having difficulty managing your emotions and are unable to be a present or responsive caregiver to your child, arrange for childcare outside the hospital or bring along a caring adult to supervise and attend to your child's needs during the visit.
"Adjusting to a loved one's diagnosis and illness can affect the whole family," says Dr. Wojciechowski. "Parents should expect changes in children's behavior during this time. However, if a child exhibits significant aggression toward others, displays self-injury or makes comments about suicide, it would be important to have them evaluated by a mental health professional as soon as possible."