Talking to Children About Serious and Terminal Medical Diagnosis – Strategies For Communication

Dealing with a serious diagnosis, whether it be your own or that of a family member, is a difficult and complex process.  Having to break the news of the diagnosis to your children is even harder.  Most parents battle between preventing unnecessary anxiety and stress in their child’s life, and preventing their child the opportunity to take advantage of the time still left (in the case that the diagnosis is terminal).  Many parents wonder how much they should tell their child, if their child even understands what the diagnosis means, and fear the damage the news might bring to their little one.

Be Open and Honest

Despite what parents may fear about too much information, a good rule of thumb is to be as open and honest as possible. Children have great imaginations. When they are left with missing pieces or an incomplete story, they will fill the gaps themselves, which can be dangerous. Even children as young as 3-years-old will wonder how exactly the pieces fit and start to fill the gaps.  Children are like sponges; they absorb immense amounts of information from the world that surrounds them.   They pick up information from the television, advertisements for medications and treatment, their classmates at school, magazines, overheard phone conversations, and their parents mood that day.  No matter how young your child is, they can tell the difference between Mommy’s mood when she is talking about Grandma who is “sick”, and when she is talking to the neighbor.

Thinking your child is too ignorant to understand what is going on will not do you any good.  A lack of communication and ambiguity about what is going on will also give your child the message that the topic is not to be talked about, discouraging your child from asking any important or bothering questions they might have.  Many times children are left with questions that go unanswered because they were too afraid to ask, and no one took the opportunity to talk to them.  Keeping an open line of communication with your children about the changes that are occurring will allow you to reassure your child of any fears they may have, relieve any unnecessary stress, and allow your children to express their love and admiration to whomever may be ill.

Once you are ready to talk to your children, there are several factors to consider and ways to approach the situation. If there is a large age difference between your children, it may be best to talk to each child separately, which will enable you to use the correct, age-appropriate language that each child will understand best.  Different age groups will also have different questions. You may not be prepared to talk with your 7-year-old about a question that your 16 year-old is wanting to know.  It is always important to remember that siblings talk as well. If you are going to keep an older child privy to more information than a younger child, it is important to remember that some of those details might be unintentionally (or intentionally) divulged by the older sibling, which may leave the younger sibling feeling shocked, and hurt for being kept in the dark.

When approaching the topic with your teenager, it is best to find a time to talk where you know you will not be interrupted and you will have plenty of time should your child have many questions.  Do not sit down with your child to talk before something important like a basketball game they have later that night, or right before they are about to go out with some friends. If your time is limited and you have to talk to them during a not-so-opportune moment, make sure you are willing to make some adjustments to their schedule or cancel any appointments should they have a hard time with the news.

Questions and Answers

When approaching the topic with your younger children, it might be helpful to get a feel for what they already know and understand about both the concept of illness and death, and also about the situation that has been going on (possibly they have an idea that something is wrong based on little pieces of information they picked up on at home).  A great suggestion for this is to have a family, “questions and answer” session.  Sit down with the entire family, and introduce the topic of illness. Ask your children to tell you what they know about being ill, and see what responses you get.  That may give you a good base and language example to use when you reveal the news.

Then give each child some strips of paper and a pen, and have them write down all the questions they have. (Depending on the age of the child, a parent may have to write down the question for them as the child whispers it in their ear) Each child will place their questions in a big bowl, and the parents will take turns pulling out each question to answer.  The bowl will allow for anonymity, so the child is not afraid to ask a “stupid” or “wrong” question.  When you pick a question to answer, before you answer it yourself, ask your children if they know the answer to the question.  This will allow you to see what they understand first.   When you are finished, make sure to let your children know they can always talk about it and ask more questions as they come.  You can even put the bowl in a common area and let them know that if more questions come up later, they can put them in the bowl to be answered.  Always leave plenty of opportunity for your children to ask questions and talk.

Also, ask your children questions as well! Ask them how they are feeling. Ask them what they want to do about the news (maybe they want to make the person a card or send some flowers). Ask them how you can help them during this time. Although this may seem like a no-brainer, I am going to mention it due to the technological age we live in.  Under no circumstances should this be topic discussed over a text or an email.  It should always be discussed in person.  Lastly, do not feel pressure to know the answer to every question.  If there is question you do not have the answer to, let your children know you will ask an expert who does know.  If it is a question about the course of a disease, call the doctor with your children. If it is a question about grief/loss, or emotions in general, make an appointment with your mental health provider. As a parent, you do not have to have the answers for everything, but just the willingness to be there and help your child find the answers.

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Vanessa Lemminger, M.A., IMF #68894
Marriage and Family Therapy Registered Intern
www.matthewbruhin.com
Employed and Supervised by Matthew Bruhin, MFT, RAS, CAS – LMFT #47460