How do parents talk about terminal illness with a child?

Dear Sharon,

My mother lives with us and is terminally ill. Do you have any advice about how we can talk to our children about this? They are 8 and 12. They will be observing her decline and the changes associated with her cancer treatment, and we could definitely use some good feedback from you and others. They adore her, and we haven’t told them yet and don’t even know if we should, or if we should just let it unfold and deal with the changes as they happen. What do you think?

Dear Parents,

The details of how to help children, and adults, be with a beloved relative who is terminally ill can be as varied as the individual personalities and circumstances involved, but here are some things to keep in mind that might be helpful as your mother’s illness unfolds.

Many 8 and 12 year olds are mature enough to have had some experience with, or thoughts about, serious illness or death. Therefore, it is often useful for children this age to take part in some discussion about a family member who is confronting a health crisis, and for their parents to be available to answer questions and offer support.

When having emotional conversations with children, I often suggest that parents plan to do so in a peaceful and relatively private environment, and at a time when no one is rushed or distracted by the responsibilities and details of everyday life. Such a conversation might take place in a restful room at home, or while walking in the park on a beautiful afternoon. It is also ideal, if possible, to set aside enough time together to relax and/or enjoy each other’s company before and after the talk.

It is often hard to know the best time to bring up such a complicated topic. It can depend on the age and emotional temperament of each child affected and the progression of the disease. Generally, I suggest that parents give ample time for children to process what is happening as signs of a sickness become more visible, but to avoid having the illness become a major focus in a young one’s life before it needs to be.

Setting up the conditions for children to share their thoughts and emotions can be one of the most caring things an adult offers in trying times. As young people often have “hunches” about family concerns, there are many ways to help a child “open up,” but it can be useful to begin with a question such as “How do you think your grandmother is doing lately?” Listening carefully to a child’s initial response can help Mom or Dad frame the pace and focus of the discussion. If and when the conversation progresses, it is usually wise to introduce specific information slowly and thoughtfully, pausing frequently for questions and giving ample time and space for reactions.

Such talks are rarely easy to have, in part because adults are upset about the challenging circumstances as well. I believe that it is fine for an adult to be emotional as she talks to her child about difficult topics, but whenever possible, it is important to not let her understandable worries and grief distract her from focusing on her child’s needs.

It is good to remember that young people often sort through and recover from major transitions differently than adults. That is fine. Asking a child what he would like to do during and after a relative’s illness can help parents think through how to set things up to go well for everyone.

Although it is always tragic when a loved one is declining, it can also be a time when family and friends gather together to share their wisdom and care, ultimately strengthening relationships for everyone.