How you answer these questions depends on the nature of the cancer and the effects of treatment. Work out in advance what your children might ask and think about how you want to respond.
Asking the same question repeatedly is normal for children. By answering your children’s questions over and over again, you are helping to ease their worries. Sometimes children may test you to see if your answers stay the same.
Q: Why?
At some stage, children are likely to ask why such a terrible thing is happening. This may be a question that you are grappling with yourself and how you respond will depend on your belief system, but there are no easy answers. The important thing is to let children know it is okay to talk about it.
A: “I don’t know. Life feels unfair sometimes and we don’t always know why sad things happen. Why do you think sad things happen?”
Q: Is it my fault?
A: “It’s no-one’s fault. Nothing you, or anyone else, did or said made me ill. And being kind and well-behaved can’t stop someone from dying either.”
Q: When will you/they die?
Time is a difficult concept for young children, so it may not help to give even vague time frames. Older children may want some idea. It is still important to balance hope with reality.
A: “Nobody knows for sure when anyone will die. The doctors have said I will probably live for at least X months/years. Whatever happens, we want to make the most of that time. I will be trying to live for as long as possible.”
(When death is near, you may need to give a different answer.)
A: “I honestly don’t know, but I will probably get a little weaker each day now.”
“No-one can answer that, but we are hoping that there will still be some good days.”
“Pop is very ill now because the treatment hasn’t made him better. He’s not having any more treatment and will probably die soon.”
Q: Who will look after me?
Many children will still be worried about who will look after them, so it’s best to tackle the question early on.
A: “It’s very important to me that you will always be safe and looked after. Dad will be there for you, and your aunty will help all of you.”
“You might be worried about what will happen if the treatment doesn’t work and I’m not around. I’ve already talked to Grandma and Grandpa, and they will be there for you and will look after you.”
Q: What happens if Mum/Dad dies too?
A: “When someone you love is very sick, it can make you feel very scared. But Mum/Dad is well and healthy now and they will be around to look after you. Whatever happens, we’ll make sure you are safe and loved.”
Q: Am I going to die as well?
A: “You can’t catch cancer. When someone you love dies, it’s normal to think ‘Am I going to die too?’ It’s very unusual and unlikely for someone young like you to die or be so ill that the doctors can’t make you better.”
Q: What happens to people when they die?
How you answer this question depends on your personal or spiritual beliefs. You may need to probe further to check what the child means by this question. Responding with an open-ended question such as “What do you think happens?” can help you work out what the child really wants to know. They may be asking what the physical process of dying involves or what happens to the body after death. Keep your explanations simple, concrete and honest. If there will be a cremation, adapt the following example – follow the child’s lead to work out how much detail to give.
A: “The body goes to a funeral home until it’s time for the funeral. Then they will put the body in a big box called a coffin, which will be carried into the funeral service. After the funeral is over, the coffin is buried in the ground in the cemetery.”
(However, the question may be prompted by more spiritual concerns, such as whether there is an afterlife. How you explain the spiritual aspects will vary depending on your own culture and belief system. You may want to explore what the child already believes before explaining your own view.)
A: “People believe different things about whether a person’s soul lives on after. What do you believe?”
Supporting grieving childrenEach child will react to loss in their own way. Do not underestimate the impact of a bereavement, even if a child is very young or does not seem sad. Their grief may be expressed through play or other behaviour. Children often work through feelings slowly, facing them in bearable doses. Allow children space to grieve – you do not need to “fix” their sorrow. Let them know that it is natural for people to express sadness in various ways, just as they express other emotions. For bereavement information and support, call Cancer Council 13 11 20 or contact one of these organisations: Australian Centre for Grief and Bereavement – 1800 642 066 GriefLine – 1300 845 745 CanTeen – 1800 835 932 Redkite – 1800 733 548 |
We thank the reviewers of this book: Professor Kate White, Chair of Nursing, The University of Sydney, NSW; Sarah Ellis, Psychologist, Behavioural Sciences Unit, Kids with Cancer Foundation, Sydney Children’s Hospital, NSW; Kate Fernandez, 13 11 20 Consultant, Cancer Council SA; Chandra Franken, Program Manager – NSW & ACT, Starlight Children’s Foundation, NSW; John Friedsam, General Manager of Divisions, CanTeen, NSW; Keely Gordon-King, Cancer Counselling Psychologist, Cancer Council Queensland; Stephanie Konings, Research Officer, CanTeen, NSW; Sally and Rosie Morgan, Consumers; Dr Pandora Patterson, General Manager, Research and Youth Cancer Services, Canteen, and Adjunct Associate Professor, Cancer Nursing Research Unit, The University of Sydney, NSW and Visiting Professor, Faculty of Health and Life Sciences, Coventry University, UK; Suzanne Rumi, Consumer; Michael Sieders, Primary School Program Manager, Camp Quality.
We would also like to thank the health professionals, consumers, organisations and editorial teams who have worked on previous editions of this title, and we are grateful to the parents and young people whose real-life stories have added to the richness and relevance of this book.
We thank and acknowledge Dr Paula K. Rauch, MD, Founding Director, Marjorie E. Korff PACT (Parenting At a Challenging Time) Program and Associate Professor of Psychiatry, Harvard Medical School, whose research and writing on helping parents talk to their children about cancer was used as source material for this book and has been adapted in several sections: pages 8 -11, Different views of cancer; page 24, Answering key questions: Are you going to die?; pages 26 -27, Involving the school or preschool; pages 30 -31, Prepare for hospital and treatment centre visits; and page 37, Encouraging family time. We also thank the American Cancer Society for permission to use and adapt material on pages 8 -11 from its book Cancer in Our Family: Helping children cope with a parent’s illness (2013); Macmillan Cancer Support for permission to use its book Talking to Children and Teenagers When an Adult Has Cancer (2013) as a source of information; Jessica Watt, Oncology Social Worker, Children’s Hospital Westmead, for her contribution on page 18, When another child has cancer; Diane McGeachy, Hobart Counselling Centre, for contributing material for page 38, Spending one-on-one time; and Dr Ranjana Srivastava, and The Guardian for permission to adapt €œHow do you tell your children you have cancer? €_x009d_, on pages 21 and 47 – full story is available at https://www.theguardian.com/society/2015/nov/29/how-do-you-tell-your-children-you-have-cancer.
View the Cancer Council NSW editorial policy.
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