Tips to help children cope with sick parent

Every year thousands of New Zealanders are diagnosed with cancer, which introduces a time of uncertainty and dramatic change. It's hard enough for an adult to handle with but what about the children? What do you tell them?

Why tell the children?

The Cancer Society says children have a right to know about anything that affects the family. It is likely they will know there is something wrong and if nothing is said, they may have fears that are worse than the reality.

"Not talking about cancer may suggest it is a subject too terrible to be discussed. There is a hopeful side," the society says in its guide for parents coping with cancer.

"You would not wish your children to have an abnormal fear of cancer or illness," says Jennie Jones, national education and training co-ordinator for Skylight (an organisation dealing with change, loss and grief experienced by young people).

People are often afraid of their own mortality. People with cancer may not want to tell their children because they want to protect them.

But Jennie Jones says it is vital for parents to keep their children informed from the beginning.

The Cancer Society says children have a remarkable capacity to deal with the truth. Telling them what is going on provides an opportunity for them to learn about the disease and its treatment - and shows how people cope with difficult situations.

Who should tell them and when?

The sick parent should tell the children if they can without getting too upset.

Alternatively, a close relative or your doctor could do it.

The Cancer Society says it's best to talk to your children after being diagnosed, when you are being treated and after treatment is finished.

Jennie Jones says keeping children informed about the changes they can expect, for example in your appearance or energy levels, will make it less of a drama.

"It's sitting down and saying, "This could happen to mummy, I could start looking a bit different. I could bloat up, my face could change with the drugs I'm on."

Plan activities together such as reading or watching television that don't need too much energy.

Be ready to answer children's questions or concerns as they pop up.

What should you tell your children?

Be honest and ensure any information given to children and young people is in a form they understand.

Story books, for example about the body so you can point out where the cancer is, may be helpful for really young children while older children may appreciate the detail a nurse or doctor can provide.

Explain what has happened and what's going to happen, for example doctors' appointments and visits to the hospital.

There may be changes to some of the routines at home. You may need more help from friends or family.

Make sure children have some feeling of hope and reassure them that they will be loved and looked after.

Jennie Jones says people often equate cancer with death but the reality is not everyone who gets cancer dies from it.

But she says if you find you are not going to recover, tell the children and be prepared for some direct questions, such as "What about me?", "Am I going to die too?" or "Is it my fault?"

Help prepare children for a future without you - a video or letter from you, a photo album or scrapbook are among the ideas suggested by the Cancer Society.

If you are a single parent or caregiver you will need to work out who will care for your children after your death.

Some of the don'ts

* Firstly, don't lie or scare children with too many medical details.

* Don't make promises you might not be able to keep.

* Don't be afraid to say you don't know the answer and don't push children to talk.

Coping with the change

Like adults living with cancer, children may go through emotions such as disbelief, confusion, anger and sadness.

Some may feel sorry for themselves, cling too much or withdraw. Others will do things that are guaranteed to get them attention.

Jennie Jones says children often find their "whole equilibrium has changed" and become more clingy, have nightmares and start bedwetting. Some also suffer physical symptoms similar to their sick parent.

Everyday routines at home may suddenly change and children may find themselves taking on extra responsibilities.

"Let kids help you out but don't rely on them to do it. Have them bring you a cup of tea but don't expect them to become the housekeeper. Children are still children and you have to remember what is age appropriate."

Helping children of different ages

* Pre-schoolers

Small children fear being left alone or with strangers, so if you are in hospital arrange for a familiar person to stay with them. Young children often feel they have magical powers and believe that what they wish will come true.

"Assure them that nothing they have done or said or thought could cause your illness," the Cancer Society says.

* Ages 6 to 11

Children in this age bracket may become unduly concerned about a parent's health. That could result in disturbances in sleeping, eating, school work and friendships. They may revert to the behaviour of a much younger child.

It is important not to put pressure on them or worry them with details. Let their school know about your condition.

* Teenagers

Teens are already struggling with a range of emotions and issues and may find it hard to talk to you or show you how they feel.

If so, encourage them to talk to a friend or another family member.

They are more likely to want to know more of the clinical, "gory" details about the disease, Jennie Jones says.

It's likely they will have to take on more responsibility but don't overburden them.

"Teenagers need to be included and consulted as adults but will continue to need guidance, support and reassurance."

nzherald.co.nz/health