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#askalyson: talking to kids about illness
when it comes to talking about illness and death with children, it's important to tell the truth.
if you need to discuss a serious illness with your child, make sure to keep the conversation age appropriate.
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dear alyson,
i am looking for some advice on how to talk to my children who are nine and twelve about illness and death. since the beginning of the pandemic, there has been so much talk about sickness and loss that it had me thinking about how i would talk to my kids about these difficult topics if i had to. i have read that it’s important to tell the truth, but would that be traumatizing?
signed, worried
dear worried,
when talking to children about complex and difficult topics, including death or illness, there are some important principles that should be followed — speak the truth, pay attention to the age of the child and allow space for them to share how they are feeling.
speak the truth. it’s important that we don’t lie or deceive children. when a child later discovers that they have been lied to, even if the motivation was to protect them from hurting or sadness, it still feels like betrayal. being deceived, duped, or discovering a family secret actually creates more psychological destabilization than any truth could.
be age appropriate. children of different ages have different cognitive abilities, but that doesn’t define whether or not you are truthful, it just means you can be more vague and general. parents should act as a screen or filter for information. for little children, we need to have a very tight filter with little information getting through, while ensuring it is still accurate and factual. as children get older, the filter can widen and allow more information and specifics to be passed on.
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ask them to share what they have heard. when children repeat what they think they hear, it gives you an important opportunity to check what they have understood. even if you are really clear and accurate, young children can misunderstand. i am reminded of a story about a boy who offered to donate one of his kidneys to his brother, and when it came time for the organ transplant he started saying his goodbyes. he didn’t understand that he had two kidneys and could live with one — he thought he was giving up his life for his brother.
if you are wondering what all of this would actually sound like, here are some examples of typical age appropriate scenarios.
i might tell a very young child that, “the doctors say a part of mommy’s body is not working properly. the doctor is taking very good care of me. he is giving me some medicine to see if that makes me better, but we don’t know for certain. while i am sick, i have to sleep a lot and won’t be able to play with you the way i did before. but you can come bring your toys and play on my bed. your company cheers me up.”
if the prognosis gets worse, i would say, “sometimes when people get sick, the medicine doesn’t work and they don’t get better. their body gets too sick and it isn’t able to work anymore, so they die. the doctors say my medicine is not working, so i am preparing for a time when by body stops too”.
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for an older child, i might say something like, “the doctor has discovered that i have cancer. cancer is when cells multiply quickly and for no reason. they make lumps called tumours and they are invasive like weeds in a garden, and stop your body from working properly. luckily, the doctor says he knows where my tumour is and can remove it with surgery and then, just to be extra sure all the cancer is gone, he is going to give me drugs that attack cancer cells. that’s called chemotherapy.” it is also helpful to talk honestly about what happens next, so something like, “the doctors think i have a very good chance of recovering fully — everyone is different and some people respond differently, and yes, some even die. but we are optimistic, i am getting great care, and i will let you know more as we learn more through the process. do you want to share back what i just said and ask any questions? are you okay? i am here for you, and i will answer any questions that come up for you as i go through this.”
for an older, educated teen, i would say, “i found a lump in my breast and the doctor wants to do a biopsy to see if it is cancerous. we won’t know for a few weeks, but i promise i will share whatever i learn with you as i hear news myself. if you have any questions for me or the doctor, let me know. yes, it’s scary, but there is no reason to think the worse. it could be benign. even if it is cancerous, the treatments today are so effective. we’ll have lots of options to talk about together. one step at a time. we’ll get through this.”
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of course, you will shape the conversation you have with your child according to your child’s personality and how much you feel they can cope with. but most important is keeping the door open to communication, questions and emotions. these are difficult discussions to have, but they are critical to ensuring your child’s mental and emotional health as they move through these scary and uncertain situations. and you might find that knowing your child feels supported and understood also helps you find comfort.
alyson schafer is one of canada’s leading parenting experts. she can be reached at hello@alysonschafer.com or on twitter @alysonschafer.
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