When a family member has a long or serious illness, it may disrupt family life. Perhaps Mom goes out every evening to visit her sister in hospital, ending the familiar bedtime routine. Or a sibling with a serious illness consumes more of the parents' time and attention. Or if Dad is troubled about sickness in his family overseas, children notice that he's not as ready to play as usual.
Explaining an illness
Children should be told about illness in a way that they will understand: "Aunt Emma has cancer. That's a disease that makes her very sick and weak." This may be enough for your six-year-old, but an eight-year-old will want to know about how cancer acts on the body, and a twelve-year-old may be interested in the details of chemotherapy. Let them know how it might affect their lives: "I'll go to see her every night to cheer her up, so Daddy will put you to bed." Often a family illness will bring out the child's fears about disease. Reassure him that he cannot catch cancer and that he won't have to go to the hospital just because he's ill with a cold. When a family member has a terminal illness, a child might interpret every upset tummy as a sign that he, too, might be ill.
If the family member faces the probability of death within a short period of time, prepare your children for that probability. Otherwise, when the death occurs, they may feel betrayed, as if everyone but them knew what was going to happen. Don't take away their hope that the loved one will recover, but introduce the idea that death might be the end result: "Grandma is in the hospital. She's had a stroke, and we're worried that she might die. The doctors are doing everything they can."
Set up a support system
When you're caring at home for someone who's ill for a long time, seek out all the help you can to keep family life stable for your children. Enlist school friends and neighbours to take them to school or to their swimming lessons. If you can afford it, hire someone to manage the household so that you can concentrate on the family and your sick spouse or child. The children will feel less lost if they can help in some way. Suggest your six-year-old draw a picture for the sick family member. An older child might help by taking water to Daddy in bed or by reading him part of the paper. Your 11-year-old may be able to help more around the house or walk to the corner store for supplies. If someone in your family is dying, nothing you can do will ease the pain of a terminal illness in a parent or sibling, and you may want to get counselling for your children or yourself.
When a loved one dies
Until recently, it was common to hear that children did not grieve, even over the death of a close family member. Although children may react to a death differently from an adult, they do grieve deeply. What adults may feel as a hollow in the heart may feel like a tummy ache to a grieving child. They may lose appetite, have trouble sleeping, be unable to concentrate in school or revert to earlier behaviours like bedwetting or tantrums. Children cannot concentrate on their grief as adults do. They may seem to bounce back, laughing and wanting to play with friends or return to school right after a death. But they will return to do the work of grieving later -- in some cases years later.
How to tell them
People who work with bereaved children recommend you use the words -- death and died -- rather than euphemisms such as passed on or gone to heaven that might be confusing to children. Try to tailor your message to your child's level of understanding. Sit close beside him and touch him as you speak.
First, give a little warning of what you are about to say: "I have some bad news to tell you." Then, say what has happened: "Grandpa died suddenly last night." Third, give a cause of death: "He had a heart attack. That's when the heart stops beating." This will be enough information for most children, as they try to absorb the news. But leave the door open to all the questions that will arise later in your child's mind. "Do you have any questions about Grandpa?" If you feel you cannot handle these questions, direct your child to someone accessible who can: "I am feeling sad today. You can ask Aunt Bea."
