My mother-in-law, with whom my seven-year-old daughter and eight-year-old son are close, has just been diagnosed with lymphoma cancer. What advice do you have for what we tell them about their grandmother’s health situation?
I want you to know how very sorry I am about your mother-in-law’s diagnosis.
As a young parent, statistics indicate that you are not alone in having to tell your children about a member of your family facing a serious medical issue, especially regarding grandparents. For example, the National Center for Health Statistics recently released annual data on numbers and causes of deaths of people over 65 (comprising the major grandparent population). Of 1.8 million deaths in this 65 + age group: 25% of the deaths (450,000) were caused by heart disease; 23% (414,000) caused by cancer; 7% (126,000) by strokes; remaining deaths due to smaller percentages of other diseases and illnesses. This means that many young parents will be asking the question you’ve posed: How do I tell my child that a grandparent or other close family member has a serious disease or illness?
In answer to your question I’ve developed a set of 14 guidelines that I hope will help you and other young parents, “Guidelines for Telling Your Child that a Family Member Has a Serious Disease or Illness.” In the remainder of my column I want to highlight and comment on several of the guidelines.
Guideline #4:
Before you talk with your child, you may want to find out from the person with the disease or illness if he/she has some preferences about what gets communicated about his/her situation and his/her thoughts about having visitors and/or involvement with your child. I think this is an important step to ensure that what you tell your children is, in fact, accurate. For example, it could be very confusing to your children if you say they will be visiting with Grandma during her treatments, only to find out later that Grandma has decided that she does not want to visit with any of the grandchildren during treatments, but rather, she wants to communicate with them via telephone, texting or e-mail, or not at all.
Of course you will want to honor Grandma’s preferences, but the one area you may disagree with her is if she does not want her grandchildren to be told anything about her disease or illness, and you feel strongly that you want your children to know, especially if they are close to her. If all of sudden Grandma is not available to them, what are you supposed to tell them, if not the truth? Grandma has every right to play a role in framing the message to her grandchildren, but you may decide that any kind of deception is not an option for you and your family.
Guideline #8:
Your child’s main questions and concerns may have to do with death: “Will Grandma die?” “Will you die?” “Will I die?”
When talking with a child about whether someone will die from cancer (or any life-threatening medical condition) The American Cancer Society has examples of what might be said. I think these examples provide a good range of possible responses, depending on what is known and not known about the loved one’s condition. (In these examples I use “Grandma” as the person diagnosed.)
- “Sometimes people do die from cancer. We’re not expecting that to happen because the doctors have told us they have very good treatments these days, and Grandma’s type of cancer usually does go away with treatment.”
- “The doctors have told us that Grandma’s chances of being cured are very good. We’re going to believe that until we have reason to believe something else. We hope you can believe that too. We’ll tell you if we find out anything new or different.”
- “There is no way to know right now what’s going to happen. We’ll know more after the first treatments are finished. When we know more, we’ll be sure to tell you.”
- “Right now there’s not a lot known about the kind of cancer Grandma has. But Grandma is going to give it her best shot and do everything she can to get well.”
- “Grandma’s cancer is a hard one to treat but she is going to do everything she can to get better. No one can know right now what will happen down the road. What you can be sure of is that we’ll be honest with you about what is going on. If you can’t stop worrying, please tell me so that we can work on that together.”
Guideline #12:
Most children like routine and structure, so you’ll want to be ready to talk about changes effecting the child and the family that may / will happen as a result of the loved one’s illness or disease. Examples:
- “Because Grandma will be tired from her treatments and will need lots of rest, she won’t be able to take you to your swim lessons like she’s been doing.”
- “Grandma will be having her treatments during the summer, so she won’t be going with us to the cabin for vacation.”
- “I will be taking Grandma to her doctors’ appointments three days a week, so I will not be with you on those afternoons, but Aunt Susan will be with you.”
Guideline #13:
Equally important, talk with your child about changes he/she may see as a result of your loved one’s treatments and/or operations. These changes may include: visible side effects; new people in the picture, e.g., caretakers; use of devices and equipment.
- “Grandma will be taking some very strong medicines to help fight the disease; one side effect of the medicine is that she may lose some or all of her hair, eyebrows and eyelashes. Sometimes she may wear a wig or scarf on her head, and other times you may see her ‘looking bald.’ Her hair should grow back later.”
- “When we visit Grandma at her home, she may have a nurse or nurse’s aide staying with her to help take care of her.”
- “Grandma will have to take some of her medicine intravenously. Here is a picture of what this will look like and this is what it means…”
In closing
I want to emphasize that as difficult as this communication about Grandma’s health situation is and will continue to be in the future, the key is to give your children truthful information when they need it to help them cope as well as possible from day to day.
Ask Dr. Gramma Karen is published every Tuesday.
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