What Do I Tell the Children If My Prognosis Is Grim?
If you are doing well now, but this reprieve is expected to be short-term, or you are not doing well and the prospects for improvement are slim, you can help your children deal with this reality. It is a tragedy if your children have to deal with your terminal illness. It is a greater tragedy if you shield them from the facts of your illness. They need and deserve a chance to say good-bye and to find healthy ways to anticipate and cope with their loss. If you mislead them or deny them open communication, they will find it difficult to trust the world around them, a handicap that could follow them into adulthood.
Focus on the good things you had in the past and that you have in the present. Validate their fears, anxiety, and grief. Reassure them that their needs will be met no matter what happens to you.
What Facts Do Children Need to Know?
There are some basic facts about cancer that need emphasis. These facts will help your children deal with your illness and grow up into adults with healthy attitudes.
Make it clear that cancer is not contagious (“catchy”). Your children cannot catch cancer from you, and you cannot catch cancer from them. Make a comparison to something with which they are familiar, such as a broken leg or a headache. This point needs to be made clearly and repeatedly during and after your treatments.
Tell them the name of your cancer. By using the word “cancer,” it becomes an ordinary term, and not forbidden or emotionally charged. Teach them that there are many different kinds of cancer. Breast cancer is very different from bone cancer. Even two people with the same kind of cancer can have very different illnesses. This is similar to one boy’s having a little break in his leg bone and being treated with a walking cast for six weeks, and another boy’s having a shattered leg bone and being treated in the hospital for six months. Both boys had broken leg bones, but their injuries were quite different. Everyone is unique.
Tell your children when changes are expected and how you will deal with them. Let them know if you expect to be tired for a few months and that you will be taking naps. Let them know when your hair will start to grow back or when you will need to have surgery. If you do not tell them, they may come to their own conclusions. They could worry that your fatigue means that you still have cancer even though the doctors said you did not. Your hair regrowth could signal recurrent cancer to them. Surgery to prevent cancer in a remaining breast (prophylactic mastectomy) or to remove an orthopedic pin could be frightening without their knowing the reason for the surgery.
Let them know that there may be unanticipated changes or problems. Reassure them that you will keep them informed and that there will be people (you, relatives, friends, and so on) to help them deal with everything.
Children notice everything. They try to understand what is going on around them and to find ways to cope. If you include them, you can guide them to accurate, healthy, and hopeful interpretations of the events. Open communication builds a deep trust that you can all enjoy from now on. Seeing your children adjust to the truth will comfort you, and may show you new ways to cope.
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