A parent or loved one nearing the end of life is an extremely challenging time for a child. It is important to help them feel safe and protected in their emotions and fears, but there are no easy answers. Strength and guidance can go a long way to help, as can being honest about what the future will bring.

Being Open With Children

As much as we may want to protect children, they need to be aware when a parent or loved one is approaching the end of life. They may have already noticed physical changes, a change in routine or greater absences of their loved one. They may overhear conversations or notice concerned glances that others think were not heard or seen.

Acknowledging that they have not been mistaken in what they have seen can be a gateway to a larger conversation about what is to come. Wanting to shield them from grief is commendable, but it is often better to address these things directly rather than let the child remain uncertain. This can improve trust as well as allow them to better plan how to enjoy the time left remaining with their loved one.

Explaining What Is Happening

It is never easy to share difficult and emotionally charged information. Consider how you would like to prepare for this conversation, where it will take place and who will be present. It is important to consider a child’s age and developmental stage when approaching these conversations. Being honest and providing concrete information will help provide a foundation for the days ahead.

You may need to explain that despite best intentions, their loved one’s treatment is not going well and the cancer is getting worse. The doctors and nurses have done their best, and sometimes this is not enough. Most of all, assert that this is no one’s fault: not yours, not the loved one’s and especially not the child’s own fault.

When speaking about death and dying, it is important to use those words. For example, if a child is told a loved one is “going away,” the expectation is that they may return. If told their loved one is “going to sleep,” children may believe their loved one will wake up or potentially cause a child to fear going to sleep themselves.

This can be a very emotional conversation and it is completely understandable to become upset while speaking about this. Know that children may not react in ways that you might expect: be prepared to allow them to process the complexity of these feelings over time.

Next Steps

Depending on what the medical team has decided, continue to share whether some type of medication or care will continue to help to relieve symptoms of the disease, such as hospice care. Continue to explain that despite this type of care, the cancer is not going to get better and that the goal at this point is comfort and peace.

Children may have questions and may also ask to speak about this again. Depending on a child’s age and level of comprehension, it may be helpful to keeping this dialogue open. Continue to update them on changes in their routine, as well as who will be caring for them in the future. Think of ways you would like to spend time together as a family and how your loved one will be honored. Try to reflect upon special memories and how the child’s loved one will always be a part of their lives moving forward. In the immediate time frame, the child may even wish to be helpful in some ways, such as helping make the person with cancer more physically comfortable.

It is okay to acknowledge how difficult this is for you, too. Children can respond to signs of vulnerability in adults as permission to both feel the power of their emotions and to feel shared strength together. For information on dealing with grief after the loved one’s passing, please refer to our fact sheets “Helping Children Who Have Lost a Loved One” and “Helping Teenagers Who Have Lost a Parent.”

Taking Care of Yourself

Helping a child when you are facing your own grief can be especially hard. As with all caregiving, try not to take on too much. If possible, see if portions of your everyday duties can be handled by others in your support network. Take time for yourself and try to find ways to lighten your spiritual load with meditation or relaxation exercises. You may find further material in our fact sheets “Advice for Caregivers: How Can You Help Yourself?” and “Advice for Caregivers: Handling Burnout.”

CancerCare offers support groups for those coping with the impacts of cancer and counseling for those living in New York and New Jersey. Online support groups and select community programs are also available nationally. These resources and more are offered free of charge.