module 2 | Activity 8: How to communicate with children

Providing support to children

Parents diagnosed with life-limiting illnesses require support to communicate age-appropriate information with their children. Common concerns include, the impact of the illness on the child’s routine, their emotional wellbeing, and their understanding of the parent’s illness.[1-5]

Often a parent’s biggest worry is what to say if the child asks if the parent is dying.[3, 5] Helping parents feel prepared to talk with children about their illness and possible death at any stage of illness has the potential to alleviate distress in both parents and children.[3, 5, 6]

Age appropriate communication

Children require communication strategies appropriate to their level of understanding and readiness.

It is recommended that you employ age-appropriate communication with children.[7, 8]

Age appropriate communication

Memory-making is also an important activity for children at all ages. It also helps the person dying to feel that they are leaving a legacy. Examples of memory making include:

• Taking day trips or holidays
• Keeping a lock of hair or a plaster hand imprint
• Collating photographs, movies, scrapbooks
• Planting a tree or creating a garden
• Creating a memory box to store some of the dying person’s special items in (eg, jewellery)
• Preparing letters/presents/video messages for the child to open after the person has died
• Recording their important stories in audio format (eg, the service provided by ‘A Lasting Tale‘)

Across age groups, it is important to maintain regular routines and expectations to promote a sense of security for children. Children can also benefit from having family time that feels ‘normal’ and isn’t always focused on the parent’s illness. Parents often need help in recognising how reminders of illness affect their child’s life and in learning how to retain a sense of normality.[6, 9, 10]

Further information and resources to support communication with children about cancer have been developed by Cancer Council Australia.[11]

Case study

Consider these points in relation to Michelle and her family.

Michelle is receiving her palliative chemotherapy in the day chemotherapy unit. Dawn Matthews, the cancer nurse coordinator, visits the unit to see how Michelle and Pete are going. Michelle and Pete raise concerns about telling their children that Michelle’s illness is deteriorating. Dawn works through these concerns with them and suggests strategies to help them address these concerns.