Harpham, Wendy S. MD
WENDY S. HARPHAM, MD
My last column (2/25/14 issue) highlighted two compelling reasons for talking with patients about supporting their children: (1) Just one comment or suggestion from you may prompt patients to make changes at home that significantly decrease the stress; and (2) Attention to your patients' challenges as parents may help them summon the courage, fortitude, and hope they need to get through treatment. To facilitate your efforts, here's a handout:
Supporting Your Children
Family life plays an important role in your recovery. We prepared this handout to help you deal with the challenges of kids and cancer at the same time. While there is no single “right” way to support your children, we want to help you find the best ways for your family. Here are a few insights and tips from parents whose families have not only survived, but thrived.
Establish and Maintain Open Communication
Good communication is the only way to recognize and respond to your children's increased needs in healthy ways for them—and for you. Establishing open communication can be difficult. Instinct drives many parents to try to shield their children from the stress. Some parents even keep their diagnosis a secret.
Don't! Just as you must suppress the instinct to run when your clothes catch fire, so too you should suppress that powerful instinct to shield your children. The reality is that cancer has become part of your family life, at least for now. Studies show that children know something serious has happened, even if parents don't say anything.
Here's the problem: Your children are observant and smart, drawing conclusions about everything based on what they see and know. If you don't talk about your illness, you run the risk of their drawing inaccurate conclusions and developing unhealthy ways of coping—problems you can minimize with open communication.
But good communication is healing only if you always tell the truth. Why? Because bonds of trust are necessary for your children to feel comforted or inspired by your words and actions. In the bigger picture, being able to trust you through this illness enables them to grow up into adults who can trust others.
Some parents get tongue-tied every time they try to break the news or talk about their cancer with their children. That's okay, as long as you let us know. We can refer you to a specialist (such as a social worker or other counselor, child-life specialist, member of the clergy, or your child's pediatrician) to assist with the family conversation.
Children's Three Essential Needs
Every day you'll face situations that pit your needs against those of your children. To keep from feeling overwhelmed, try thinking in terms of your children's three essential needs:
- Satisfaction of their physical and emotional needs;
- An understanding of what's going on around them, on their level; and
- Reassurance that they will be cared for, no matter what happens.
Along with meals, clean diapers, and rides to afterschool activities, children also need someone saying good-night before bed and listening if they get their feelings hurt. In addition to knowing why you are bald or in the hospital, they also need to know about incisions or IVs that cannot be bumped by a hug. Don't forget about subtle changes that seem minor to you but may signal disaster to your child, such as a Band-Aid from a routine blood test or regrowth of hair after chemo. Last, let your children know it is okay to be concerned about their own needs.
Whenever thinking about your children's needs, keep your top priority in mind: Optimizing your medical care—even if that means delegating some or all of your parenting responsibilities at times. Delegating (so you can take care of you) is fulfilling your parenting duties responsibly, wisely, and lovingly. Your job is only to make sure someone is tending to your children's three essential needs, and not necessarily to meet all those needs yourself all the time.
How Much to Say
A challenge over the months of treatment and recovery is figuring out exactly how much to say. Simply put, “Tell your children enough (and not everything).”
You are telling them enough by (1) telling them what they need to know to deal with their world, and (2) answering their questions.
Use simple language they understand. If you don't know the answer to a question, just say, “I don't know, but I'll find out.” Be prepared for unanswerable questions, too: “Your excellent question doesn't have an answer—and that's okay.”
It's important to teach your children that cancer is not contagious. Try comparing it to non-infectious conditions with which they are familiar, such as a grandparent's arthritis or a friend's broken leg.
In addition, state clearly that they are not to blame for your illness, since it's normal for children to worry that somehow they are responsible. Over and over in a variety of ways, tell them, “Nothing you ever said, did, or thought caused my illness.”
Repeat. Repeat. Repeat. Children can know things before they understand or believe them, so teaching them about your illness must be an ongoing process throughout your treatment and recovery. This repetition, while tiring, provides innumerable opportunities for you to show your love and help your children in healthy ways.
Cancer is an unwelcome visitor to family life. Yet, we have seen many parents use their illness positively as a powerful platform for teaching life skills and family values. Whatever you say and do, remember: The greatest gift you can give your children is not protection from the world, but the confidence and tools to cope and grow with all that life has to offer.