Professional help and support are not necessarily needed. Many children who have a mother or father with cancer manage with the help of the people around them. Education, explanation and support are important concepts. In any case, ask parents the following questions. What is the family like? How much are the children told about the illness and the treatment and how have they dealt with it up till now? What questions are there concerning the children?
If you are in the position to see and talk to the children, then, depending on the age, various options are possible. Those vary from giving an explanation and talking, to drawing together, writing, boxing, making film clips, making memory boxes or treasure chests, visualizing a safe place, playing music together, playing games, writing poems and taking a walk together.
Bear in mind that each child has a personal history: that parents know their children best; that a parent who is ill sometimes just doesn’t know anymore; that there are parents who have to deal with it all on their own; that most children actually do think about cancer.
Parents also often wonder how they can tell their children that they have cancer. They want to protect their children. But children have feelers, they hear and see that something is wrong and develop their own frightening fantasies. You help parents by telling them that not knowing is worse than knowing.
It is understandable, but not sensible to avoid the word ‘cancer'. If parents avoid it, children can be misled and maybe hear it from friends instead of from their own mother or father. Ask parents what they have told their children, give them information and help them with the explanation.
Many children with a mother or father with cancer are sad. Just because of what is going on, or because it is so different at home. Parents often find it very difficult. It is painful to realize that your child is sad because of something that is happening to you. It helps if parents can share thoughts about what to do with that feeling. After all, every child gets to deal with sadness sooner or later. Sometimes it helps to talk, whereas other times it helps to go for a walk or to go cycling. And of course, there are many alternatives.
Sometimes the reaction is the opposite and it seems as if the children are hardly sad at all. That is also often hard for parents to understand. Tell them why children do that, because they do not want to burden their parents with their sadness, for instance, or because they need distraction. That children actually worry in an indirect way can often be seen and heard, in the stories in the chatroom, for instance, in their drawings and poems or in the music they listen to.
Feeling anxious is also normal. Many children, for instance, are afraid of the hospital environment, for changes in appearance, for the probable loss of an ill parent, for the loss of a healthy parent or to die themselves. If children have ideas about cancer that are not right, then an explanation is needed. Explain to parents and children that frightening thoughts have the tendency to overcome you, and think together about what to do about it.
Sometimes it helps to do a visualization exercise. Put the fear in a jar, screw the lid on tight and put the jar in a cupboard. Think of a superhero and together with your hero chase the fears away. Or, take a shower, rinse your thoughts away and let them go away down the drain.
There are children who try to overcome their fears by showing compulsive behaviour or by starting to avoid things. Luca put the table straight every day, only then could she be sure that her mother would not become even more ill. She also compulsively washed her hands and only allowed herself to walk on the pavement slabs on the right. No way was Jonas was going to go to the hospital, even when he needed to see a doctor himself. Of course, in these kinds of situations professional support is needed.
Some children blame themselves for the fact that their mother or father has cancer. They think they said, did, or thought something that caused cancer. Be aware of the fact that most children cannot give voice to those thoughts.
You can ask older children if they know where cancer comes from. To young children, you can say: some children think that… what do you think? Also here it is clear that giving an explanation, in this case where cancer comes from, is very important.
Many children are angry. Angry because the whole world has changed, because home is not home anymore or because it has happened to their mother or father of all people.
Physical activity can channel these feelings. Make parents and children aware of possibilities such as dancing, fitness, street dance, kicking a ball or hitting a boxing ball. Making music can also be a good emotional outlet.
Swearing about cancer often really gets to you. It gets even worse if the swear word “kanker” (cancer) is used on purpose. As a professional helper you can try to make the children more resilient. Talk about what to do if there is swearing going on. As a child, do you opt to attack? Do you build a wall around you so that the arrows do not hit you like that? A class presentation can help. Older children could start a poster action or make a film clip on this subject.
Sometimes children become extra caring. That is nice, because it is difficult enough as it is for parents. It goes without saying that children have to stay children too. It should not go so far that a child does not go to school anymore because she/he has to look after a parent, or because the mother or father is in hospital, or that she/he has to look after her/his younger brothers and sisters.
As professional helper you can be the children’s advocate and sometimes your role is as a mediator.
Children who have a mother or father with cancer can feel very lonely. It is as if they are the only one with an ill mother or father. By bringing together children who are in the same situation, you allow them to discover they are not an exception. Furthermore, they can learn from each other and give each other tips and advice. Refer them to a children’s or young people´s group in your neighbourhood, and point out the chatroom on this website or other websites.
Can you deprive children of hope?
However bad the situation, every child and every parent needs hope. Sometimes dreams come true, sometimes they do not. Prepare the child for a situation that can also be different, but do not deprive them of hope.
Teenagers and adolescents are not only concerned with themselves, but also with life in general. A mother or father with cancer turns that life and ideas completely upside down. These vulnerable young people can intensely struggle with that. They in particular need somebody who really listens to them.
Do not take it for granted that teenagers understand everything. They pretend to have more knowledge than younger children, but there is a danger of overestimating their understanding. Therefore, use clear and simple language for teenagers and give them time to think about it. Take into account that maybe they will react completely different from what you would have expected!
Here are some questions that are on many children’s minds. You can find the answers to these questions divided into age categories on this website.
- Why is it that my mother/father got cancer?
- Are you sure that my mother/father will not get better anymore?
- How does chemotherapy work?
- What is radiotherapy?
- Can children get it too?
- Is cancer catching?
- Is cancer hereditary?
Sometimes children take the initiative to write a letter or they would like to have an appointment with the doctor concerned. Encourage them to write their questions down and ask them.
Should the prognosis be bad, then the children have the right to know. Just like adults they need time to prepare for saying goodbye and that is only possible if they know what is going on.
At that moment do not leave the children to their own devices. Looking back together with their ill mother or father on everything that has happened in the last years can give direction to their feelings. As a professional helper you can support the children and offer them a place where they can be sad. You can offer parents tips and advice about how to arrange to say goodbye.
Perhaps you strive for openness, but that parents absolutely do not want that. Denial of the seriousness of the illness, upbringing and religion can play an important role. You can try to convince parents that openness is the best way, by telling them what it means for the children if they remain ignorant. But if the parents really do not want that, then that is the end of it. Respect their boundaries. Maybe it could help by putting them in touch with other parents who are going through the same thing.
Some children really do not want to talk about it, even if you try approaching it in another way. The fear is clearly too great. If everything is allowed and nothing is a must, you offer the child a safe starting point. Sometimes it may bring you unsuspected reactions.
Your profession has boundaries too. See what you can handle and want, because working with children and parents can come very close to home. Take time to reflect. Talk with colleagues about situations you encounter and exchange experience.
- Ask about the children, ask what they have been told and how they are doing
- Tell them that not knowing is often worse than knowing
- Explain that it is good to use the word ‘cancer'
- Make parents aware of the children’s possible feelings of guilt
- Remember the children’s names
- Do not let questions happen by chance, but establish a structural basis
- Encourage parents to bring their children
- Make sure your knowledge about the reactions of children who have a mother or father with cancer stays up to date
- Make sure there are enough information leaflets and so on
- Ask the children themselves something sometimes
- Tell children and parents about this website
- Indicate that children can come to you too with questions