When a parent becomes gravely ill, the entire family is thrown into crisis; for children, it may well be the worst of their lives so far. Often, the first impulse is to protect children, to spare them as much pain as possible. But children usually have to take on new responsibilities and confront stark realities, frightened and exhausted adults often have little energy to spare for children who are themselves terrified and confused.
As a parent you feel like the whole world is crashing down, feeling like you are sinking, and hard to give your kids the support, and at the same time you don’t want them to be ruined by this.
Ms. McCue, the supervisor of the Child Life Program at the Cleveland Clinic Foundation, a major medical center, has spent years trying to help adults and children not only to endure these crises, but also to emerge stronger. For years, she said, children were “the invisible people” in hospitals. Only in the last five years, she said, have professionals begun to recognize that techniques devised to help seriously ill children can be used to help healthy children whose parents are sick.
Probably the most difficult principle for well-meaning parents to follow, but the most central, is to tell children the truth, with the details adjusted to suit their ages. Parents, she writes, should always tell the children three things: that the mother or father is seriously ill, what the name of the disease is, and what the doctors say is likely to happen.
Most parents, she said, have found their children are far stronger than they thought. Children must be allowed to express their grief.
“Although telling the children the truth is very frightening and can be very emotionally overwhelming at the time, once you’ve gotten past that moment, everyone is carrying the burden together,” Ms. McCue said. “You can deal with it and help the child make the most of it. You say, ‘Here’s what we’re going to do to handle this.’ ”
Adults must be careful, however, not to overburden children or to expect them to offer more than fleeting comfort, Ms. McCue said. They will need help talking about their fears, reassurance that the illness is not their fault and permission to have fun, Ms. McCue said.
Children may also need to be prepared for the sight of a sick parent in the hospital, and Ms. McCue recommends showing them pictures of hospitals and describing in detail the machines or other medical devices the children will encounter.
In many cases, children’s grades might suffer, but both the well and the sick parent, if possible, need to tell children that illness cannot be an excuse for failure, example, stopped doing his homework and started acting up.
While these are normal reactions for children, Ms. McCue also provides a list of warning signs that should prompt parents to seek professional help. These include severe problems with sleeping or eating, risky actions that might indicate suicidal thoughts — like deliberately dashing in front of cars — very aggressive or withdrawn behavior and extreme fears.
When the worst happens, and a parent is going to die, Ms. McCue offers detailed guidance about how to prepare children and how to handle final hospital visits. Although generally she advocates not pushing children if they are reluctant to talk about their parents’ illness, she said that if death is imminent, children must be told as soon as possible, to give them time to prepare.
She suggested that parents offer children several opportunities to visit the parent, but not to force them to do so. Whenever possible, the dying parent can be encouraged to dictate a last message to children, something they can hold on to in later years.
In her years of work with children, Ms. McCue said that she has been continually surprised at how much children can grow and even thrive despite the trauma of parental illness. “They develop some skills they didn’t know they had,” she said. “If you could make it go away, that’s the first choice. But if they can get through this, they can get through many things.”