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How to tell your child about your diagnosis: Tell the truth from the start and talk about your emotions

Children don’t think asking about death is taboo, which can be an asset

If you’ve been going for medical tests, or have received a diagnosis, it’s important to communicate what’s happening to your child.

“All the research right back to the 1980s says ‘Tell the truth’,” says paediatric psychologist Dr Claire Crowe, who is a member of the Irish Association for Counselling and Psychotherapy.

“Parents are always amazed at how much their children already know,” says Crowe. “Children are body-readers, which means they tune into our body language. They can already sense a change in atmosphere in the household.”

“They have heard the conversations that their parents think they are shielding them from. In my experience, every parent that shares a diagnosis with their child always comes back and says, ‘Actually, they knew’.”

Should I wait?

Lots of parents wait until a diagnosis is confirmed to talk to their child, but that can take a long time.

“I always think it’s worth saying it from the start,” says Crowe. “You could say, ‘I feel a little bit sick, I don’t know what it is, I’m going for some tests’.

“The earlier you start the conversation, the better. It builds up that trust. It shows I trust you enough to tell you these big things.”

What should I say?

Allow the child to lead, says Crowe.

“I’d recommend the parent says, ‘I’ve had lots of visits to the doctor, do you have any questions?’ Often the child will ask, ‘Well, why are you going to the doctor?’”

Think in advance what you are comfortable saying and how you are going to say it, but be honest, she advises.

What if they ask about death?

That’s a hard-hitting question, but one to expect, says Crowe. Kids don’t think asking this is taboo and that can be an asset.

“If that’s their question, and you are unclear about whether you will survive, then you need to say, ‘I don’t know’,” says Crowe.

“You could say, ‘I’m trying really hard and the doctors are trying really hard.’”

Talk about your emotions too

“Say how you feel – sad or worried. The role of the parent is to make sense of the world with their children. We are storytellers with them. You are telling the story with them but you are sharing the emotional parts of the story too. That’s really important so that the child can say, ‘I’m scared and I’m worried’ too.

“It’s important to say, ‘I hear you are afraid. I’m afraid too; this is not a nice thing,’ and then allow for more questions,” says Crowe.

What if they shut down?

If your child doesn’t want to talk about it, let them know they can come to you at any time.

Bring up the topic another time. At bedtime, they can be more receptive, says Crowe.

“It’s a time when kids process what has happened in the day. Their defences are a little bit softened. You could say, ‘I’m just wondering how you are doing today. I was at the doctor today. Do you have any questions about that?’”

Younger children can worry they caused the illness. “They can think, ‘I did something. I was bold’. They can make huge assumptions in their interpretation of things,” says Crowe.

“Reassure them it’s nothing they did. Mommy got sick. And say it’s not something we can control,” she says.

“For teenagers, the most important aspect of support is peer and social support,” says Crowe. Linking them with an Irish Cancer Society support group can show them they are not alone.

Should I prepare them?

If the treatment is debilitating, or will cause hair loss, for example, prepare children for that, says Crowe.

“Let them know, ‘I’m going to lose my hair and then I’m going to pick a wig. What colour do you think I should get? Would you like to pick it with me?’” says Crowe.

“You could say, ‘I will be sick afterwards, but this bit helps me get better. What we can do on those days is have a movie day together’. Let them know they will have access to you every day, but this is what you will be able for.”

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