Tender topics- Part 4: Talking with preschoolers about serious illness

Having a discussion with your child about someone who is seriously ill will take preparation and thought.

Children need to hear the truth about an illness in terms they can understand. Photo credit: Pixabay.
Children need to hear the truth about an illness in terms they can understand. Photo credit: Pixabay.

The prospect of explaining the serious illness of a family member, close friend or a child to a preschooler can be filled with uncertainty and dread.  Communicating about a serious illness is a tender topic that you may have to face as you care for children. 

The diagnosis of a serious illness affects an entire family and that includes the children.  Kids know when something is wrong or different.  They may see adults have serious conversations or whispering.  They may see Mom or Dad crying.  Kids notice if there is unusual tension that upsets their normal routine. Young children live in the "now" and are generally concerned about how things affect their world.

So, when do I tell my child?  How much should I share about the illness?  How will they react?  Am I prepared for all the questions that could occur?  Fear of saying something wrong can often lead to adults avoiding the discussion altogether.  As with discussing any "tender topic" it is important to consider the age of the child that you are dealing with.  Children of all ages need to hear the truth about an illness in terms they can understand.  Michigan State University Extension recommends a few things that you may want to consider when facing the daunting task of describing a serious issue with a child.

  • Choose a time and place for the discussion where a child will feel safe.  Plan to give the child undivided attention when you approach the topic.
  • Use simple words. Give the illness or disease a name.  When you describe the illness, explain how your family routine may change. Use terms and descriptions of time that the child will understand.  "We will be having lots of doctor's appointments.” “Aunt Sally will be staying at our house tonight." "Daddy needs to sleep at the hospital for a few days." "Shots can hurt, but I will be right there with you." 
  • Be prepared for questions. Anticipate what the child might want to know, and do your homework.  If your child asks a question that you're not sure how to answer it is okay to tell them that you don't know the answer.  
  • Pay attention to emotions and give feelings a name; “You look sad.” "It is okay to be angry when you have to go back to the hospital." “I know it is disappointing when Grandma can't come to your Birthday party."  Teach your child to identify and express their emotions.
  • Be prepared for a variety of reactions.  Depending on who is ill, your child may worry about whether they will get sick too.  Young children often display jealousy due to your extra time spent with the sick person.  They may feel that they are being ignored.  Some children think that they may have caused this to happen because they have been bad.  Reassure your child.  Remind your child that you love her and will always make sure she is cared for.  Let him know that this is not his fault.  Allow the child to visit the sick person if appropriate.  Children fear the unknown. Sometimes just seeing the person who is ill can make it less scary.  Always prepare the child for what she might see or experience. 
  • Find ways to enlist the child as a family helper.  Feeling part of a family is important to young children.  Find ways for a young child to assist with easy household chores or projects that may cheer the patient.  Even 3-and-4-year-olds can help pair socks, fold washcloths or color a special get-well picture.
  • Ask your librarian for assistance in choosing children's age appropriate books that deal with similar issues. Tender topics can be easier to discuss when you use story telling as a vehicle to approach the topic. The Center on the Social and Emotional Foundations of Early Learning has prepared a list of children’s books that can assist parents and caregivers in discussing tender topics that affect young children. 

Parents and caregivers do not have to face serious issues alone.  Explore local resources and ask for help!  If your child experiences noticeable serious changes in behavior (weight loss, inconsolable crying or recurring misbehavior) you may want to consult your physician or a counselor to assist you in talking to the child.  Seek out disease specific support groups for you and your child. Talk with other family members or friends who have had a similar experience.

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