Nov 24, 2013 3 min read

“Talking with my kids about my breast cancer was almost as bad as battling the disease,” one mom told me a few years ago. Engaging kids in such tough conversations goes against every parental instinct to protect our kids from the harsh realities of the world. Here are a few guidelines about talking with your kids about a serious illness.

• Connect at your child’s developmental level.

What you say and how you say it depends upon your child’s age, emotional maturity and previous experiences. While some parents prefer a family meeting to discuss a difficult topic, be certain to meet individually with each child to allow you to engage youngsters at their level. Take their lead in when, what, and how you communicate.

• Find that balance of giving just enough information.

My experience has been that parents overload kids with too many details, leaving youngsters confused and anxious. Keep your explanations simple and concise. Be guided by your child’s reactions and questions.

• Continue the conversation.

It takes kids a while to fully understand the impact of a serious disease on them and on their family. Periodically go back to your child and let them know what’s going on with the illness. Ask your youngster to explain back to you their understanding of what they’ve been told.

While you can ask kids if they have any questions, I’ve found that approach is generally not successful. Instead, try to anticipate and then respond to their concerns. One teen I worked was worried that his dad’s prostate cancer meant that the family savings intended for college would now be spent on his dad’s treatment. He was too embarrassed to ask, but a perceptive mom offered him some reassurance.

• Acknowledge your own feelings.

Many parents are reluctant to express their own anxieties, anger, and uncertainties for fear of scaring their children. I’ve found the opposite to be true. A parent’s verbalization of their feelings about a serious illness, within limits, gives kids permission to express what they are really experiencing.

• Focus on routine events.

At least until the teen years, kids are pretty egocentric. They will be very concerned about “how will this affect me?” I’ve had kids in my office express concerns about whether their dad will still be able to drive them to baseball practice or if they will lose their house if their mom dies. Parents may understandably view such concerns as insensitive and selfish, but they are developmentally normal.

• Don’t predict the future.

“Are you going to die?” is one of the toughest questions a child can ask. We are all going to die, but I suggest that you never tell a child that an illness will result in death, as you can’t predict tomorrow.

Dr. Gregory Ramey is a child psychologist.