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This is an archive article published on April 5, 2024
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Opinion Kate Middleton diagnosis: How to talk to your child about a life-threatening illness

Families differ in the way they make decisions. However, there is no disputing the evidence that if parents remain loving towards their children and allow them to vent their feelings, they will be better able to navigate what lies ahead of them

This grab taken from a video released by the BBC Studios on Friday March 22, 2024, shows Britain's Kate, the Princess of Wales recording her message announcing that following her abdominal surgery in January "tests after the operation found cancer had been present." (AP)This grab taken from a video released by the BBC Studios on Friday March 22, 2024, shows Britain's Kate, the Princess of Wales recording her message announcing that following her abdominal surgery in January "tests after the operation found cancer had been present." (AP)
April 5, 2024 10:40 AM IST First published on: Apr 5, 2024 at 07:08 AM IST

The recent video shared by the Princess of Wales about her cancer diagnosis alludes to a dilemma. As a parent, there is a natural urge to spare your children from bad news but there comes a time when keeping the truth from them may cause more harm. The question is when and how to do this best without causing anxiety.

In India, by and large, children are not told about a parent’s life-threatening illness but are left to work it out for themselves. This leaves them confused as they notice changes that they cannot comprehend and sometimes mistakenly think they may have caused. They are unprepared and vulnerable when a parent’s condition worsens and they die. Many carry the burden of regret and unresolved grief throughout their lives.

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At CanSupport, we see children struggling to understand why they are being ignored by adults or told to fend for themselves. Little things matter. I recall a young girl telling our home care team how much she hated her mother because she no longer bothered to tie her shoelaces before she went to school. Hate is a strong word but that is how children react. They experience emotions that they find difficult to control and do not always have the words to express them.

This is why so often they start acting up and may regress to behaviours like bed-wetting, crying and becoming more clingy than usual. When hard times come, parents and school authorities must work together to provide school-going children with a safe environment, both at home and at school. Classmates, close family and friends also need to be sensitised. Often, the failure of parents to speak to their children means that they hear the news from second-hand sources that are not necessarily well-informed and may harbour misconceptions — the most common being that cancer is a death sentence. This is another reason children should first hear the news either from a parent or an adult who knows the facts and whom they trust.

Depending on age and circumstance, communication is going to differ. The golden rule is not to overload the child with too much information at any one time but to give it in easily digestible doses. Children are keen observers and even if not told can sense something is wrong. It is important to reassure them that their needs will be taken care of no matter what. Physical gestures like a hug and holding hands, accompanied by simple explanations (but not lies) can go a long way in easing fears. What must be conveyed, more than anything, is that they will always be loved and cared for.

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Children are surprisingly resilient — their ability to adapt should not be underestimated. What they need is proper preparation, information and guidance tailored to their age. If a parent feels unable to do it, a professional may be brought in. The advantage of a parent or family member doing this is that it need not be done in a formal setting which can be intimidating to a child.

Facing and talking about death is hard and yet children must be prepared for the passing of a parent who is unlikely to recover. At a younger age, the permanence of death is difficult to grasp. Nevertheless, children do have questions and a natural curiosity, especially when they see physical changes in a parent or frequent hospitalisation. They also pick up on the sad atmosphere that prevails. They may have frightening ideas about death. A counsellor, who had been brought in to speak to the child of a dying parent, once told me that the little girl kept asking when the big black bird would come to remove her Daddy’s eyes before he died. The mother of the child had just told the counsellor that she did not know that he was dying.

Coping with a sick parent is hard at any age. It is more so for young adolescents who are just beginning to discover themselves. When talked to, they may change the subject abruptly or walk away giving the impression of being uninterested. In reality, they are protecting themselves. Keeping them in the loop and involving them in the care of an ailing parent is also a good way of making them feel they matter. However, one must guard against demanding too much from an older child as this may breed resentment if they are no longer able to meet their friends or participate in social activities outside the home.

Finally, parents must ensure that despite hard times, fun activities, joy and laughter are not sacrificed. How these children will face challenges of their own will be influenced in no small way by how their parents coped. There are no hard and fast rules. Families differ in the way they make decisions. However, there is no disputing the evidence that if parents remain loving towards their children and allow them to vent their feelings, they will be better able to navigate what lies ahead of them.

The writer is Founder-President, CanSupport

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