Living with a progressive, terminal illness, whether it’s your own or a loved family member’s or friend’s, is a complicated and emotional process. Sharing the news of the diagnosis with a child can be one of the hardest parts. A parent or caregiver’s protective instincts make them naturally want to shield their child from pain and suffering. But when a loved one is terminally ill, children must be involved in the process, encouraged to ask questions and supported through very difficult emotions. Here are some tips to help you share the news with your child:

• Don’t Wait: Aim to talk to your child about the illness as soon as you feel able to. Children are very sensitive to emotion, tension and stress in their lives. Adults can mistakenly think that if they don’t say anything, children will be less affected. Yet trying to protect your child in this way may actually have the opposite impact. You don’t have to give them all the information at once but being out of the loop can make them feel lonely and scared, or that this illness is somehow their fault.
• Find the Right Place and Time: When you’re ready, find a quiet place where you will have your child’s full attention and they can feel comfortable showing emotion. Don’t bring it up right before an important event. Make sure you won’t be interrupted and leave plenty of time. It can be helpful to write notes or rehearse with someone you trust before having the discussion.
• Be Age Appropriate: Let your conversation be guided by your child. How you share the news will depend on their age and understanding of illness and death. To get a better idea of what they already know, ask a few questions before you start. If you have multiple children and there’s an age gap, you may want to talk to each child separately. Different age groups will have distinct questions, so consider what your teenager may ask before you have your younger child in the room.
• Be Honest: While age and development are big factors, it’s also important to be as truthful and open as possible. Use simple, straightforward language and don’t be scared of words like death and dying. If they sense it makes you uncomfortable, they will hesitate to talk about it. If there is something you don’t know the answer to, let your child know you will ask someone who does.
• Prepare Them: Explain how the disease may affect both their life and the patient’s so they’re less scared when things start to change. For example, say, “Mommy’s hair may start to fall out because of her medicine.” Or, “Aunt Mary will drop you off at school to let Grandpa get lots of rest.” Before hospital visits, talk about the beeping machines, hospital bed and change in appearance to avoid scary and unpleasant surprises.
• Keep Checking In: After you’ve had the conversation, don’t leave it at that—regularly find opportunities to bring it up. Children need time to process what they’ve heard and will likely have lots of questions. Ask them how they are feeling, what you can do to help and find activities you can do together to put their feelings into action.

While preparing children for death does not eliminate the heartbreak, it does help them make sense of what is going on around them. Offer your child lots of reassurance that they are safe and loved and that they can openly discuss their emotions to help them better manage a terminal diagnosis.

If you found this article helpful, you may also want to read:

• Recognizing Mental Illness in Children and Youth
• Helping Your Child Deal with Death