Few experiences in life are as devastating as having a loved one receive a cancer diagnosis. Although we know on an intellectual level that many cancers are survivable, we still closely link cancer and death. Also, we know that many cancer treatments are difficult and debilitating. Finally, we know that a peaceful death may be elusive for some patients with terminal cancer. For all of these reasons, cancer is possibly the most dreaded of all diseases.
If cancer is hard for an adult to understand, just imagine how difficult it is for children to deal with. Knowledgeable and loving adults can help children through this journey, and there may be a special role for grandparents.
One thing most grandparents instinctively do is research. While it is important to learn about the type of cancer your family is dealing with, it is also helpful to get advice about how to help your family. One resource that may be helpful is Things I Wish I'd Known: Cancer and Kids by Deborah J. Cornwall. What follows is partly based on Cornwall's book and partly based on my experiences having a family member with cancer.
What to Tell the Children
The first concern is usually what to tell the children, and you will want to have this conversation first with the parents. They get to determine how much the children should be told. Generally speaking, it is not a good idea to keep the diagnosis secret, for several reasons.
First, children often sense when the adults in their lives are upset about something, and not knowing what is wrong is often worse than knowing. Second, the children may find out through some other means. Cornwall cites the case of a child who saw a cancer center's number on caller ID. Third, when the family is the main conduit for information, children are less likely to receive inaccurate and upsetting messages.
It's important to remember that children don't have the life experience or the resources to grapple with complex issues on their own.
Once the decision to share the diagnosis has been made, it's important to think about exactly what to tell the children. The most important rule, according to Cornwall, is to keep your responses "kid-centric." Think carefully about what the children will be concerned about, and gear your information to them. Don't assume that children know what cancer is. Be prepared to explain it to them in an age-appropriate way.
Children, no matter what their age, will not only be concerned about the health of the person with cancer but also about how the illness will impact their lives. It's important to reassure them that their lives will proceed as normally as possible. When a parent is ill, grandparents can play crucial roles in maintaining a degree of normalcy.
It's also vital to remember that the initial conversation isn't a case of "one and done." The initial conversation is just the beginning of an ongoing dialogue about the cancer and what it means to the whole family. Still, it's not always necessary to answer every question. Due to the nature of the disease, some questions have no answers.
If you are unsure how to respond to a question, it's okay to say, "I don't know," or to tell them that you will try to find out and tell them later.
The Specter of Death
Regardless of whether they ask the question or not, children will be wondering whether the person with cancer is going to die. If the question is asked, it's best to acknowledge that some people with cancer die, but many others do not. Emphasize the positive things that are being done to combat the cancer.
If the family member with cancer receives a terminal diagnosis, that may change the picture. Again, the parents will have the right -- and the burden -- of deciding how much to tell their children.
How Families Cope
Families tend to have their own cultures, which will cause them to handle cancer differently. A family that has strong religious beliefs may find solace there, although some may find that the cancer causes them to challenge their beliefs.
Some families even find relief in humor, although such humor will admittedly be of a somewhat dark nature, and some families will never be able to treat cancer as a laughing matter. For others, however, joking about the cancer can show children that the topic is not off limits and can help them to process it as a part of the "new normal."
Dealing With the Reactions of Others
One of the hardest things about having a diagnosis of cancer in the family is realizing that friends and members of the extended family will process the news differently. Some will be solicitous and helpful, and some will become what Cornwall calls "pull-aways."
Older children may have friends who withdraw, especially if it is a parent or sibling who has cancer. Grandparents can help them understand the reasons friends may pull away and let them know that it is through no fault of their own. It's easy to dismiss a pull-away as someone who wasn't really a friend in the first place, but a better way to process it is to realize that the person who has pulled away may simply not know what to say or do. A child shouldn't feel that he or she has to immediately write off a person who is a pull-away. It's hard enough to deal with cancer in the family without losing friends, too. Instead the child can be encouraged to think of the friendship as being on a kind of hiatus, to be renewed or dropped at a later date.
Just as friends and family members may not know how to act, they may also have trouble knowing what to say. Artist Emily McDowell has received a lot of notice for her empathy cards, which are a reaction to her experiences with cancer, during which she received a lot of non-comforting messages. (One of her cards simply says, "There is no good card for this.") Although I admire what McDowell has done, I also think that it's important to let friends and family members express their feelings in their own ways without taking offense. During normal life, we have to forgive the missteps of others. Having cancer in the family does not confer the right to be prickly and judgmental, even though the stress of dealing with the diagnosis may predispose us in that direction.
When a Grandparent Has Cancer
The risk of cancer increases with age, probably because our bodies lose some of their ability to fight off cancerous mutations. So it's possible that you may be the person in your grandchild's life who receives a diagnosis of cancer. If so, it's important to give yourself time to process the diagnosis before discussing it with your grandchildren. It's best if you can be as matter-of-fact and yet as positive as possible.
When a Death Does Occur
Because a death from cancer is not usually sudden, family members have the benefit of being able to prepare for the death. My article on preparing for a grandparent's death has a number of ideas that can be applied to the death of any family member.
When a death does occur, family members can be so caught up in their own grief that they aren't able to help children process their grief. Grandparents can play a vital role in seeing that that doesn't happen. Cornwall's book lists a number of resources for grief support. Grandparents can consult those resources but also should not hesitate to get professional help for any family member whose grief is a cause for concern.
Learn more about Deborah H. Cornwall and her work in cancer advocacy. Cornwall's book also covers childhood cancer, a topic that I don't touch upon in this piece.
If you are dealing with a cancer diagnosis in your family, the articles listed below may also be helpful.
- How to Tell Your Children You Have Cancer
- Telling Family and Friends You Have Cancer
- Giving Support When a Loved One Has Cancer
- How to Use Online Support Groups