The Aword

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Children who have an ill relative

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Children are likely to react differently according to their age group.

Preschool and under 7s: predominantly, they fear that their needs won't be met and the child is likely to feel a high degree of helplessness, guilt and anger, which he/she may not be able to express directly, but may show up in play behaviour or at school.

If the relative is hospitalized, especially if it is a parent, there will be separation anxiety, which can manifest itself in a variety of ways depending on the length of separation.

There may be acting out of angry feelings or withdrawal or the child may become very clingy with other family members. Ways in which to reduce the stress on the child is to sustain comfort; explain simply and repeatedly; keep a routine.

It may be helpful for the child to have access to an advocate (such as a friend of the family who is less closely emotionally involved) so that they have a safe place to turn to.

Age 7-11: children of this age may go through a period of ?magical thinking' in which they fantasise that all is well or make unspoken ?deals' about how things should be, but there is also often a great deal of anger which tends to mask the fear that the child feels.

There may also be shame of not being like other kids, ?our family is different' and envy of other children who may have parents who can do more with them (which can then make the child feel guilty); there may also be jealousy of the ill relative and if it is a parent, ambivalence towards him/her because parents are ?meant' to be in control and coping with life.

At this stage, beware ?mummy's little helper or the child being a surrogate parent to siblings; aim for straight talk, give the child permission to feel especially the negative feelings; there is a delicate balance in developing the child's sense of responsibility. 

Age 12-18: the chief emotions at this stage are: embarrassment; fear...especially a secret fear that something will happen to the well parent; anger; on the plus side there may also be compassion for the ill person; the key at this stage is: ?attentive listening', allowing the child to express their feelings but not being too prescriptive in your suggestions.

Helping your child when someone is ill:

Here is a brief list of some suggestions that might be of help:

  1. Use correct medical terms
  2. Keep it simple but be honest (the unknown is often worse than reality) Children cope best by understanding what is happening. Answering some questions will help prepare your child for the changes occurring in his/ her life.
  3. When the patient is in hospital, it may help to describe to the child what he or she may be likely to see if they visit. Offer the choice of a phone call, letter, or drawing if the child seems reluctant to visit.
  4. Reassure your child that nothing they did, or didn't do, caused the illness or in any way contributes to the pain felt by their relative. Some children feel guilty for things that have nothing to do with the illness.
  5. Children are very sensitive to the emotions of adults, and will respond to how you are coping, as much as to how ill their relative is.
  6. Encourage communication. Lack of questions doesn't mean lack of interest. Children are more likely to express themselves through art, play, or action rather than words.
  7. Share your feelings to help your child understand his/ her feelings and to encourage him/her to express them. By sharing, you reassure your child that it is all right to have certain feelings.
  8. Try to maintain a normal routine. Children need structure to feel secure during stressful times. They also need to be involved in appropriate ways in order to not feel left out when the focus of the family is on the patient's needs. Small tasks can make them feel they are important.
  9. Encourage other family members, friends, and neighbours to provide support and structure for the child when you have to provide care for the patient. This ensures the child doesn't feel completely displaced and unimportant.
  10. Never let the child assume the caretaker role. Some children will try to take care of the parent. Reassure them that there are things that they can do to help, but they are not expected to assume adult responsibilities.
  11. Communicate with your child's teachers and others about the changes in your child's life. They may be able to provide extra support and personal time. They can also be vigilant for signs that the child is coping poorly, perhaps by behaviour changes.