The following is a list of suggestions for patients, parents and siblings that may help each individual cope with his/her emotions, depending upon the age of the child with cancer and the age of the siblings.
Infants and very young children (birth to 3 years of age)
- For patients
- holding
- touching
- rocking
- soft music
- hugging
- cuddling
- distracting with toys or colorful objects
- creating a cheerful hospital room
- having siblings visit
- keeping their regular schedule for sleeping and feeding
- For siblings
- providing cuddling
- hugging frequently
- arranging visits to ill brother or sister
- keeping them near parents, if possible
- using relatives, friends or a daycare center to maintain their usual daily routine
- having one parent spend time with them daily
- recording lullabies, stories, messages when parent cannot be at home
- offering frequent reassurance to toddlers that mommy or daddy will soon be back
Toddlers, preschool (3 to 5 years of age)
- For patients
- giving very simple and repeated explanations for what is happening
- providing comfort when child is upset or fearful
- checking on child’s understanding of what is happening
- offering choices when possible
- teaching acceptable expression of angry feelings
- maintaining a normal daily schedule for feeding and sleeping
- giving simple explanation for parent’s distress, sadness or crying
- For siblings
- giving a simple explanation that brother or sister is sick and that people are helping
- offering comfort and reassurance about parent’s absence
- arranging for reliable daily care and maintenance of usual routines
- having one parent see child daily, if possible
- remaining alert to changes in behavior
- reassuring child about parent’s distress or sadness
School-aged children (6 to 12 years of age)
- For patients
- offering repeated reassurance to your child that he or she is not responsible for the cancer
- teaching that sadness, anger and guilt are normal feelings
- allowing your child to keep feelings private, if that is preferred
- suggesting personal recording of thoughts and feelings through writing and/or drawing
- arranging for physical activity, when possible
- providing explanations your child can understand about diagnosis and treatment plan; including your child, when ppropriate, in discussions about diagnosis and treatment
- answering all questions honestly and in understandable language, including, “Am I going to die?” (talk with cancer care team about how to answer)
- listening for unasked questions
- facilitating communication with siblings, friends and classmates, if desired
- arranging contact with other patients to see how they have dealt with diagnosis
- For siblings
- teaching about normal feelings of fear, anxiety, sadness or anger
- encouraging sibling to communicate feelings; suggesting sibling write, telephone, send drawings or taped message to patient
- providing understandable information about diagnosis and treatment
- answering all questions honestly, including, “Will he or she die?”
- listening for unasked questions, especially about personal health
- offering repeated reassurance that sibling is not responsible for causing the cancer
- informing teachers and coaches of family situation
- arranging for school and other activities to continue on schedule
- supporting sibling’s having fun, despite brother or sister’s illness
- planning for daily availability of one parent
- explaining that parents’ distress, sadness or crying is okay
Adolescents (13 to 18 years of age and older)
- For patients
- giving information on normal emotional reactions to a cancer diagnosis
- encouraging expression of feelings to someone: parents, family, staff or trusted friends or adults
- tolerating any reluctance to communicate thoughts and feelings
- encouraging journal keeping
- providing repeated reassurance that they are not responsible for causing the cancer
- being included in all discussions with parents about diagnosis and treatment planning
- being encouraged to ask questions (parents should listen for unasked questions)
- addressing spiritual concerns about “Why me?”
- permitting private time for interaction with team professionals
- offering assurance that parents and family members will be able to manage crisis
- encouraging sharing news of diagnosis with peers and classmates
- arranging for visits of siblings and friends
- facilitating contact with other adolescent patients, if desired
- For siblings
- involving adolescent in events around diagnosis
- reassuring that cancer is not contagious
- offering assurance that nothing they did or said caused the cancer
- providing detailed information on diagnosis and treatment plan
- answering all questions honestly
- arranging access to treatment team, if desired
- discussing spiritual issues related to diagnosis
- encouraging expression of feelings
- arranging for management of daily life at home
- providing assurance that family will be able to handle crisis
- informing teachers and coaches of family situation
- encouraging usual involvement in school and other activities
- asking relative or friend to take a special interest in each adolescent sibling
Various members of your cancer team can assist you and your family as needed.