Communicating Serious Adult Illness to Children

Betty R. Ferrell, PhD, RN


April 02, 2013

Devising a Plan for Talking to Children

In this scenario, the best option is to arrange for Jan to meet with the oncology social worker for help in deciding what to tell the children about their uncle's illness and prognosis. Although we may believe that children need honest information, communication about serious illness or death with children must be planned and done in collaboration with parents and other members of the family.

Imparting information to children about adults who are seriously ill must be done so according to the child's developmental level. When information is delivered in a way that is understandable and with ongoing emotional support, fear and uncertainty can be addressed. Research confirms that children want to know what is happening and that the unknown creates anxiety and fear.[1,2] Children also want to be helpful and involved in the loved one's care. Open communication can help children to be involved and to create lifelong memories of how they helped to provide comfort, gave a back rub, or brought food to the patient. In these circumstances, children can feel helpful instead of helpless.

This issue also is an excellent example of the need for interdisciplinary care. It may be helpful for the health professionals in the oncology area to consult with their pediatric colleagues about how best to support this family. Child life specialists or pediatric social workers are very skilled in communicating with children and may offer advice and support.[3]

Without effective communication and support, children experiencing the serious illness or death of a loved one will feel excluded and may develop fears and misconceptions. For example, children may believe that they are responsible for the illness, that it is contagious, or that other close family members will also die soon.

Professionals involved in supporting children through a loved one's illness should also encourage communication with the child's school, because much of their time is spent there and it is helpful for teachers to know what the child is experiencing.[4,5,6] Facing serious illness or death of a loved one will always be challenging for children, but support and communication can help them feel included and informed.