Younger Children

Younger children can be a source of great joy and comfort for people living with cancer. Having your children or grandchildren around may help you feel better. Children’s hugs, kisses and love can be very comforting. Talking with children and doing things with them can help take your mind off cancer.

Younger children may have a difficult time adjusting to cancer in the family. It can be especially difficult if their routines are interrupted or if the person who has cancer looks and acts differently or is in the hospital. You may also feel guilty if you are constantly asking children to be quiet, help around the house or stay with friends after school. Children have various ways of trying to get your attention: they may misbehave, act younger than they really are, become clingy or refuse to leave your side.

There are several ways to help younger children cope with your own or a family member’s cancer treatment:

• Consider having someone else look after the children when you are not feeling well or are busy caregiving. People are often happy to help out so that you can have a break and concentrate on feeling better.
• Be easy on yourself if you can’t do all the things you usually do with or for your children. This is not a sign of failure but it is an indication that you need to balance your family responsibilities with saving your energy to cope with your treatment, recovery or caregiving.
• Try to find ways to let children participate in your day-to-day routines and give them small jobs to make them feel helpful – things like bringing in the mail or anything else that makes them feel special and good about themselves.
• Since children strive on routines, do what you can to keep the children’s routines as stable as possible. If there is going to be a change, warn them whenever possible and let them plan the changes whenever possible.
• Allow your children’s teachers, principals or guidance counsellors to be partners in helping your children cope with cancer. Tell them about the situation and talk to them about any changes in your children’s behaviour.
• Think about taking children to the hospital so they can see what happens during treatment. The makes treatment less mystifying and scary. Let the hospital staff know that you plan to bring your children since it may help to have a healthcare professional around to talk to them if necessary.
• Keep things as simple as possible. Divorced or separated parents may want to find strategies to ease tension in their relationship, if necessary, during treatment and recovery.

Teenagers

Teenagers are at a stage in their lives when they are trying to break away and be independent of their family. When someone in the family has cancer, breaking away may be harder to do. They may react in very different ways, which may include getting angry, acting out, getting into trouble, withdrawing from you, taking on (but possibly resenting) more responsibilities, or offering help and assurances of love. Like everyone else, teenagers may be worried that the treatments won’t work and like younger children, teenagers too can feel abandoned as the family focuses on the sick member.

Here are some ways to help teenagers deal with your own or a family member’s cancer treatment:

• Encourage teens to keep doing the things they like to do and try to maintain their routine as much as possible even if that means involving another adult to help.
• Try to make sure the teenager gets a break from the situation at home perhaps by spending time with friends or having regular movie or pizza nights.
• Try to get your teens to talk about their feelings and answer their questions as honestly as you can. Ask for their opinions and, if possible, let them help you make decisions.
• Ask teens how their friends have reacted to the news of cancer in the family. You can offer suggestions on how to deal with awkward situations.
• Encourage your teenage children to talk about their fears and feelings with people they trust, especially with people they feel close to. Friends can be a great source of support, especially those who have also dealt with serious illness. Other family members, teachers, coaches and spiritual care providers can also help. Find out if there is a support program in your community for teens whose parents or relatives have cancer.
• Try to be patient if you can’t understand or predict your teen’s behaviour or emotions. Teens may not have the words or the ability to express emotions such as anger, guilt or grief and may resort to moodiness or outbursts instead.

Adult Children

Like teenagers, adult children of people with cancer are often in between two worlds: they are still your children, but they may also be parents and have the responsibilities of adulthood. Cancer may reverse your roles and your adult children who are used to you taking care of them may now need to take care of you. They may feel torn about how to fulfill all the obligations of their lives.

People with cancer and caregivers may find their relationship with their adult children change with the diagnosis of cancer. For example, you may:

• Ask your adult children to take on new duties such as making healthcare decisions, paying bills or taking care of the house.
• Ask your adult children to explain some of the information you’ve received from your doctor or go with you to appointments.
• Rely on your adult children for emotional support. For instance, you may ask them to act as go-betweens with friends or other family members.
• Become closer to your adult children and find that your family is brought closer together by the cancer diagnosis.
• Want your adult children to spend a lot of time with you. This can be hard, especially if they have jobs or young families of their own.
• Find it hard to receive, rather than give, comfort and support from your children.
• Feel awkward when your adult children help with your physical care such as feeding or bathing.

Even though they are grown up, your children may be scared of cancer and the possibility of losing a parent. They may feel guilty if they have not been close to you, or if they cannot spend a lot of time with you because they live far away or have other duties. Some of these feelings may make it harder to talk or relate to your adult children. Here are some tips on talking to them:

• Include your adult children when talking about your treatment and let them know your thoughts and wishes regarding your treatment and care. It is important to talk about cancer with your adult children even if they get upset or worry.
• Make the most of the time you have with your adult children. Talk about how much you mean to each other. Express all your feelings, not just love, but also anxiety, sadness and anger. Don’t worry about saying the wrong thing. It is better to share your feelings rather than hide them.
• Let your adult children know they can talk to a doctor about their risk of developing cancer and consider asking your doctor or healthcare team about risk factors for your children.

Parents

It is one life’s most painful experiences to be the parent of a sick child even if the child is an adult. Although you may be fairly independent from your parents, the changes in your life throughout your cancer experience may mean that you will turn to your parents more often than you used to.

If your parents are in good health and live close by or are able to spend extended periods of time with you and your family, they might be a source of great support for you. They can help around the house, run errands, look after your children or go to appointments with you. Your biggest challenge may be working with your parents to make them understand how they can be helpful without making you feel helpless or like a child again.

If your parents’ health is poor and you’ve been caring for them, you may need extra help with this job while you’re in treatment or caring for someone with cancer. There are no easy answers for sorting out what is best for your entire family in this situation. You may feel guilty that you can’t look after your parents as you have in the past or as you would like to but it is important to focus on your own health issues.

Here are some ideas for helping you and your parents cope throughout your cancer experience:

• Make the most of the time you have with your parents. Talk about how much you mean to each other and express your feelings of love, anxiety, sadness and anger. Don’t worry about saying the wrong thing. It is better to share your feelings than hide them. If you or your parents are having trouble communicating, a counsellor may help.
• Try to keep your parents informed about your situation. They are likely feeling extremely helpless, or possibly left out so being informed may help them cope.
• Give positive feedback to your parents if they try to help. Be as specific as you can about what is most helpful.
• Respect the right of your parents to agree or disagree with the decisions you are making but make it clear to them that these are your decisions to make.
• If necessary, turn to other family members and friend to help with looking after your parents. Help through community agencies may also be available.
• Talk to your healthcare team if you are struggling with feelings of guilt.

Partners or Spouses

Cancer is a very stressful event that can strengthen or strain a relationship. You and your partner may cope differently with cancer. For example, one of you may feel more hopeful, while the other is more pessimistic. One of you may want to find out as much as you about cancer while the other feels better not knowing as much. One of you may want to opt for more aggressive treatment than other does and one of you may be more comfortable with talking about feelings and emotions, or asking for help, than the other.

If both partners can recognize their strengths and weaknesses, then your differences can be an advantage. For example, the person who likes to do research can take on that responsibility and feel useful while the person who is better at talking about feelings and emotions can make sure that you both talk about what you need and feel.

Even the best relationships can be challenged by cancer. Here are some things to keep in mind as you and your partner face this disease together:

• As you cope with you cancer, think about how the two of you have coped with difficult times in the past. What worked, what would you change? It can help to write down a list of things that you both can do to make the relationship strong.
• If you’re feeling stressed, it may help to give yourself short breaks from each other. You may be so worried about your partner that you forget to look after yourself. The partner with cancer may need time to be alone and not feel like “the patient” while caregivers need time to rest and find ways to care for themselves.
• Sometimes talking to someone else, such as a relative or friend or even someone completely outside of the situation can help. If this feels like a sensible option, discuss it with your partner.
• Think about what you need from the other person when times are tough. Then ask for it.
• Try to keep communication open and honest. Avoid assuming, attempting to read your partner’s mind or expecting your partner to just know what you need.
• Be sensitive to signs of a bad day or a bad mood. Test the waters before launching into complex or emotional discussions.
• Give yourself some “cancer-free space.” This is a space where cancer is not the topic of conversation. Talk about and do other things together.
• It is important for both partners to be involved in making treatment decisions. You can meet with the healthcare team together and learn about cancer and treatment options.
• Even if it isn’t easy, both of you should think of the future and make plans for it. Planning your care in advance and writing it down lets you decide for yourself how you want to be cared for in different situations and who will act on your behalf, if necessary. Meeting with a lawyer or financial planner will help you both plan for the future.