How do we tell our children their dad is terminally ill?

We have two children – a boy of 11 and a girl of 14 – and we have just learned that their dad is terminally ill with cancer. My husband has been given about 12 months to live. We are both in shock but trying to think about what is best for our children. How do we broach this with them? Should we tell them now and what should we say?

You have received very sad and shocking news and everyone reading your question will feel a great deal of sympathy for what you and your husband must be going through. As good parents you are right to think of how you talk to your children and help them prepare for dealing with such a family tragedy

Whether to tell or not
Often out of a desire to protect children from unnecessary pain, sometimes parents are tempted to delay excessively and even not to tell their children when they are coping with a fatal illness. Indeed, historically, many medical services often did not support parents telling children about this difficult news.

However, learning from adults who lost their parents as children, this seems to be a largely mistaken view. Though very painful to hear, most people – children included – prefer to know when a loved one has a fatal illness so they can appreciate the time they have left with their parent and can prepare themselves for the end. While the timing and how you tell is crucial, it is important to decide to tell them.

Take some time to prepare yourself
Before you tell your children you may both wish to take some time to get to grips with the shocking news yourself. You might want to discuss in detail with the medical team about the specifics of your partner’s illness, how it is likely to progress and the palliative options available.

How definite is the prognosis of 12 months? Are there treatment options to slow down the progress? What can you do to ensure a quality of life for your husband for as long as possible? You may wish to gain a second opinion about your options so you are fully informed of your choices going forward.

You may also wish just to take time to yourselves to think it all through and absorb what it all means.

In the face of a terminal illness, many people choose to change how they live and to focus on new priorities in the time they have left. This can include changing your work focus, and thinking through carefully how you can make the remaining time most meaningful.

There may be special projects or family activities that your husband and you would like to now prioritise for yourselves and your children.

How to talk to your children
In telling your children, pick a place where you can be comfortable and when you have plenty of time. The important principle is to tell them gradually and gently. You might start with something like: “You know the way Dad has been sick in hospital . . . well, unfortunately the news is not good . . . and his illness is very serious.”

Have plenty of pauses and note carefully their responses. Though it may come up in their questions, at some point you may need to be direct about the news “though they can’t be sure about the time, the doctors think your father has about 12 months left to live”.

Be prepared for shock, upset and tears on their part (though this can be delayed until later) and be prepared to reassure, support and communicate with them. They may have lots of questions, some of which you can answer and some of which you can’t. Indeed, one of the big challenges about living with a terminal illness is living with uncertainty.

Make sure to be clear as possible about practical arrangements (for example, visits to hospitals) and discuss with them how they can be involved.

Make sure to finish any conversation with a focus on the support and love within your family. Though you are upset, you all love and support one another and you will all care for each other.

You may also wish to focus on positive plans you can make as a family; how you want to be together in the coming months and what special memories you want to create together.

Get some support
Consider getting some emotional and practical support for your children and family. The hospital team where your husband is being treated should have access to a social worker or family counsellor who could assist you in talking to your children and in thinking through their specific needs.

These services will be able to help you work out any practical or financial issues that need addressing so you can plan accordingly.

You also may find it helpful to ask for support from your extended family. For example, there may be close family members who can commit to being there for each of your children as they go through the next few months. Tell your children’s teachers so they can be sensitive and supportive to them.

Children coping in the long term
A big stress and worry for parents who are dealing with a terminal illness is how their children will cope beyond them. While it is a devastating event, it is important to realise that children are resilient and can go on to live well-adjusted lives with happy memories about the parent they lost.

Also, unlike children who lose parents through sudden death, you have the opportunity to help them prepare and to share special time with their father. This can be big consolation at a very difficult time.

Dr. John Sharry, Irish Times Newspaper, January 2015. John writes in The Irish Times Health+Family every Tuesday.