How can I support a child or young person when someone important to them has a serious illness?

Parent sitting next to young child reading

Supporting a child or young person when an important person in their life has a serious illness can feel like a very tall order.

You may feel that you are protecting them by not talking about it, but based on our experience of supporting families both before and after the death of someone important, it is better to encourage open and honest communication, whatever their age or level of understanding.

They will be feeling a range of different emotions at this time. They may be scared, angry, upset, resentful, or even feel guilty – perhaps thinking that they have done something to cause the illness. It is important to remember, and to remind them, there is no right or wrong way to feel, and reassure them that it’s no one’s fault, certainly not theirs.

Anticipatory grief

Once a child or young person has been told the news that the person has a serious illness, they can react in a variety of ways. This stage is sometimes referred to as ‘anticipatory grief’ or ‘pre-bereavement’. Anticipatory grief refers to feelings of loss before someone dies. This could include things like starting to feel sad about the fact that the person is going to die or imagining the future without them in it. This can start a long time before the actual death, even as early as diagnosis, and bring about all the intense feelings of grief. It is completely normal to begin grieving before a death.

How you can help them

Here are some ways in which both family members and professionals can help a grieving child or young person communicate and process their feelings once they find out about the serious illness.

Keep them involved and informed

It is important to include them and keep them informed throughout. This avoids confusion, will allow them to feel more in control, and give them the opportunity to make informed choices about what they want to do and how they want to navigate this time. It makes things easier for children to process if they have ‘all the pieces of the jigsaw’.

Initially, children can respond very differently to the news that someone is seriously ill. They may be very distressed or angry. They may not react much at all and ask normal questions like, ‘what’s for tea’ or ‘can I go out?’ This doesn’t mean they don’t care, or that they don’t want to know anything. It can be hard to take in what is being said straight away and they may need time to understand the news and process their emotions. 

Talk about the illness

It’s good to mention the illness from time to time, as children sometimes don’t want to or don’t feel able to ask questions themselves. You could start by saying:

“You know I told you that [name] is ill? Well, I’d like to talk about it with you a bit more.”

“I wondered if you had some questions about [name’s] illness that I can try to answer for you?”

If they struggle to ask questions verbally, perhaps give them a pen and paper and some space so they can draw or write their questions or worries.

Tough conversations have to be had

As time goes on, continue to include them and update them on the progress of the illness, keeping them informed in real time, as things happen. This can feel incredibly tough to do, but we know that children cope better if they are involved and included. Conversations may include:

“The doctor said that sometimes mum’s medicine makes her feel really tired and she might say things that come out all funny. You two might need to play a board game or watch TV together instead of playing football when she feels like this.’

“Do you remember that we told you we would always let you know what the doctors said about mum’s illness? And that we wouldn’t pretend to you even if the news wasn’t good? Well, today mum spoke with the doctor and he told her that the cancer has got much worse. He does not think he can make her better now. He thinks that she may not have very long to live and that is why she is so sleepy.”

Should I tell my child their person is dying?

Book: As Big as it Gets

Finding opportunities to talk

Although some children and teenagers can be resistant to conversations with adults at the best of times, it is important is that you offer this opportunity to them on a regular basis. This is a careful balance of not bringing it up constantly but not shying away from it either. There are other ways to communicate other than talking, such as sending a text message, writing a note, or spending some time together doing something they enjoy. 

They might come to you at the most unexpected or even inconvenient time. However, if you feel you can, make the most of this opportunity because it may not come along again. It may feel frustrating, but this will be outweighed hugely by them opening up to you and expressing their grief. 

What if they don’t want to talk?

There could be many reasons why young people do not want to talk about their feelings. Just because they are not talking, it does not mean they are not experiencing grief.

Some young people might not understand what they are feeling, or that it’s connected to grief. They may express emotions such as anger via challenging or risky behaviours. 
Grief can feel unpredictable and overwhelming, especially at the beginning, and many people need time to understand what is happening and work out their ‘new normal’.
They may also be afraid of ‘taking the lid off the box’ without knowing how to close it again.  
Families often want to protect each other from challenging feelings and conversations; some young people might feel they don’t want to worry a parent who is coping with their own grief.

For many young people, talking about difficult feelings and situations is unfamiliar or uncomfortable: they don’t know how or when to start conversations. Lots of people lack the words to express how they are feeling. Adults taking the initiative can do a lot to support young people who might not know how to reach out. 

How can I encourage communication?

If the young person is not keen to talk, let them know that’s ok: ‘It’s completely understandable to not want to talk about it.’  Whilst it’s important to respect a young person’s need not to talk, there are a few things you could try to encourage them to start to open up when they are ready. 

You might, for example, talk about the positives of talking with someone they trust by saying, ‘One part of you may want to tell someone about your feelings, whilst another part might not want to, but dealing with things on your own can be really hard’. If you’re supporting a young person aged 13-25, they may find it helpful to hear some Youth Ambassadors talking about their experiences on our Talk Grief website or Grief in Common podcast.  

Try to check in regularly, focusing on questions that require more than yes or no answers, e.g. ‘What was the best/hardest part of your day and why?’ 
 Talk about normal, everyday things, so that they do not become worried that they should be thinking and talking about their feelings of grief all the time.
 Talking can be easier when there is less eye contact – an activity such as cooking, gaming, or sports could help and walks, or car journeys are also a good time to chat. Teens may sometimes find WhatsApp, Snapchat, or texts an easier way to check in. 
Use ‘naturally occurring opportunities’ to talk about feelings, for example, with characters on TV – this can help teach young people to recognise and name them. 
 Remind young people that emotions can be like waves: they don’t last forever, and it is possible to manage intense feelings and then feel calmer again.

Consider using a tool like the First Aid Kit to help manage emotions. Watch a video about this activity:

First Aid Kit Activity

Encourage them to communicate about the person

It’s good to get the child or young person to talk about the person who is ill, this could be asking questions, but also encouraging them to reflect on positive memories and events. It can include making things in school to take home to the person who is poorly.

Shared memory work can be helpful too, if appropriate, i.e. creating memory jars or boxes. A memory box can be made together with the person who is ill. It can be an important reminder for children and young people that they will always have a strong connection with that person. There are all sorts of things they can put in the box, from photographs of them together, tickets from places they have been, to birthday cards, or even a bottle of the person’s favourite aftershave or perfume.

There are several activities that can be used to help alongside some of these really difficult conversations here.

Help them understand what is happening

Ways to help the child or young person understand what is happening could involve:

Helping them with their feelings, which may be overwhelming.

Answering difficult questions.

Looking at what support is around (for example, family, friends or organisations like Winston’s Wish).

Coping with not knowing timeframes (supporting them with the uncertainty of ‘when’).

Acknowledging how things may be different and discussing how others can help.

It may help some children to use practical activities to explore their feelings and understand what is happening. Worry dolls and dreamcatchers, for example, can be a helpful way for children to express their worries, but then to put aside those concerns that may be stopping them from sleeping. This can also help adults understand what specific things are troubling the child. Creating a Memory Jar or using our Little Box of Big Thoughts can help children to name the different emotions they may be experiencing, such as anger, love, fear, and sadness, and to understand it’s okay to talk about them as well.

Some children and young people may need support with separation anxiety – this is something that can be experienced by younger children and teenagers alike. Read more about separation anxiety here.

Coping with the emotional rollercoaster of a serious illness is exhausting for everyone, and it can be particularly tough to cope with the uncertainty of ‘when’. Continue to talk openly and honestly about what is happening and how people may be feeling.

You may say something like, “The doctors have tried everything they can. We hope we will have a few more months with dad, and whilst we can’t say exactly when he will die, we don’t think he will be alive by the end of the year. I know, it feels so confusing and unsettling not knowing when.”

If a child is facing the imminent death of a parent, they may be worried about other people, particularly their other parent, dying too. As much as you want to reassure them, and this is obviously important, it is also important to be as honest as possible. You can validate their feelings and normalise their emotions whilst still providing as much reassurance as you can. For example, you could say something like:

“I do understand why you are worried, because of what is happening to mum, but your dad has every intention of being around for a long time. It’s really unlikely he will die before you are an adult and whilst you still need him, but if he were to die…” and then give a reasonable answer.

You can also use books to help you explain or explore certain issues with children – take a look at our recommended reading list for children and young people.

Remember to look after yourself

Try to remember that you are doing the very best you can in exceptionally challenging circumstances. It is much harder to support others if you are overwhelmed yourself. Make sure to call on any help available from friends, family or colleagues to help you during this time. That way, you’ll be more able to be there for the children and young people you are supporting.

Where to get support

Our team of bereavement specialists are available to speak with right away. No appointments or waiting lists, just real-life grief support. Call us on 08088 020 021 (open 8am-8pm, weekdays), email ask@winstonswish.org, use our online chat (open 8am-8pm, weekdays) or text or WhatsApp us on 07418 341 800 (open 8am-8pm, weekdays). You must be 13 or older to receive support via WhatsApp.

For urgent support in a crisis, please call 999.