Talking to kids about end of life?


Question from Carl H: My wife has Stage IV with bone metastases and we are preparing for the end of her life. She has worked amazingly hard to stay upbeat, but it's really tough for me to hide my own anguish and I'm very worried about our kids. They are 12 and 14, both boys. I just don't know what to do or say to help them. I can tell that it tears them apart to see me cry.
Answers - Paula K. Rauch, M.D. Your boys are lucky to have a father who loves their mother so much. It is hard to hide sadness when someone you love is approaching the end of her life. Still, there may be a lot of important and life-affirming family time between now and the end of your wife's life. If your wife is still well enough to be engaged with your sons and be enjoying their accomplishments and activities, you want to work together to try to make this next period of time as meaningful as possible. You need to have optimism about the future for your sons and for yourself, including being able to carry the love that you all share for your wife in your hearts even after she's gone. If you are afraid about the future without her, it's important for you to get help now so that you can be the loving and life-affirming guide you want to be for your children into the future.
Tamara Shulman, Ph.D., FAACP I concur that finding a way to spend time together if your wife is still up to it is very important. Letting the boys know that anything they would like to share with their mother about their feelings, their daily lives, their experiences and thoughts are things she would like to hear. Keeping a sense of family connectedness through this process can be very important. Each child is different in terms of their temperament and ability to be involved with a seriously ill parent who is dying. It's important to try to check in with each child in some way and find a place that is comfortable for that child. For example, one child may be comfortable with a bedside visit; another may wish to send a note or email or stay in touch in other ways. However, it's very important for each child to find a way to stay connected with their mother through this process and to plan ways to remember her so they know their feelings for their mother will live on even after she's gone.
Paula K. Rauch, M.D. It's important that you not be afraid of expressing your honest and heartfelt emotion. It's not dangerous to your boys for them to see that you feel deeply sad about their mother's advancing illness and, to the extent that they fully understand it, her approaching death. What they do need to know is that the fact that you sometimes cry doesn't mean that you'll be crying forever and continuously, but rather that the feelings are so big that sometimes they overflow and that you feel better after you've cried. Or that there are times you let out your feelings in other ways—by exercising or cooking—so kids know feelings are strong at some times, and not so strong at others. What's most frightening for kids is the idea that a parent is just going to get more and more and more upset and that they could lose them in that sadness.
Tamara Shulman, Ph.D., FAACP Seeing a range of feelings expressed by their father may indirectly allow the boys more freedom to express their own feelings about their mother's illness.

On Wednesday, May 17, 2006, our Ask-the-Expert Online Conference was called Talking with Kids about Breast Cancer. Paula Rauch, M.D. and Tamara Shulman, Ph.D., F.A.A.C.P. answered your questions about specific ways to support your kids while you undergo treatment, and different communication strategies for helping your kids to feel secure during a time of uncertainty.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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