When a parent is diagnosed with cancer, a conversation with the children, no matter what age, is inevitable. Instinctively, many parents feel strongly about protecting their children from any emotional trauma that may come from learning about their parent’s diagnosis, especially if the prognosis isn’t favorable, or from watching their parent deal with adverse side effects of treatment. But according to Allison Schaffer, LCSW, shielding children from the truth is actually doing them a large disservice.
At the 2015 SURVIVORville meeting, Ms. Schaffer, oncology social worker, and program manager at Vanderbilt-Ingram Cancer Center, Nashville, TN, offered her insight on how a diagnosis
of cancer impacts family dynamics, with a focus on emotionally healthy and productive ways of involving children in a parent’s survivorship journey.
Although children have different ways of coping than adults, they often sense when their family members are going through emotional changes, Ms. Schaffer said. The danger of hiding information from children, she says, is that they are likely to misunderstand and draw their own conclusions from conversations they overhear or from things they observe in the household.
“So be honest,” she said. “You should be the one in control of the information. Otherwise, they might get confused or create inaccurate stories that may be emotionally disturbing, and you may not be aware of at all.”
It’s also important to communicate with children that they will be safe and secure, no matter what happens. Maintaining the child’s routine and consistency of daily expectations, especially when multiple caregivers are involved, is key for providing such stability, Ms. Schaffer said. “It’s very common to feel guilty when you’re sick and often too tired to consistently enforce family rules and expectations when children are acting out, but you need to stick to your disciplinary behaviors and communicate those behaviors to all of your child’s caregivers.”
“Also, remember that children like to feel helpful and want to be included,” she said. “Engage them in the process, and ask them how they want to help. They may choose to make a get-well card, fetch a blanket, or pick a movie for movie night. They might even want to go with you to a medical appointment so they can meet the team and see the environment. That can help remove the mystery of where parents go all the time.”
How families cope with a diagnosis of cancer depends on several factors, such as previous exposure to cancer in the family, the intensity of treatment, and short-term/long-term side effects, but a diagnosis of cancer can definitely magnify preexisting family dynamics, Ms. Schaffer said. “As with any crisis, families either get closer together, or they get further apart.”
To stay strong as a family, Ms. Schaffer discussed “the 8 empowering C’s of coping with cancer” that patients should apply not only to their own lives but also share with their children and other family members.
- Create a “safe space” where people can express their feelings
- Ask for help
- Use “I” statements to avoid blaming or accusatory statements
- Pause to take breaths if you feel yourself becoming angry or emotional
- Know when to listen; sometimes people just want to vent, and the expectations of listening should be communicated upfront.
- Be honest about finances and discuss mutually agreeable ways of saving/spending money if needed
- Know your own strengths and weaknesses
- Discuss the care plan with the healthcare team early and often, and get all your questions clearly answered
- Identify new solutions to recurring problems; if you have no time to make dinner, consider a meal service or going out for dinner on a regular night as a treat
- Make time for fun in a cancer-free zone>, setting up a regular time during which you all agree not to talk about cancer
- Try out a new hobby
- Create new health habits, such as eating well and exercising
- Take time to reflect on how you have grown, what good has come of this experience
- Think about what is working or not about your day-to-day life; use the answers to those questions to effect meaningful changes
- Maintain regular schedules and disciplinary behaviors as much as possible
- Establish a single method of communication with friends and family members, such as >e-mailing, texting, or calling
- As Ms. Schaffer says, “Living with cancer is courage, so give yourself permission to say, ‘today was awful, and tomorrow I’m going to do better’"
- Take time to connect with friends, neighbors, and other local resources when you need help with your children, especially with regard to transportation, housecleaning, and meal preparation
8. Cheese Dip
- Cheese dip refers to Ms. Schaffer’s personal coping mechanism of treating herself to a bowl of melted cheese with chips when all else fails
“Remember that you’re doing this your way, so it’s about finding what works for you,” Ms. Schaffer said.