There is no one way to approach talking to your children. The purpose of this brochure is to inform you of what others have found useful, so you can make an informed decision about how you choose to talk with your children. If you require further information on subjects in this brochure you might like to also see the web site at: http://www.rch.unimelb.edu.au/gcrc/patinfo/parents.htm

Some parents try to protect their children by not telling them about their cancer. Many studies have found that telling children the truth about your illness can aid in their coping. Researchers report that while accounting for your child's developmental stage, being open and honest about your illness can address feelings of guilt, abandonment, fear, insecurity, low self worth and loss of control. All are common feelings among children with a seriously ill parent. Information relating to children at different developmental stages is included below. This information is accompanied by comments made by parents and carers who have survived this experience.

Infancy: Birth to 1 year "It was difficult to bond with him because I wasn't there doing things for him." Be assured that the primary concern for babies is to ensure that their basic needs are met. This includes practical tasks and primarily the establishment of love and affection. Meeting these needs will assist baby's development of trust and ensures (s) he is well cared for. Managing with a young baby through a cancer diagnosis and consequent treatments can be difficult. Being sick during your baby's first few months of life will amount to a loss of time together and cherished memories for both of you. As you recover you will be able to offer your relationship with your baby a healthy and comfortable focus, knowing that priorities have been handled in the most important ways. These qualities can be transferred back onto you as you recover, allowing your relationship with your baby to develop more fully, as it should

Early Childhood: 2 to 3 years "I was worried about how she'd be if I wasn't there doing things for her like bathing and dressing her. I had always done these things for her." Children of this age are likely to have little understanding of illness. This is not to say that your illness will not affect them. The onset of a parent's cancer can deflect from time spent meeting basic care needs of children and there may be a consequent need to offer extra reassurance that basic needs will be attended to. If at this time it is necessary to recruit alternative caregivers to assist, it is important to establish a routine that is regular and contributes to a sense of security for your child.

Preschool: 3 to 6 years "[She] didn't have the vocabulary to express her feelings, so her anger and sadness came out in her behaviour." Children of 3 to 6 years are beginning to understand the differences between being well and being sick. Many parents find that their children sense changes in their family. Without explanation, your child may attribute such changes to something behavioural (s) he has done, often something they may term as 'naughty' or 'bad'. This age group will generally focus on themselves and what the changes mean for them. Commonly asked questions include the following: 'Who will look after me while you're in hospital?' and 'Will I get cancer too?' It is natural for children of this age to believe, magically, that their thoughts and actions 'cause' things to happen. This misconception can be corrected by talking with your children, identifying the behaviours that they believe triggered or caused the illness and reassuring them that it is not their fault that you are sick. Key questions to ask might be 'Why is Mummy sick?' or 'what do you think caused Mummy to get sick?

School age: 6 to 12 years "I spoke with the social worker and the doctor, but in the end it was up to us to decide what we told them." Children between the ages of 6 to 12 will have a greater capacity to understand your illness. Openly and honestly discussing your illness with your child and answering any questions they may have can prevent them from attempting to fill any gaps in their knowledge with fearful imaginings. Your child might have imagined your illness to be worse than it actually is or that they have somehow caused you to get sick. Giving honest and factual information, and letting them know that there is nothing they could have done to cause your illness, can minimise feelings of guilt and self-blame in children. Children may actually benefit from being given definite roles. Each child can do something to be included in your healing process. A 6 year old might help the nurse take your temperature, an 8 year old might get you a drink and a 10 year old could put water in the vase of flowers. It is important that the tasks given to children are achievable. This ensures that each child will succeed in their contribution to help you get better

Adolescence: 12 to 18 years "My son appeared quite worried. He said he needs to know everything so he wouldn't worry." Many parents find that being open and honest with adolescent children is a good approach. Children of this age group are capable of understanding your illness in detail and need to be informed about what is happening. It can be particularly difficult for adolescents when a parent has cancer because this is the time when they are testing out their own independence and breaking childhood dependencies from adult family members. When a parent has cancer, however, adolescent children may be needed to help with younger children and with household tasks that an unwell parent is normally able to do. Allowing your child some control in choosing what they help you with can provide them with some independence. Alongside this you may have difficulty coping with inconsistent responses as are often reported by parents with adolescent children. One day they may seem sensitive and sympathetic and other days they may not want to know about any caring matter at all. Explaining that this situation is temporary and as soon as you are well you will be able to do things again can address feelings of resentment and thoughts that you are offloading chores onto them. Ultimately you will decide what and how to tell your children about your illness. You may choose to tailor your individual needs with the aid of a counsellor. You could see the social worker at your hospital to discuss this task