The diagnosis has just come in. Grandma is dying from cancer and may have only three months to live. You are stunned and trying to cope with a flood of emotions. You have three young children ages 4, 7 and 10. Should you tell them? When? And what? How can you deal with their emotions when you can't deal with your own right now?

It is my firm belief that children need to be told about important things happening in their lives, but they don't have to be told instantly. You may need a little time for this horrendous news to sink into your own head and to plan how you will tell your children. But don't wait too long, because your children will be picking up signals from you: your tone of voice, hushed telephone calls, your red eyes from crying, your lack of patience, or the absence of your smile--all sorts of cues will tell them something is wrong. Without some information, they will be left to their imaginations and fantasies, creating unnecessary anxieties.

Children want and need to be involved in whatever is going on.

When you're ready, I suggest you gather them all together and tell them that Grandma is very sick and they may see you upset because you are so worried about her. It is important that you talk to all your children together so each knows what the others know. You may hesitate about telling your youngest child, feeling he is too young, but even the youngest needs to know what's going on in the family. And if you tell only the older two children, think about how burdensome this "secret" will be for them to carry.

Of course, the first question out of their mouths will be, "Will Grandma die?" Your answer needs to be, "The doctors are doing everything they can think of, but she is very, very sick." That's enough for now. As the disease progresses, you can give them more information. At this point, have your children write letters, draw pictures, or make cassette recordings that can be taken to Grandma to make her feel better.

Children want and need to be involved in whatever is going on. They need information, simple, basic information without a lot of detail. They will process what you tell them, then perhaps ask to go over to a friend's house to play. It may appear they didn't hear what you just said. But don't worry, they heard. They are just doing what kids do best, flipping the switch to think about something happy. They will work through your news and come back to you for more information when they are ready. In the meantime, you have set an important standard for them: that you will keep them informed, and that they can come to you for straight, honest answers.

I also recommend you take your children to visit Grandma. Whether she's in the hospital or at home using hospice care, some preparation needs to be done. Your kids may be expecting Grandma to be her old self, offering cookies and milk and playing a game of Uno. Before you go, tell them what they might expect to see on this visit. Let them know of any physical changes, as well as any special medical equipment that might be there. Give them ideas of what they could say to Grandma to help lessen the awkwardness. Some things to say might be: "Grandma, I miss you and I'm sorry you're sick," or "Grandma, I love you. I brought a picture for you to hang near your bed so you can see it and feel better," or "Grandma, here is my report card."

Bringing a gift or show-and-tell is a good idea. It will give your children something to focus on and remove some of the tension. If you wrap a gift, let your children help unwrap it. Take something that requires some interaction, such as a book from which a child could read to Grandma, or a homemade gift a child can explain.

The visit should be short so it doesn't tire Grandma or add to the discomfort of your children. The next visit can be longer, and your children could be invited to help in some of Grandma's care. I was so impressed with my nieces and nephews around their grandfather's (my father's) dying. Upon arrival, they would immediately go into his bedroom to say "Hi, Grandpa" to him. They did not seem to mind the unpleasant odors in his sickroom or his unshaven face. They even helped in his bathing and were willing to do whatever chores needed doing. Such love!

As death approaches, it will be time to let your children know their grandmother is dying, that her body just cannot live with the cancer any longer. This is an opportunity to teach your children about whatever your religious beliefs are. But do take some care when you and your children pray for Grandma. Children generally believe that God will answer their prayers and grant their wishes. If the prayer is "make Grandma well," and then she dies, you can imagine how angry your children could be with God. They will be confused in their religious beliefs. Rather, decide on what you and your children could pray for. Perhaps it could be for strength to get through this, or that Grandma will have a peaceful death. I remember a dying person who told her family, "God answers your prayers, but not always the way we tell him to. My prayer was to go home, and I will be going home. Not to our house on Elm Street, but to my home in heaven with Him."

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