Q: My wife is struggling with breast cancer, and the doctors are not encouraging. We are hoping for the best but know that she could die in a matter of months. Meanwhile, we have a son, 3, and a daughter, 7, who haven't been told how serious this is. What do we tell them? We hesitate to break such terrible news if it isn't necessary, but we worry about not telling them if it is.


I hope that your wife will recover, but it is important that your children know that your wife's illness is serious and could get worse. The death of a parent is a terrible loss for a child, but being prepared in advance is far better than getting such dire news out of the blue. Telling them now that their mother is very, very sick will enable your kids to make the most of the time that is left and, if she dies, give them the all-important chance to say goodbye.

Consider for a moment what would happen if you did not tell them. Would they be totally in the dark, or would they pick up unintended signals that something was wrong? Children observe a lot more than adults realize--changes in the family routine, in meals, in visits from strangers, in hushed conversations, in trips to the doctor's office or hospital, and most especially in their parents' demeanor. They don't miss much, but without accurate information they may come to the wrong conclusions. If your wife spends time in the hospital, your little boy might think that she is staying away because she doesn't love him anymore. Or your daughter might think that her mother's mysterious illness is contagious--worse yet, that it was brought on by something bad the daughter did. It is amazing what powers children imagine they have.

Some people think that age 3 is too young to expose children to the realities of illness and death. This is not true. For several years I have conducted a group for pre-school children grieving the death of loved ones, and I have been impressed by their grasp of what has happened and their ability to articulate it. Your 3-year-old undoubtedly has some of the same ability to understand what is happening if given the essential information, and he will definitely benefit from an early warning should your wife die.

I suggest that, if possible, you and your wife together have a family meeting with your children. One of you might hold your son on your lap while the other one hugs or holds the hand of your daughter. Your wife could begin by telling them that the doctors say she is very sick and might not get better. You could add that the doctors are doing everything they can to make her well again, but that they are worried, too.

If your wife is too ill for such a meeting, you could have a meeting consisting of just you and the children.

After breaking this disturbing news you could then ask if they understand what you are saying. You may not get much response from your 3-year-old, but your daughter is bound to have lots of questions, giving you an opportunity to explain that cancer is not contagious and that they can kiss and hug their mother all they want, to assure them that you are well and free of any life-threatening disease, and to remind them of the grandparents, aunts, uncles, and cousins who love them and will always help care for them.

It is possible that the children will not ask if their mother might die, but if they do, you should be prepared to answer truthfully, but gently, that you hope not but, yes, it could happen.

Sharing this news with your children, while hard on you and hard on them, will give them the assurance that they are important to you and that they are going to be part of the effort to save their mom--perhaps helping around the house, straightening up their rooms, or being careful not to make too much noise when your wife is sleeping.

Even when the news is bleak and the prospects for a happy outcome are bleak, it is better to tell children about important things happening in their lives than to subject them to the endless anxiety that stems from being kept in the dark. And if the outcome is a happy one, they will share a joy with you and your wife they otherwise would have missed.

Helen Fitzgerald is a nationally respected educator, author, and lecturer on bereavement. Her books include 'The Grieving Child: A Parents' Guide' and 'The Mourning Handbook.'

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