During a relative’s severe illness, a child’s response will to some extent be determined by their ability to understand what is going on. A little child may ask, “When is Mummy going to get better?” They may still be unable to understand that death is permanent and their loved one will not be coming back.

They will, however, be aware that their relative is sick, and not the way they used to be. This may cause an intense reaction, one sometimes directed against the sick person. Fears of abandonment and guilt may well start before the death, If the relative is being looked after at home, the child may feel guilty and unhappy that they cannot make them feel better. They may feel jealous of the amount of time and attention the other family members spend taking care of their relative, or upset by medical equipment or appliances, all of which require explanation to the child in understandable terms. With adequate explanation and preparation a great deal can be achieved.

Practical tips

1. In these circumstances it is advisable not to make a child do something they do not want to do. Instead, try to understand what is behind the refusal: it will usually be anxiety or fear. Remember that children tend to express their emotions in actions rather than in words. If they refuse to see or visit the dying relative it may be because they are frightened of the illness, or of not knowing what to say.
Encourage your child to tell their sick relative about school and friends. It is usually easy for the child to talk about these things, and reassuring for their ill relative.

2. Keep the visits short for young children. Try to time the visits so that they coincide with their relative’s most alert times or best times of day. Reassure them that their sick relative is being
cared for.

3. Include and involve your child with activities. It is useful for your child to make cards for their ill relative, to paint pictures, to write notes, and to see those notes displayed by the bedside.
These remind the child that they are a valued member of the family. Use games and other play items so that the patient can have some interaction with the child.

4. Some children may show no response whatever to a very ill relative, whereas other children may react more openly. Anticipate responses and don’t panic. Do not be frightened if your child shows anger towards their ill relative by saying things like “I never want to see you again”. The child is experiencing a tremendous sense of loss and outrage at the perceived abandonment. Try not to criticise the child but see if you can make them understand that seeing their sick relative unwell is hard on all the family. Just stay close.

5. Let the school know. Since the child’s behaviour or performance at school may well be affected by what is going on, it is important that you let the school know so that they can make reasonable allowance for changes. More importantly, they can let you know of any important changes in behaviour or performance.

6. Reserve time for the children. You may feel the need to be at the sick relative’s bedside as much as possible. This can be emotionally draining and it is advisable to try to have time for yourself and your children.

A few important points:
• Children need information about what is happening

• Try to include them as much as possible in what is going on. Give them choices about what to do

• It helps to show children that you are also grieving and this may help them to express their feelings

• Grieving children often need extra reassurance and affection