Supporting Children When a Parent Has Cancer

A diagnosis affects not just the person with cancer but also their friends and family members, including children. Oncology nurses often reach out to social workers or spiritual leaders to provide support and resources when they are available. Fewer oncology prac­tices have dedicated staff for support, however, so nurses are more frequently called upon to fill that gap.

Three impactful ways oncology nurses can help children cope with a parent’s cancer include encouraging frank family discussions, coaching patients to monitor children’s behavior, and offering access to resources for support.

ENCOURAGE DISCUSSIONS

Parents often want to protect their children, but it is important to tell a child about the cancer at an early stage. The illness can’t be kept a secret, because most children will sense that something is wrong, especially when adverse events appear. Nurses can help parents discuss their concerns and practice how to talk with children at different ages.

ASK ABOUT THE CHILD’S BEHAVIOR

Each child reacts differently to a family member having cancer. Nurses need to ensure that parents understand that, depending on a child’s maturity, experience, and age, responses can vacillate widely—crying, clinginess, indiffer­ence, sleeplessness, problems at school, or eating disorders, for example. Help parents make a list of adults (such as day care workers, teachers, coaches, school nurses, or school counselors) who can help watch for behavior changes.

HELP PARENTS EXPLORE RESOURCES

Encourage parents who have cancer to explore extra school support, faith-based programs, and organizations within their community. Supply information about where to find support groups and counseling. Look for programs that specifically offer support to children.

• Noogieland and other Cancer Support Community programs offer support for children and teens impacted by cancer—either themselves or through a loved one. Programs vary by affiliate (in some they are called after the original Gilda’s Club program). They include support groups for children facilitated by licensed mental health professionals, and educational and interactive workshops to help them learn new coping skills and ways to express themselves through creative art and fun activity. Visit cancersupportcom­munity.org to find locations and specific programs.
• CancerCare for Kids is a CancerCare program that offers free professional support, information, and resources for parents, children, and adolescents affected by cancer. Online, parents will find education workshops, publications, answers to specific questions, and a list of credible resources. Go to cancercare.org to learn more about these services.
• Kesem is a nationwide community of college student leaders that support children aged 6 to 18 years. Each year, thousands of children whose parents are cancer survivors or who have lost a parent to cancer can attend a week of fun with children who have similar life experiences. The coast-to-coast campsites are free of charge. To find locations, visit campkesem.org.

Even as an adult, learning that a parent has cancer is overwhelming. Those in the sandwich generation need to carry on responsibilities of their immediate family while also meeting the needs of their parent. This may mean traveling distances to provide care, leaving family at home to pick up extra responsibilities, or having a parent move in with them—all of which change the dynamics of the family unit. This can create an internal struggle of “whom do I care for first?” along with feelings of guilt that can lead to depres­sion. Nurses are in a key position to provide encouragement, resources, and support, as well as assess for caregiver burden and promoting self-care.¹ Caregivers may not realize that they can attend a support group with or without their parent.

Many resources exist for cancer caregivers, including Livestrong (livestrong.org), which offers an orientation to caregiving, self-care information, and a list of other web resources. Patients and caregivers often need extra support during the holidays, which can be stressful even without cancer. Fatigue, treatment, adverse events, schedules, and finances often require defining a new holiday norm. Nurses can offer suggestions such as prioritizing activities, delegating, and simplifying traditions. The Leukemia and Lymphoma Society offers a quick tip sheet, “Coping With Cancer at the Holidays” (lls.org).

Staying informed about credible sources is a major way oncology nurses can positively affect patients, caregivers, and family members. Think about attending a CLIMB (Children’s Lives Include Moments of Bravery) program through The Children’s Treehouse Foundation. This training workshop is for cancer center professionals interested in offering a CLIMB psychosocial intervention, group-support program for children whose parents have cancer. Visit childrenstreehousefdn.org to learn more.

The way children cope is often closely related to how their parents cope. When oncology nurses provide support to help parents cope with cancer, they also inspire emotional support for children of all ages whose parents have cancer.

REFERENCE

1. Johansen S, Cvancarova M, Ruland C. The effect of cancer patients’ and their family caregivers’ physical and emotional symptoms on caregiver burden. Cancer Nurs. 2018;41(2):91-99. doi: 10.1097/NCC.0000000000000493.