Parental Cancer: Changes in Family Routines

If you are a parent who has recently been diagnosed with cancer, there are few concerns that seem as important or basic as how to help your children cope with all the stress and changes facing your family. Children are very sensitive to changes in their parents' moods and behavior. They may even sense that something is wrong before you begin talking with them. Talking about cancer and the emotions that arise is not a one-time discussion, but rather a series of talks that will continue through your treatment. There is no way to change the fact that cancer is a serious illness that affects the entire family. In general, talking with your children in a calm, hopeful way, and being able to answer their questions, will help them to accept and meet the numerous challenges that arise. Recognizing and voicing feelings among family members can be the basis of finding strength and resilience for the entire family. The following questions and answers may help you anticipate and respond more easily to changes in your family rhythms and routines as a result of a parent's illness.

Q: I am a parent of two school-aged children. I've recently been diagnosed with cancer. Will our family life be able to remain "normal"?

A: The short answer is no. Many things are likely to change. But your family will develop a "new normal" as you all learn to cope with your illness and treatment. It takes time for a new routine to emerge and for errands, meals, and transportation to happen the way your family expects them to. Have patience, communicate with one another, and ask for support from others when you need it.

Q: What changes can I expect?

A: You and your family will need to be flexible. It is likely that, for the foreseeable future, you will not be able to count on a predictable schedule. Physical and emotional changes, as well as reactions to treatment, will probably affect your daily routine. Demands for a new level of flexibility may never have been so great. Ask your family to think about which routines are most important. Try to put your energy into them. These are a few of the things that you can expect to change: transportation, meal preparation, errands, attendance at your child's functions, visitors to your home, communication with friends, house rules, everyone's energy levels, emotional needs, holidays, and vacations. It may be frustrating. Learning together to be more flexible and overcome adversity may be a hidden benefit of the cancer experience for you and your family.

Q: How do I blend our old routines with the new demands we are facing?

A: It may be hard, if not impossible, to try to follow old routines. Sometimes trying to maintain old routines may demand more energy than adjusting to new ones. Changing old routines is not bad. As a parent, you are always preparing your children to deal with adversity. This is an opportunity to continue teaching them, though it is one you didn't ask for. There are many things you can do to help prepare your family for some of the changes that will occur. Maintaining open communication is one of the most important. Help your children to prioritize the important events in the upcoming months. Have backup plans for the most important of these, such as arranging to have a friend drive your children to a party if you are unable. Let your children know when you are feeling tired or sick. Let them know that no matter how you feel or act, you love them the same as always. Think about what types of things your children can do to help out that can contribute to their sense of purpose. Finally, let other adults know what they can do to help. Most will be happy to help with the day-to-day tasks of caring for children. Try to remember that things will likely return to a sense of normalcy after treatment ends.

Q: How involved should my children be in taking care of me at home?

A: First, it is important to find out how much your children want to be involved. Some children may find caring for a parent too difficult emotionally. In this case, try to find other ways they can help at home. In some cases, you may have to rely on your child's help. Try to give them tasks they are easily able to do. Let them know how much this means to you. Keep in mind that age matters. Young children have shorter attention spans. Give them tasks that are easy and safe for them to do alone. You might ask them to let the dog out, bring you a glass of water, or bring you something to read. Preteens and teenagers will help, despite the protests you may hear. Find out what tasks are comfortable for them. Often teens are embarrassed by bodily changes and by the routines and tasks that come with cancer treatment. By communicating, you will be able to work out errands and tasks they are comfortable doing. Teenagers often have to sacrifice time with friends to help out at home. Some teenagers may already be used to having more freedom and separation from the family. They may resist the demand to focus more on family matters. An older teenager might prefer tasks that emphasize their maturity, such as driving to the drugstore to pick up a prescription or driving younger children to school.

Q: Are my children coping well?

A: Children let you know how they are doing through their words and behavior. There are a number of signs to look for that may indicate that your children are struggling. When talking with your children, note if efforts to engage them in conversation or daily activities are often unsuccessful. Do your children refuse to talk with anyone about your illness? Watch your children's moods, and if you notice increased levels of anger or worry that persist, you may want to seek help. Increase communication with your children's teachers or guidance counselors, who can tell you of any school-related issues. Other potential warning signs include declining interest in hobbies or sports, and giving up peer activities. You may find that your children's behavior has regressed. Or they may have developed new habits or physical symptoms such as frequent bedwetting or physical complaints such as stomachaches, headaches, and fatigue. Listen for reports of new aches or pains. Your children's signs of distress can be eased by professional support. Coping with a parent's cancer is an unusual stress in a child's life. Discuss concerns with your child's healthcare provider. They can help evaluate symptoms and behaviors or refer your child to another specialist. Even children who appear to cope well may benefit from the opportunity to check in with a counselor or therapist for emotional support.