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Supporting Children and Teens Through a Parent’s Serious Illness

Supporting Children and Teens Through a Parent’s Serious Illness

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No one likes to think about their own mortality—especially when they’re raising children. But for many parents living with a serious illness, or simply wanting to plan ahead, the question quietly lingers: What if I die? How can I prepare my child or teen if that were to happen?

Although death is a natural part of life, talking about it often feels unnatural and painful. It’s even harder to face this conversation when it involves your children. Still, part of preparing for any outcome, especially when facing a serious illness, is making sure your children are emotionally equipped to understand, process, and cope if the unthinkable happens.

This journey begins with small, open conversations that help children make sense of life’s uncertainties. They need to be part of this journey; not just for understanding, but for healing, should the time ever come.

Start with Communication

One thing nearly all research agrees on is that honest communication is vital. Start by asking your child what they think is happening. Have they noticed changes? What are they wondering about?

This is a good starting point for deeper, more honest conversations. As your child begins sharing their understanding of the situation, gently and honestly introduce words like ‘serious illness’ and ‘dying.’ If death is a possible outcome, it’s important they hear and understand that word from you, so they can begin making sense of it in a safe and supported way.

Keep These Tips in Mind:

  • You can’t shield children from all pain. They are perceptive. Even if you try to protect them, they will sense that something is wrong. Help them feel informed, not confused or excluded.
  • Don’t wait for the “perfect moment.” Instead, create safe and honest spaces for ongoing conversations. Open communication now can reduce fear later.
  • Be the one to talk to them. Children and teenagers should hear serious news from you and not accidentally from someone else.
  • Listen carefully to their questions. Their understanding will depend on their age, personality, and life experience. Be present, and follow their emotional cues.
  • Use clear, simple language. Use language that matches the child’s developmental level. Avoid euphemisms like “in treatment” without explanation, and steer clear of false reassurances such as “Mommy is sick, but she’ll be okay.” These kinds of statements can create confusion, false hope, or unnecessary fear. Honest, age-appropriate communication builds trust and emotional security.
  • Offer emotional support, but don’t hesitate to ask for help. Supporting your child is hard when you’re emotionally vulnerable yourself. Accept support from others, whether that’s family, professionals, or community resources.
  • Let them help, but don’t burden them. Involve them in small, age-appropriate caregiving tasks if needed, but ensure they remain in the role of a child. If you are parenting alone, bring others in to help maintain structure and stability.

Creating Memories

Preparing children for a possible loss is not only about explaining what could happen, it’s also about leaving behind connection and comfort. If the worst were to happen, these preparations can become treasured sources of strength.

Help your child or teen build memories now. Even while you’re still here, this can help them feel closer and more secure.

  • Write letters your child or teen can read at key moments in life: graduation, birthdays, first heartbreaks, or just when they miss you. These can hold your love, encouragement, and even advice.
  • Create a memory box with simple, meaningful items: a scarf, a watch, a favourite recipe, or a small memento from your youth. These objects can become anchors for your child’s sense of connection.
  • Involve them in meaningful rituals, not necessarily funerals, but rituals of bonding. Let them help pick a photo for the wall, a song to share, or a story to write down. These create emotional tools they can carry forward.
  • Encourage journaling.  A private journal allows children and teens to process their feelings freely. Writing can be a safe place to release fears, hopes, and emotions. Over time, this may even lead to deeper conversations.

Facing the Unknown, Together

Preparing for the possibility of death is emotionally complex, for adults and children alike. But regardless of age, we all experience the same loss. And in a family, that loss is shared.

Losing a parent changes the entire family dynamic. It’s a lifelong shift, a kind of emotional disability the family learns to live with. That’s why preparing early, honestly, and together can help everyone navigate that shift if and when it comes.

This journey is about more than preparing for death. It’s about creating connection, clarity, and continuity. So no matter what the future holds, your child never doubts that they were loved, supported, and understood.

Written by: Ilana Kilian, social worker

Sources:

My Experience Caring for My Friend with Advanced Cancer

My Experience Caring for My Friend with Advanced Cancer

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I’ve known *James for several years from work. He doesn’t have a close relationship with his family, and there aren’t many people he could call close friends either. When his cancer got worse, he asked me to be his proxy. I didn’t fully understand what that meant, but I said yes. After his last hospital stay, it was clear that James needed constant care, so I invited him to stay with me for a while.

The Challenges of Being a Caregiver with No Experience

Caring for James was a huge challenge, especially since I had no experience. The first thing I struggled with was my physical strength—James was much bigger than me, and I was worried about how I’d manage to lift him if needed. It was also tough to balance giving him dignity while handling his intimate needs. I learned that I had to respect his choices, especially when it came to things like eating. I could only encourage him so much before I had to step back and let him make his own decisions. Balancing work and caregiving was another big challenge, one I hadn’t anticipated.

How I Took Care of Myself While Caring for Someone with Medical Needs

I was fortunate to have an incredible support system. My partner was very understanding and stepped in to help with James when I was too busy or too tired. We also had the help of a home-based care team. They came in regularly to check on James’s physical and emotional well-being and offered me a lot of guidance. Their support made it easier to handle the little things that were keeping me up at night, like worrying about his oxygen nasal prongs falling out. It sounds small, but they even suggested taping the prongs to his cheeks, which helped me sleep a bit easier. Having this support made my life as a caregiver much more manageable.

Here’s the Advice I Would Share with Those Considering Caregiving

I know that for some people, caregiving isn’t a choice but a necessity. For those who find themselves in this position, I encourage you to seek help from local agencies like home-based care and build a good support system around you.

If you’re thinking about taking on the role of a caregiver, I would say take time to fully understand what you’re committing to. I didn’t realise how physically and emotionally demanding it would be. I also didn’t realise how much help I’d need. It’s easy to think that feeding someone or helping them to the toilet is straightforward, but it’s so much more than that. The person’s health condition at the time also greatly impacts your role as a caregiver. Whatever your situation, don’t hesitate to reach out for help and build a network of support. It makes all the difference.

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Breaking the Barriers: Promoting “phila unethezeke” (palliative care) Awareness in Khayelitsha

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According to community members, palliative care in Khayelitsha has long been associated with death, making it a sensitive topic for the community. Cultural and spiritual beliefs about death contribute to barriers in accessing palliative care resulting in many community members avoiding discussion and options for palliative care. Our goal in Khayelitsha is to change the community’s perception and tackle some of these barriers, as many palliative care patients only receive support from immediate family members, not the wider community.

Health Promotion Day in Khayelitsha: Who Was Involved and Why?

Health promotion enables people to make informed decisions regarding their health. The health promotion event was organised by fourth-year medical students from the University of Cape Town (UCT) and Judith Mahlangu, Khayelitsha Site Facilitator and Researcher at UCT’s Department of Family, Community and Emergency Care, in partnership with The Association of Palliative Care Practitioners of South Africa (PALPRAC).

A diverse group of participants were invited to join the Health Promotion initiative. There were two components to this initiative. First, students and PALPRAC spent the morning on the live, local radio station, Zibonele FM, to introduce the topic of palliative care to listeners, who had the chance to send in their questions.

Some of the questions and concerns raised by the community:

-Palliative care is not for everyone; my child suffered and was not supported after being released from hospital. (Concern from the radio audience)

-Some families believe that if someone is serious ill, people should not be visiting the sick patient because they bring bad spirits.

-Why is it important that we are talking about caring for people who are dying?

-How do we (carers and general community) help someone who needs palliative care?

-What can we do, because we are supporting our family member who is sick, but the community is scared because they think a sick person is bewitched?

The second half of the project included an information session where community member, persons with disabilities, the elderly, carers of palliative care patients, community health workers (CHWs), and neighbourhood watch members could join the team to discuss the basics of palliative care. Bringing this community group together was crucial for raising awareness and giving marginalised, vulnerable individuals a platform to express their concerns. We aimed to promote inclusion to ensure that everyone felt heard and supported.

Goals and Achievements of Health Promotion

The primary goal was to challenge the barriers surrounding palliative care in Khayelitsha. The project created a space where the community could ask questions and discuss palliative care openly, marking a significant step towards normalising conversations about palliative care and providing better support for the community.

Our long-term goals for the Khayelitsha community includes; continuing to raise awareness about palliative care, starting support groups, and ensuring that local resources in Khayelitsha include palliative care support. We aim to have local clinics deliver essential palliative care medication to patients at home and support patients and their families emotionally and physically, addressing issues like poverty and mental health. Academically, we want to include the community’s voice in the curriculum, collect evidence on the impact of palliative care, and present our findings at conferences.

Gratitude

We extend our heartfelt thanks to Sr Shole of Khayelitsha District Hospital, Community members, Zibonele FM, PALPRAC, and UCT for their support and sponsorship. Together, we are working towards a future where everyone can, in palliative care, “phila unethezeke” –live comfortably.