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Sharing Difficult News with Children (7280)

Sharing Difficult News with Children (7280) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Pediatrics, Parenting


Sharing Difficult News with Children

No matter how much you want to protect your
child, sometimes he needs to hear difficult
news. News like this can be life changing.
The way your child learns this kind of news
affects how he learns to adjust and cope with
it. There is no one way to share this kind of
news with a child. You know your child best.
With this handout and our support you will be
gently guided to share this news.

This handout offers ideas about how to share
difficult news with children based on age.
The younger your child is the fewer the
details you need to share. You may find it
helpful to read this and think about what you
might want to share before you talk to your

Common Questions

Am I the best person to share difficult news
with my child?
You have a role in helping your child cope
with hard times in his life. You are the expert
on your child. Members of your child’s
health care team will work with you and
support you as difficult news is shared with

Isn’t it better to protect my child by not
sharing difficult news? Why should I make
my child feel sad?
A parent’s first instinct is to protect the
child’s feelings. We feel it is best to be open
and honest with your child about the news.
Here are some ideas that might help you.

Children. . .
 Are strong and resilient.
 Want you to be honest and direct;
honesty and directness form the basis
of hope.
 Want to know how the news affects
 Don’t want you to downplay the news.
Isn’t it best to hold off sharing difficult
 It is best not to try to keep the news a
 Your child may worry more about
what is not being said than about the
 If you wait too long to share the news,
your child might hear it from someone
else first.
 Waiting to share difficult news until
your child asks can be a problem.
Some children may never bring it up.

But won’t waiting help me hide my sad
feelings from my child?
 Most children cope best if they learn
difficult news close to the same time
as the rest of the family.
 If you are worried that your sadness
will scare your child, explain that
feelings and tears are a normal part of
talking about this kind of news.
 Let your child know you will be ok.
 Letting your child see your sad
feelings will not harm him.
 Sharing feelings can bring you closer.
 You can model sharing feelings in a
healthy way. This can help your child
feel safe doing the same with you.
 Teach your child to find words for his
feelings. This will help him learn to
describe these feelings to others.
 If you are too upset to keep talking,
take a break and let your child know
you will talk more later.

What might my child ask me?
This is a list of some of the more common
questions children ask. If you don’t know the
answer to a question, it is ok to say “I don’t

 Can I catch it?
 Will someone die?

 Does it run in our family?
 What is going to happen to me?
 Is it going to hurt?
 Did someone do something bad to
cause this?
 Is the sick person being punished?
 Am I being punished?

Some things to think about as you get
ready to share difficult news
 Who else do I want with me?
Examples are: other family, family
friend, doctors, nurses, psychologists,
social workers, chaplains, and child
life specialists.
 Where do I want to share the news?
Examples are: a quiet place where
your child feels safe and has favorite
things nearby.
 When do I share the news? Choose a
time when you won’t be disturbed and
there won’t be a major event later that

How do I prepare my child to hear difficult
 Start by saying to your child in a calm
voice “I have some difficult news to
share with you.” This will avoid
catching him off guard.
 Ask your child what he knows
already. He might have some ideas
that are not correct or he may know
more than you think.
 Pace the news by making a few key
points and then check to see if your
child understands or has questions.

Some things to keep in mind as you share
difficult news
 Be loving and give comfort.
 Be honest and share your feelings.
 Share the news with your child in as
much detail as you think he can take
 Make eye contact.
 Explain that it’s not your child’s fault.
 Listen to your child and accept his
feelings no matter what they are.
 Give your child a chance to ask
questions any time.
 Help your child think of other trusted
adults he can talk to.
 Praise your child for having the talk
with you.

Be ready for any response. There is no
right or wrong way for your child to
Your child may react to difficult news with:
 Anger
 Frustration
 Fear of the future
 Helplessness
 Confusion
 Tantrums
 Acting younger than his age
 Changes in eating or sleeping habits
 Bad dreams
 Physical complaints (stomach ache
 Shock
 Denial
 Sadness
 Embarrassment
 Guilt

Does my child’s age matter?
How you share the news depends a lot on
your child’s age and her own needs. Here are
some ideas based on age.

For Children 0 to 18 months:
While a baby doesn’t understand news the
way an older child does, you can still help her
when her routine is changed by sickness or
being away from her parents.
 Keep the number of caregivers small
so they get to know your baby and she
feels safe with them.
 Stay in touch with caregivers so they
know of day to day changes.
 Try to keep your baby’s routine and
surroundings from changing. If you
need to be away from her, leaving a
recording of your voice, a picture or
other object may comfort her.

For Children 18 months to 3 years:
 Explain the news so your child learns
how it will affect her.
 Keep the number of caregivers small
and known to your child. It will help
when you can’t be with her.
 Give your child choices when
 Keep your child’s routine the same. If
it needs to change, tell her in a way
she can understand.
 Give your child lots of time to play
and practice new skills such as
medical play.

For Children 3 to 6 years:
 Explain the news in an honest and
simple way.
 Have your child tell you what she
 Stay with your child as much as you
 Keep your child’s routine the same
from day to day.
 Give your child lots of time to play.
 When you can, tell your child about
treatments and changes ahead of time.
 A toy, blanket, pillow or picture may
help when you need to be away from
your child.
 It helps your child when you stick
with the limits and rules you used
 Share the news with teachers and
other adults in your child’s life and tell
her that these adults know.

For Children 7 to 12 years:
 Be honest and give your child
concrete details.
 Keep your child’s life as normal as
you can.
 Give your child praise and support.
 Help your child stay in touch with
friends and things she likes to do.
 Share your feelings with your child
and talk about her feelings.
 Demonstrate and share ideas for
helping your child cope with stress
(music, quiet time, breathing, etc.)
 If it is a sibling who is sick, give your
healthy child a few extra tasks, but not
too many. Thank her for helping and
tell her you are proud that she cares.
 Offer to talk with your child’s friends
and their parents.
 Tell your child the difficult news is
not her fault.
 Explain what will happen in
treatments and how they might make
your child feel.
 Share the news with teachers and
other adults in your child’s life and tell
her that these adults know.

For Children 12 to 18 years:
 Show respect and give your child
space and privacy.
 Give your child as much control as
you can.
 If it is a sibling who is sick, help your
healthy child balance time with her
sibling and time with her friends.
Give her some extra tasks at home, but
not too many.
 Try to talk when you won’t be
disturbed and when there is not a
major event coming later that day.
 Involve your child in making choices.
 Find ways to let your child be herself.
 Share the news with teachers and
other adults in your child’s life and let
her know that they know.

For Children of all ages:
 Children might react to difficult news
in ways that don’t make sense to
 Children need to deal with the news at
their own pace.
 Watch for cues that your child may be
ready to talk some more. At first, she
may act like nothing happened and go
back to playing. This is common and

 Your child is watching you for cues,
too. Let her know you are there to
help any time she is ready to talk or
has a question.

What Should I Keep in Mind After I’ve
shared the News?
 Expect questions as your child re-
thinks the news. New questions can
come up as she grows and matures.
 Be there for your child. Give her lots
of love and support.
 Your child may worry that talking
about the news makes you sad. Help
her to see it is healthy to talk about
feelings and ask questions.
 A healthy sibling may feel guilty or
she caused the sickness. Your child
may act out if she has trouble talking
about it, or is too young to know how
to share those feelings.
 Be open to asking for help. There are
many people who can support you and
your child in the hospital or at home.
Examples are: Psychologists,
therapists, social workers, chaplains,
nurses, doctors, child life specialists,
teachers and counselors. There are
also many books and other resources
that can help you and your child.
 Keep life as normal as you can.
 Let your child have fun without
feeling guilty.
 Help your child figure out people she
can turn to for support.
 Be ready to repeat things you have
talked about as your child takes the
news in and works through her
 Tell your child when things change.
Keep her up to date.
 Ask your child often if there is
anything she wants to talk about or to
ask you.

How Can I Tell if My Child Needs More
Sometime it’s hard to know what is normal
and what is not. Every family and every child
is different. Here are some signs that your
child may need some extra help from you or a
 The normal ways you support your
child aren’t working.
 Your child’s mood or actions are
getting in the way of life at school,
home or with friends.
 You see changes in your child’s sleep
or eating habits.
 Your child’s grades are slipping.
 Your child avoids school.
 Your child doesn’t want to do things
she used to enjoy.
 Your child stays quieter, sadder, more
anxious, or fearful.
 Your child keeps complaining of
sickness or pain (stomach aches,
headaches, tiredness).
 Your child begins making choices that
reflect poor judgment (examples are:
not following typical rules, significant
negative changes in behavior, using
drugs or alcohol).
 You are worried your child will hurt

Your health care team may have given you this information as part of your care. If so, please use it and call if you have
any questions. If this information was not given to you as part of your care, please check with your doctor. This is not
medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health
needs are different, you should talk with your doctor or others on your health care team when using this information. If
you have an emergency, please call 911. Copyright © 5/2017 University of Wisconsin Hospitals and Clinics Authority. All
rights reserved. Produced by the Department of Nursing. HF#7280