Seriously ill parent

The following is an excerpt from the ebooklet Working with children of parents with a serious illness by Murray Evely and Zoe Ganim.

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Introduction

A large number of children live with a parent who has a chronic, distressing or possibly life-threatening illness. The parent may have a mental illness, such as depression or schizophrenia, a terminal illness such as advanced cancer, a chronic illness such as diabetes or heart disease or an episodic or acute short-term condition such as severe migraine. These parents may require hospitalisation or suffer from short- or long-term periods of being unwell at home.

Often, children of seriously ill parents may be reluctant to tell school staff and others of the parent’s illness.

This may be for a number of reasons, including the fear of being treated differently, not wanting to make others feel uncomfortable, or the fear of the associated stigma (particularly for children of parents with a mental illness).

Effects of living with a seriously ill parent

Growing up with a parent with an illness can be stressful. Some children take on a caretaking role or assist with jobs around the house when the parent is unwell. The level of stress and anxiety experienced by the child is likely to depend on a range of factors including:

the attitude of the ill parent towards the illness
the child’s understanding of the illness, medications and various treatments
exposure to negative effects of the illness, such as psychotic episodes, vomiting, anaphylactic reactions and physical changes such as hair loss
the support the child receives from the parent and other significant adults
the level of support the child is expected to offer when the parent is sick, such as chores and caretaking
the personality and coping skills of the child.

Many children living with a parent with an illness cope remarkably well and may become more organised, empathetic and independent than other children. It is important to offer support to these children if needed, as well as to children who are not coping so well.

Children who do not cope so well can be overwhelmed by feelings of anxiety, guilt, anger and isolation.

Research shows that these children tend to hide their feelings and frequently do not have a proper understanding of the parent’s illness^[1] Marsh, D.T. & Dickens, R.M. (1997). Troubled journey: Coming to terms with the mental illness of a sibling or parent. New York: Cambridge Press .

They tend to be worried about issues related to their parent’s illness, such as thinking they have caused the illness, that the parent may be sick or hospitalised forever, or that they might develop the illness themselves.

Indicators that children may be experiencing difficulties

Indicators that children may be experiencing difficulties coping with their parent’s illness may include:

incomplete homework
poor concentration in class
a decrease in academic performance
messy schoolwork
unkempt appearance
tiredness
irritability
being withdrawn, tearful or aggressive
an increase in absences from school
an increase in somatic complaints, including stomachaches and headaches
disengagement from peers or changes in friendships
over-willingness to please
over-helpfulness
perfectionism.

These changes in behaviour tend to coincide with a change in the parent’s health, such as during and following a period of hospitalisation. However, many children who are suffering from anxiety in relation to their parent’s illness may not present with obvious or dramatic symptoms. For some children, school is a safe place and they are able to ‘tune out’ from the demands of the parent’s illness and focus on participating in school and enjoying time with their friends.

The above symptoms may also be related to other major life changes or problems experienced by the child or the family. It should not be assumed that unusual behaviours are necessarily a result of the parent’s illness.

You or other school support staff such as the principal or school psychologist should investigate the possible reasons for any behaviour change.

When to seek additional assistance

Children of a parent with an illness may need additional support and assistance if you notice major changes in behaviour and attitude, or persistent difficulties in coping with everyday school demands.

Strategies to support the child with a seriously ill parent

Provide social and emotional support

Assist the child to build and develop social networks and connections at school.

Encourage the development of friendships. It is important that the child has friends of similar age who they can talk to and have fun with. If the child is having difficulty making friends, link them with one or two classmates who have similar interests or who are willing to be friends.

Check in regularly with the child. It is important for the child to know they have supportive adults in their life they can trust. Regularly set aside time to listen to the child privately.

- Ask how the child is going.

- Listen to the child in a supportive, non-judgemental way. It is important to listen and to answer all of the child’s questions honestly and sincerely. If you do not know the answers to their questions, let the child know you are unsure, too.

- Offer assistance if you can.

- Acknowledge and validate the difficulties the child is facing, for example ‘That must be very scary for you’ or ‘It is normal to feel sad if we can’t see our mum when she is sick.’

- Ask the child what they can do in the short-term to help themselves feel okay. If the child lacks ideas, provide a strategy, such as saying ‘You might like to have Mum’s photo in your school bag’ or ‘You can make a card for your Dad.’

- Take care with responses. It is not helpful to say: ‘I know how you feel’. This takes ownership of the child’s feelings away and may make the child less likely to speak to you in future. It is also not helpful to say ‘Everything will be fine.’ If things do not turn out okay, the child will lose trust in you and will no longer come to you for support.

Know your limits. If you are uncomfortable talking with the child about their home life and the parent’s illness, speak to the principal to ensure that someone else such as the school psychologist, special-needs coordinator or another teacher with whom the child has a strong bond can be the child’s support at school. Tell the child privately that there is a special person the child can go to when they need to talk about what has happened or is happening.

ISBN 978-1-921908-14-9

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References[+]

This article is an excerpt from the ebooklet Parent with a serious illness.

Download the complete ebooklet for full access to strategies and resources, including:

Provide social and emotional support
Establish contact with family and maintain regular communication
Teach pro-active problem solving and coping strategies
Provide the child with accurate age-appropriate information
If a child talks to you about a traumatic event that occurred as a result of their parent’s illness
If the child talks to you about a recent event that may be considered abuse or neglect
Resources