By Dr Natalie Cheatle and Dr Annika Clark at The Parent Space
We all want to protect our children from pain and it is hard to realise that we can’t always do so, or necessarily make it better. Being a parent can be tough enough at the best of times but when your child or another close family member is ill it takes things up another level. Illness, whether mild or serious, disrupts family life both practically and emotionally. However, with a bit of thought and preparation, parents can play a big role in helping their children understand and manage what’s going on.
Managing minor procedures
Our natural instinct may be to play down or avoid talking about anything that might be distressing but when a child needs a medical procedure it is best to be age appropriately frank about what they can expect to happen. For smaller procedures, such as injections or blood tests it is important to be honest that they will feel it and it may sting a bit, but that it doesn’t last long. You can illustrate this by asking them to pinch their arm so that it hurts a little and then letting go. With younger children using a pretend doctor’s kit and asking them to watch while you give their arm a good poke with the pretend syringe will probably be more effective. Ask them how much they felt it and how long the feeling lasted for. If they say it hurt a lot then help them plan what they will do straight afterwards to take their mind off it and ask if a little treat will help. You can explain that the injection might feel like that or it might feel different and you’d be interested if they could tell you afterwards what it was like. Research shows that if children watch the needle go in and observe the procedure they are more likely to feel in control and feel less pain. So, even if you are not able to look yourself, asking children what they see and getting the nurse to explain the procedure as she does it can also be helpful. Sometimes a local anaesthetic may be offered for blood tests and while these do work well they can take around 30 minutes to take effect, so are rather situation dependent. Children take their cues from their parents so the more matter of fact and calm you can be yourself, the more likely it is that your child will be the same.
Preparing a child for an operation or other hospital treatment takes a little more planning. The more information that parents can gather from the hospital in advance the better. It is helpful for children to go to the hospital in advance to see which door they will go in, which route they will take through the hospital, where they will wait, where they will go to be prepped, what they will be expected to wear for an operation and what a ward looks like if they will go onto one. The more you can let your child know about what to expect, before and after the procedure, the less of a shock it will be on the day. The majority of hospitals have a paediatric psychology department which specialises in preparing children for procedures so it is worth asking if they can have some input if you feel you and your child need more support.
When children have a recurring or chronic illness their needs are understandably prioritised by the family. However, when parents feel sorry for their children their natural parenting style often shifts considerably. Children may be excused poor behaviour, parents may bend over backwards to meet their children’s every need or try to ensure that their children remain happy at any cost. While the desire to try and make things right is absolutely understandable and somewhat inevitable it can lead to some unforeseen consequences, especially over time. Children who no longer have limits on their behaviour or requests tend to behave worse and expect more of everyone around them. This can make them quite unpleasant to be around and can cause huge resentment from siblings who may feel forgotten in comparison but feel unable to say anything. Keeping parenting as normal as possible, despite the circumstances, helps everyone feel safe and contained. This is also true when children have minor illness. It is of course understandable that rules are relaxed a little while children are unwell but getting back on track with bedtimes, extra treats etc as quickly as possible will prevent unhelpful patterns becoming entrenched.
Helping children understand when others are ill
When parents, siblings or other people very close to your child develop a serious illness, there is no standard reaction to expect from children. Some may seem blissfully unaware or even appear coldly insensitive to the distress around them while others may become clingy and anxious. Keeping serious illness a secret from children is never a good idea, it may feel like you’re protecting them from pain but they will inevitably pick on something. Without an understanding of what’s going on children usually make their own assumptions about why people are upset or behaving differently and often these assumptions can be worse than the truth. Younger children need a very simple explanation of the illness with a focus on how it will impact on them e.g. ‘this means mummy will be very tired and might need naps in the day. She won’t be able to take you to school or play with you as much as usual.’
The most important thing is to be clear with your child that the illness isn’t catching (e.g. they and others can’t get cancer etc from the ill person) and that it is not their fault. Children need to hear that there is absolutely nothing they could have done to cause this to happen. This is especially important if they have heard talk about the illness perhaps being brought on by stress, as they may worry their misbehaviour is responsible. Having a nominated adult, to whom they feel close, to talk to, answer questions and spend time with (in addition to parents) can also be a helpful source of support and reassurance for children.
How much information to give can be hard to judge. With younger children it is best to give just enough to help them make sense of the situation and stop there. Let them know they can ask questions at any time and simply answer each question as it comes up without feeling the need to say anymore. With older children ask them what they would like to know and put them in charge of the process rather than automatically assuming that they want to know everything. Encourage questions and let them know you’ll be as honest as you can. Teenagers are likely to resort to the internet to search for information and it is best to be upfront about the internet being a poor source of reliable information for health issues, apart from a few trusted websites.
Lastly, parents also need support and someone to talk to when a child or other family member is ill. It is easy to fall into the trap of trying to take care of everyone else and not giving your own needs enough consideration. Taking some time out for yourself is not a luxury, it is a necessity. In order for children to come through difficult experiences they need their parents to look after themselves too.