When a parent or other family member has a serious illness, it can be hard to know how to tell children. You might think you’re protecting kids by sparing them from any worries or fears. But they tend to know when something’s going on, and not being told about it could make them feel anxious.

Here are some tips on when to start talking with your child, what to say, and how to support them.

How Should I Have the First Talk?

Pick a time when you’re relaxed enough to talk and won’t be rushed. Maybe a weekend afternoon when no activities are happening and there’s time to answer questions. Just try to avoid telling kids at bedtime because they may have trouble sleeping afterward.

It’s OK to talk with your child even if you don’t have all the information yet.

What Should I Say?

Your goals are to help your child understand what’s happening and what to expect — and comfort them. It’s important to be honest. Kids may have no questions or lots of them. If you don’t know the answers, say you’ll try to find out.

Other things to keep in mind:

Start with the basics about the illness, like what it’s called, what part(s) of the body it affects, and the treatment. It may help to ask them what they’ve heard about the illness.

Support your child’s emotions. Be patient and don’t dismiss what kids are feeling. If they tell you they’re upset or scared, echo what they said: “Yes, I see this makes you very scared. It’s OK to feel that way.” This lets children know you’re hearing and understanding them.

You can also share how you feel and any positive steps you’re taking to cope, like going for walks outside. This may help kids open up more and give them ideas on how to manage their own big feelings.

Explain things based on kids’ age and maturity. Consider how much kids can understand and absorb. Try these age-based tips:

• Early grade school: Keep the information short and simple. For example, “Your mommy is sick. She’ll need to go to the hospital for about 3 days. Doctors will give her medicine.” Tell children that they didn’t do anything to “cause” the illness and they can’t catch it. The doctor may be able to recommend children’s books that can help you explain the illness.
• Older kids: This age group understands more, but don’t give too many details, which could cause worry. You can talk about how a serious illness is different from a headache or cold. Mention the people who will be helping, like doctors and nurses.
• Teens: Teens often want a lot of information. Assure your teen that you or another trusted adult will keep them updated on things like changes in treatment. This helps them know what to expect. Encourage them not to look up the illness online because they may find worse-case examples. Explain that you can ask the health care team for the facts.

Kids and teens of all ages may have a tough time talking about what’s going on. Very young kids can use drawings to help them “say” what they’re feeling. For older kids and teens, suggest that they write in a journal, create artwork, or play music to express themselves. You also can encourage them to find healthy ways to cope with stress, like doing breathing exercises, yoga, or sports.

You don’t have tell your child everything at first. You can share what’s happening little by little. This can be helpful if you’re not sure how long the treatment will take or if it will be a success.

What Else Can Help?

Explain what will be the same and what could change. Tell kids that you and the rest of the family love them and that will always be the case. Talk about how you’ll try to keep things the same, but some stuff may change for a time. For example, someone else may have to pick them up from school and stay with them until dinner. Or maybe the ill person will be in the hospital; need to stay in bed for a while; or have side effects like changes in weight, tiredness, or hair loss.

Talk about what your child can do to help. Finding ways for kids to pitch in can give them a sense of control. Suggest they do things like keep their room clean or wash dishes. Younger kids can pick flowers, draw pictures, or make cards for the person who’s sick. Teens might be able to watch their siblings when needed.

Stick to a routine. This can help kids feel secure. They should be physically active, get enough sleep, and eat well. See that they do all their homework and go to any usual after-school sports or clubs.

Find support. Let your kids know about people they can reach out to. They can lean on another family member or close friend. Or they might talk with a teacher, school counselor, or religious leader.

Consider joining a support group to share experiences and get advice from families who’ve been through it. There are also camps for kids with family members who have a serious illness. These can provide a healthy space for coping.

Watch for stress. If your child shows changes in behavior (like not sleeping or eating, not wanting to be around people, or worrying all the time), call your doctor or a behavioral health care provider. They can help your child manage anxiety and cope.