Conversations That Matter: Discussing Serious Illness with Children/Tamariki and Young People/Rangatahi

Facing a serious illness within the whānau be daunting, and explaining it to your tamariki and rangatahi can be a challenge. In our latest article, we offer guidance on how to approach these difficult conversations.

When a family member faces a serious illness, its impact reverberates throughout every aspect of family life. One of the most challenging tasks for parents and caregivers can be discussing this daunting situation with their tamariki and rangatahi (children and young people).

It's instinctive for us to want to safeguard our tamariki and rangatahi from situations that can cause pain and distress. We often believe that young children might not fully comprehend the concept of illness, hence it might be best to not inform them about a loved one's condition. However, children and teens, regardless of their age, tend to be more aware than we might think – they could have received information (which might sometimes be incorrect), overheard conversations, conducted an internet search, scrolled through social media, or intuitively sensed changes in the emotions of their whānau members. Without access to correct and age-appropriate information, our tamariki and rangatahi might imagine the situation to be far worse than it really is.

It's more beneficial to convey an unfortunate truth than to propagate a lie, and then surround them with the necessary support to help them navigate this challenging time.

Younger tamariki, including pēpē (babies), are usually quite sensitive to the emotional tension and stress that an illness can create within the whanau. They may have questions such as:

Is it my fault?
Younger children, due to their egocentric and magical thinking (believing that all events revolve around them/are caused by them), might think that their actions or words resulted in the illness. This can lead to guilt, confusion, and distress. It's essential to reassure them that nothing they said or did led to the illness.

Can I catch it too?
The fear of contracting the illness might discourage children from wanting to be around their loved one. If the illness isn't contagious, assure your children that they can't catch it. If it is contagious, explain the precautions your family will be taking to stay safe, such as regular handwashing and wearing a mask.

Who will look after me?
Children need reassurance about who will care for them, particularly when a loved one is seriously ill.

Even our youngest family members can sense when something is wrong within their whānau. Infants might not comprehend the situation as older children or adults would, but they can sense their caregiver’s emotions. Their need for trust and security can be disrupted when a caregiver falls seriously ill or gets hospitalised, causing changes in their daily routine.

Supportive Measures for Pēpē/Babies:
Try to maintain consistency as much as possible and enlist the assistance of other whānau members, friends, or daycare workers to keep the baby’s routine stable.
Find ways to maintain the bond and connection between the infant and caregiver. This can include giving the baby an item of their loved one’s clothing that carries their scent, using a video of their loved one talking or singing, displaying pictures of their loved one in their cot, and arranging for the baby to be with their loved one whenever medically feasible.

Toddlers and Preschoolers:
Younger tamariki can often become very worried, thinking not only that they might contract the illness but also that it might be their fault. They can get overwhelmed by too many details, so keep the information simple and direct. Be honest without delving into every aspect of the illness. However, if the illness is serious, make sure to inform them. Don’t be surprised if tamariki display regressions, such as bedwetting or thumb-sucking, or behavioural disturbances like throwing tantrums or issues with eating or sleeping.

Supportive Measures for Toddlers and Pre-schoolers:
Validate tamariki’s emotions – it's common for them to experience a wide range of feelings when a loved one is sick, such as anger, sadness, and confusion. You can help tamariki handle these feelings by assuring them that these emotions are normal, by demonstrating and sharing how you deal with your own emotions, and by reminding them that you are always there to listen to them. Teaching children calming and grounding strategies can be beneficial, such as deep belly breathing/balloon breathing, visualizing a happy place or memory, or drawing their feelings.

Take time to explain the 'helpers' – the doctors, nurses, and other individuals who are assisting the whānau member in getting better.

Try to maintain routine and structure as much as possible. If there are changes in routines and new people involved, discuss these changes with your children. It's beneficial to try to revert to normal routines and activities as soon as possible.

School-age tamariki/children:
Our school-age tamariki can become extremely concerned if a whānau member falls ill. They have a basic understanding of how our bodies work and function, so it's essential to provide them with simple, clear, and concise information about the illness and how it affects the body. Just like with younger tamariki, explain who is involved in your loved one’s care, keep routines as normal as possible, and let the Kura/school know about your situation. They can keep an eye out for any concerns and anxieties your child might display at school and put in place the necessary supports. You might also want to ask your child if they would like others to know, such as their friends' parents or after-school activity leaders.

Rangatahi/young people:
Older tamariki are likely to understand more, have complex thoughts about the illness, and might worry more about recovery. They may need time to process information, grow quiet or have delayed or no obvious reactions. Some may lose focus with schoolwork, may become depressed, oppositional and defiant, angry, or engage in risk-taking behaviour. As rangatahi tend not to be as communicative with their parents, creating an environment where they feel safe to talk, or accessing support for them to discuss their feelings with others, is important.

Supportive Measures for Older Tamariki and Rangatahi:
• Provide explanations that are straightforward, concise, and truthful. Use the correct medical terminology, such as cancer, surgery, stroke, chemotherapy.
• Many young people turn to social media to find out health information, so it’s a good idea to share reputable websites with them, so they can read up in their own time. We have a list of support organisations on our website under Need Support.
• Give them choices about visiting the hospital or participating in the medical aspects of the loved one's treatment when suitable.
• Keep routines as normal as possible, while encouraging their independence. This can mean letting them make decisions about their routines, responsibilities, and how they want to be involved in the care of the ill family member.
• Promote healthy ways to manage stress, such as regular exercise, a balanced diet, adequate sleep, and mindfulness techniques like meditation or deep breathing exercises.
• Let the Kura/school know as they can provide additional support. Ask tamariki and rangatahi if they’d like you to let other people in their network know, such as sport coaches, trusted adults outside of the family or other friends.
•If your young person is struggling to cope, express their feelings or are showing signs of anxiety or depression, you can reach out to the therapy team at Kenzie’s Gift on

We are here to help.