News of a poor prognosis is never easy to break鈥攅specially when there are young children involved. But how do we bring up the subject of a parents鈥� terminal illness to their kids? It is a topic both health practitioners and patients find hard to address. Avoiding it, however, produces far worse outcomes.
As part of Palliative Care 大发彩票平台鈥檚 speaker lineup for National Palliative Care Week 2025, social worker Vivian Myron (MSW, TS) will teach participants how to approach this difficult subject in her talk, 鈥淢ommy is Very Very Very Sick . . . How to Teach Adults to Talk to Their Children About Advanced Disease and Impending Death.鈥�
Lexa Frail (LF): Can you tell us a bit about your National Palliative Care Week talk?
Vivian Myron (VM): I work in the palliative care unit at the Jewish General Hospital, and I feel privileged to support young families navigating end-of-life care. Many of our patients are parents with children under 18, and sadly, it seems that this population is growing. Far too often, these children haven鈥檛 been told about their parent鈥檚 illness until just days鈥攐r even hours鈥攂efore their death.
Because we are in an acute care hospital, hospitalizations are usually brief. Families often arrive in crisis, with little time to adjust. And when we ask what the children have been told, we often find that they鈥檝e been kept in the dark. Understandably, this can be devastating for them.
My goal with this talk is to demystify the process of teaching adults how to talk to their children about serious illness and impending death. Yes, it feels difficult鈥攂ut it isn鈥檛 complicated. There are simple, effective techniques that can help guide these conversations, and I want to share those tools. More importantly, I want to explain why it matters to speak with children early and honestly.
Research clearly shows that children鈥攅specially young ones鈥攚ho lose a parent are at heightened risk for trauma. The loss stays with them for life. If the information they receive is poorly managed, that trauma can deepen. But when we communicate thoughtfully, we can reduce some of that burden. We can help children make sense of what鈥檚 happening in a way that supports their healing, rather than adding confusion and fear.
When a patient has a potentially terminal diagnosis and young children at home, the medical team has a role to play. It鈥檚 not about telling parents what they 鈥渉ave to do,鈥� but about offering gentle, common-sense guidance that resonates. We need to meet families where they are鈥攁cknowledging their deep love and desire to protect their children. Most often, the decision not to tell a child comes from a place of love. Our job is to support that love while helping them understand why openness, at the right time and in the right way, is also a profound act of protection.
LF: I can see parents getting that impression, given how taboo a subject death is. I also imagine that a one-size-fits-all approach to this subject doesn't work.
VM: No, there鈥檚 no one-size-fits-all approach. Every person brings their own cultural lens, belief system, and emotional response to the table. At the same time, we share some core human truths鈥攍ove for our children, our shared humanity, the fact that we all have a soul. These commonalities give us a foundation to start from, even when the topic is difficult.
Talking about death doesn鈥檛 become easier just because we know it鈥檚 important. But when people begin to understand why it matters to be honest with children, it starts to make sense. Respect is crucial鈥攑arents know their children best. If we approach them with judgment or rigid rules, we鈥檒l lose them.
Everyone grieves in their own way. And in palliative care, by the time families arrive, they've already started grieving. We call it anticipatory grief. It begins, for example, with a cancer diagnosis鈥攜ou start mourning the healthy self you believed you were. That diagnosis inevitably brings the thought of death, even if it鈥檚 just a flicker.
That doesn鈥檛 mean you should scare your child or immediately talk about dying. But it does mean you should be brutally honest鈥攕omething like, 鈥淢ommy has an illness, and she鈥檚 getting treatment.鈥� Because when kids hear the truth from someone in the schoolyard, it鈥檚 not only shocking鈥攊t鈥檚 damaging. I鈥檝e seen children blindsided like that, and it鈥檚 heartbreaking.
Children learn from how we navigate hard truths. If you鈥檙e the kind of parent who tells them the truth鈥攇ently, but honestly鈥攜ou鈥檙e teaching them to trust you. But if we treat big things like secrets, they learn to hide things, too. It鈥檚 common sense, but we don鈥檛 always think about it.
I鈥檓 constantly struck by adults who lost a parent when they were young. Many validate what I teach鈥攅specially those who were left in the dark. One woman shared that growing up with secrets made her deeply distrustful of everything she was told. That鈥檚 a heavy burden to carry through life.
LF: Is there anything that you want your audience to know about youth grief specifically?
VM: That it鈥檚 not the same as adult grief. Children process through play. Their grief can look like puddle-jumping鈥攆ine one moment, devastated the next. Every child grieves differently, just like adults. But adults often misunderstand this. At funerals, for example, kids might be outside running around, laughing, playing鈥攁nd some parents worry, 鈥淲hat鈥檚 wrong with them? Their father just died.鈥� But that鈥檚 healthy. That鈥檚 a child coping. The red flag isn鈥檛 laughter鈥攊t鈥檚 when a child can鈥檛 climb out of their sadness. That鈥檚 when they may need professional support.
LF: Is there anything else you want to add?
VM: I hope this message reaches beyond those who already understand. I want it to resonate with the people who could benefit to hear it. I'd especially love to see more residents from oncology, cardiology, pulmonary, and neurology take part in these conversations. Many of their patients are young adults with families, facing serious illness鈥攁nd those providers and the interdisciplinary team play a very important role. They need to know how to help guide families through these conversations.
Vivian Myron鈥檚 talk will take place on Friday, May 9, at the Jewish General Hospital and on Zoom. For more information, please view our schedule. Make sure to for this session and more.