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Supporting Children When Someone They Love Has a Serious Illness Part 5 - Guidelines for Teenagers

Part 5 of our 6 part blog series sharing coping tips to help support children when someone they love has a serious illness. 

The Teen Years 

During the teen years, children are finding their own identity and becoming more independent. They need more privacy and often withdraw from family members.  This process of growing up is harder for them when someone in the family is ill.  They try to balance the family’s needs with their own very different needs. 

Teens may show anger as they become more anxious and fearful about the illness. When much of a parent’s time and attention is focused on the sick person, the teen may feel that they are being abandoned and become resentful. 

As the ill person gets closer to dying, teens often are able to talk about it and cry as they express their sadness.  They may also become very anxious and worry about how the death will affect their lives.  Around this time, they may try harder to behave well and do what is asked of them. 

Teens need as much time as possible to prepare for the death. Let them know when death is near so that there is time for them to have a final conversation and say goodbye, if possible.  If they have been angry and resistant, they may become more cooperative when the death is near, but not always. Sometimes they may become even more angry as a way to protect themselves from their sadness. Teens’ hostility and anger before a death may lead to feelings of guilt after the death.

Guidelines for Children 12 – 14 Years Old 

Teens between the ages of 12-14 can understand the illness and how it will effect their lives, yet it may be hard for them to cope with the feelings that come with it. They may not want to talk about it out of fear that they’ll lose control and cry.  They may act “grown up” as a way to ignore their strong feelings. This can make it seem like they don’t care, which can be upsetting to parents, but this is not the case.   

Teens this age can also be very optimistic that the sick person will get well and they may not want to hear otherwise.  They hold on to their positive outlook by avoiding facts and feelings. This is normal for a young teen and should not be discouraged.
Reactions to expect:
Not wanting to talk about the illness
Feeling strong emotions but acting or saying that they are “fine” 
Holding on to the belief that the patient will get better 
Tending to argue and be more “difficult” or demanding
Resenting chores and other demands that take them away from school and friends
Having trouble with school work, or, sometimes, trying very hard to please adults by being extremely good
Trouble sleeping 
How to help:
Talk with them about the disease
Keep them up-to-date with what is really happening, even if they don’t want to hear it.  Don’t assume that they understand as much about what’s going on as they seem to. Let them know when death is near so that there is time for them to have a final conversation and say goodbye, if possible.  

Give them a chance to talk about their feelings and concerns
It is important to talk with your teen about how they are feeling, even if only briefly and even if they don’t really want to talk. Try to be as open and nonjudgmental as possible when they share their feelings. Sharing your feelings and concerns can help them feel more comfortable sharing their own.  This helps them see that the feelings they have are normal and expected. 

You may say, for example:
“You look kinda sad today.  I’m feeling sad about this too.  How are you doing with all of this?”

“Sometimes talking about what’s going on helps.  I’m here to listen any time that you want to talk about any of this.”

It is also normal for grieving teens to have strong and often negative feelings about the person who is sick.  They can feel frustrated and angry about the illness and may direct their anger towards the person.  Often after having or expressing these emotions, teens can feel guilty.  Help them understand that having a wide range of feelings is normal, and help them figure out ways to cope with their strong feelings.

Be understanding of the teen’s reactions
Remember that if your teen pulls away from you, has lots of ups and downs, or is defensive or self-centered, this is all normal given their age. Teens often find writing, quiet time alone, and time with friends helpful as they deal with a difficult situation. 

Be an advocate for your child
If possible, try to limit the teen’s duties and chores at home, since pulling them away from school and friends can cause them to become angry or difficult.  Understand that they may not do as well in classes at this time. Let their teachers know about the illness. Help them connect with any counseling or support groups offered by the school or local hospice.  Often teens don’t want their classmates to know that they are receiving counseling.  Listen to your teen’s concerns, offer options, and help find creative solutions to this issue.
Guidelines for Children Ages 15 – 18

Teens between the ages of 15-18 can usually understand the realities of the illness and deal with their emotions. Yet at times they still may feel overwhelmed.  Though they can generally talk about what they think and feel, their feelings about the illness may not be clear. 

Teens this age tend to be more practical in their thinking than younger teens. They may also be more considerate.  Because they’re more aware of the possibility of death, they may feel more grief during the illness than a younger child might. 

At this age, teens want to be treated like adults and are trying to rely more on their friends than their family for support.  They’re able to be more concerned about the needs of their family members, though they may resent having to do more. 

Expected Reactions:
Fears about the future
Having strong feelings like anger and guilt toward the person who is ill
Trouble concentrating 
Being torn or frustrated when having to focus on the needs of the family rather than attend activities or socialize with friends
Feelings of resentment, anger, and defiance.

How to help:

Talk with the teen about the illness and how it will progress 
Include older teens in family discussions about the illness. It’s helpful if the sick person can talk directly to the teen about the illness as soon as possible. Teens this age can understand personal or spiritual thoughts and feelings, including uncertainties and unknowns, so these can be shared with them as well.  Let them know when death is near so that there is time for them to have a final conversation and say goodbye, if possible.   

Expect that the teen will not perform as well during this time 
Keeping up grades, activities and friendships is very important to most teens. However, during a serious illness, it’s normal for them not to do as well in school, sports, etc. This can be hard for teens and parents who believe that grades will affect future opportunities.  However, some teens actually do better at this time as a gift to their ill parent.  Either way, be understanding of what the teen is going through. 

Recognize how the stress caused by the illness can affect them
Teens this age may feel overwhelmed by the stress from the illness on top of the other pressures they feel in life. Talk with them about ways they might reduce the stress in their lives, dealing with the things that are causing them stress one at a time.

Know that they may be worrying about the future 
Talk with older teens about how future plans will be affected by what is happening. Reassure them in a way that is realistic. Provide a listening ear as they share any fears they may have about their future.

Know that teens may be afraid that they too could become ill 
Let older teens talk to medical professionals if possible to allow them to ask questions about the illness-how it is caused and what to expect. Talking with your teen about the actual chances of them getting sick can help them feel less fearful.

Talk with the teen about ways they can be helpful to the family
Giving the teen helpful tasks can sometimes help them feel less anxious.  Look for opportunities for them to help in ways that they enjoy, such as cooking, shopping, or errands. They may also want to spend time with the patient reading, listening to music together, watching a movie, sharing food, or writing a card or letter.

Understand that the challenges of growing up are even more stressful when a parent is seriously ill
The normal process teens go through to become their own person is harder when a parent is seriously ill.  It can be challenging for them to see a parent be needy. It can also be hard for them to deal with a parent wanting to control their activities and comings and goings more at this time. They might react to this with resentment or anger and then later feel guilty about it. 

Be an advocate for your teen
Consider helping your teen join counseling or support groups that may be offered by the school or local hospice.  They benefit from talking with understanding people who are not directly involved.  They may find that friends who are usually supportive “just don’t get it”.  Speak with teachers and coaches about the illness and about ways they might help support the teen. 

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