Children with life-threatening illness are usually able to guess their condition by observing and interpreting the behavior of adults in their environment.
When a child’s life is threatened by serious illness, it affects the whole fabric of family life. In families that deal openly with such a crisis, the parents tend not to derive their personal identity solely from the role of "being a parent."
Sick children use a variety of coping mechanisms to deal with anxiety, confusion, and the sometimes painful treatments that accompany life-threatening illness.
Although the legal right of consent for a minor child's treatment remains with the parent(s), it can be argued that health care providers should work to secure the child’s agreement to a proposed treatment or procedure.
Providing optimal care for a child who is dying involves implementing the principle of whole-person care.
Longitudinal studies of children who have experienced a parent's death reveal that children typically construct an inner representation (manifested in memories, feelings, and actions) that is used to maintain a relationship with the dead parent. The nature of this relationship changes as the child grows older and acute grief diminishes.
Spontaneous drawings and other forms of art therapy are excellent methods for working with young children.
Honest communication tailored to a child's level of comprehension can promote healthy coping with life-threatening illness and grief.
In discussing death with children, it is important to listen carefully and verify what you believe they are saying. Accept the reality of the child's grief and answer questions honestly and directly, taking care not to use metaphorical explanations that may confuse or mislead the child.
Social support for children includes many of the same kinds of options available to adults who are coping with life-threatening illness or bereavement. In addition to a variety of peer-oriented support groups, there are programs that focus on the needs of specific populations (such as children bereaved as a result of random violence) and programs that seek to "grant the wishes" of children with serious illness.
