If a teenager has cancer, they may be more dependent on their parents than they normally would be. When your teenager is really sick, they rely on you to make important decisions, understand their cancer and care, communicate with the health-care team and organize their treatments and care for them. As they start to feel better, they can and should take on more responsibility for managing their cancer.
Your teenager will only gain responsibility for their health when they are given the opportunity to do so. At first, they may not manage the way you would, but this is all part of learning! Be patient. Allow them to learn and make mistakes. A lot can be learned from mistakes if you discuss them openly and reasonably.
Your teen will need to deal with cancer and its long-term physical and psychological effects for a long time after treatment ends. Teenagers who take some early responsibility for managing themselves often find it easier to make the transition to adulthood as a cancer survivor.
Decision making
A crucial way to promote your teenager’s independence is to involve them in making decisions. For this to be truly effective, your teenager needs to feel that they have a real part to play in their own management. This can be a difficult step for parents to take, especially with major decisions regarding cancer treatment and health.
Here are some steps you can take to help support your teenager as they begin to make important decisions for themselves.
- Be prepared. Be sure that you are ready to give some responsibility to your teen. This can be scary for parents, since you are releasing some control. After all, your teen may make mistakes. You may feel a bit nervous, but you can feel proud too! Remind your teenager that you trust them and are always there to help them if they need support.
- Help your teen define the decisions that need to be made and then ask them where they can contribute. Help your teen list all their options by giving them time and some prompts, but don’t list their options for them.
- Ask your teenager to think through all of their options and identify the positives and negatives of each one. Depending on your teenager, they may need more help from you.
- Let your teenager make the decision! You can give them input, but let them know that the final decision is up to them (but only if it really is).
- Later, discuss the outcome of the decision. Help your teenager evaluate their decision, and talk about what they might have done differently.
Promoting independence
Consider what you currently do to help your teenager. Then think about ways you can gradually let them take on some of these tasks by themselves.
For example, consider your teenager’s medication.
- Who remembers when it is time to take pills?
- Who keeps track of which medications they are using and how often?
- Who keeps track of when it’s time to buy more?
Encourage your teenager to start a medication journal. By using the journal, they can start to keep track of what they are taking and when. Many pharmacies now offer free bubble packing or blister packs for medications. This can be a tremendously helpful way to manage medications.
You can use this chart full of practical tips to promote your child’s independence at any age. By starting early, your teenager will learn to develop responsibility without much pressure.
8–11 years old
General
- Let your child make mistakes
- Teach your child to speak for themselves and express their needs and wishes
- Help your child recognize their special talents and interests
- Help your child open a bank account
- Recognize your child’s increasing need for independence
Social
- Encourage hobbies, leisure and physical activities
- Help your child make friends
- Support your child’s participation in community activities without parents where possible
Self-care
- When you take your child food shopping, discuss diet needs and read labels together
- Teach your child their personal information, such as address, phone number, etc.
- Involve your child in preparing their medication. Use proper names of medications. Explain to them why they are taking the drug
- Help your child reduce stress through art, exercise, music and journal writing
Education
- Let your child do homework on their own as much as possible, waiting for them to ask for your help rather than stepping in
- Talk to your child about what they want to be when they grow up
- Encourage them to talk about the future
Medical
- Ask your child what they know about cancer, and fill in the gaps in their understanding
- Help your child to talk directly with the health-care team
- Prepare for clinic visits one week before appointments. For example, ask your child if there is anything they want their doctor to know, or if they have any questions they want to ask the health-care team
- Encourage your child to visit kid-friendly websites
12–16 years old
General
Encourage your teen to:
- Ask questions if they don’t understand something
- Advocate for themselves
- Talk about sexuality with someone they trust
- Look for older role models
- Talk to their health-care team about how they feel about their cancer care
- Discuss dating issues with you and their peers
Social
Support your teen in:
- Connecting with other teenagers with cancer in a group or online
- Keeping in contact with friends while sick at home or in the hospital
- Going to school whenever possible
- Going to a camp for kids who have had cancer
- Hanging out with friends
- Letting your teen choose who they would like to share details of their cancer with
Self-care
Have your teen:
- Set up their own health-care routines, such as taking medications
- Learn more about their special dietary needs and prepare food when able
- Care for central lines at home and in the hospital
- Start to find their way around the community
- Plan ahead to fit health-care routines into their life
Education
Have your teen:
- Take part in meetings about their education and keep a record of their progress
- Get to know their school guidance counsellor
- Talk about career interests and set goals for college or university
- Communicate with their school and teachers about their health needs
- Find volunteer work or a part-time job
Medical
Encourage your teen to:
- Discuss the eventual need for adult health care
- Attend part of their medical appointments alone
- Prepare a list of questions to ask the health-care team
- Start to set their own medical appointments
- Be knowledgeable about their health, including their diagnosis, treatments and symptoms they are experiencing
- Keep a record of their medical history, such as current weight, blood pressure, etc.
- Keep a record of current medications, doses, side effects and prescription renewals
- Discuss fertility, birth control, parenthood, drugs, alcohol and smoking with the health-care team
- Know who to call in an emergency
17 years and up
General
Encourage your teen to:
- Continue to seek special funding and follow their drug plan
- Become a mentor for younger children
- Begin thinking of themselves as a role model
- Budget and manage their money
- Discuss dating issues with you and their peers
Social
Support your teen in:
- Connecting with other teenagers with cancer in a group or online
- Participating in community programs for adults that match their interests
- Being a leader for younger kids with cancer
- Keeping in touch with friends from high school or camp and making plans with them
- Joining teams or committees at school
Self-care
Have your teen:
- Plan and prepare meals according to their diet needs
- Keep an ongoing record of tests, procedures and medications
Education
Have your teen:
- Register with the special needs office at college or university, even if they are feeling fine
- Go for career counselling, shadow someone at their job, or attend a job fair
- Research their cancer: meet others who have already transitioned to college or university
- Review their college or university workload: is it too much?
Medical
Encourage your teen to:
- Visit an adult health-care centre
- Get a summary of their medical record
- Transfer to an adult health-care facility
- Learn skills for good self-care, and symptom and treatment side-effect management
- Attend appointments alone, without a parent in the room
- Ask their paediatrician for a referral to a family doctor if they don’t already have one
Problem solving
Learning to solve problems independently is a big part of developing into an adult. If your teen feels well enough, include them in solving problems related to their care.
This may be as simple as thinking out loud in their presence or asking for their input on a solution you have come up with. Slowly increase your teen’s involvement as much as is appropriate. For example, the teen program outlines common side effects of treatment and describes strategies to manage them. Encourage your teenager to use these strategies as much as possible.
Transferring responsibility
In allowing your teenager to gain some independence, both you and your teenager’s health-care provider will have to give up some control. With an increase in age, and as your child feels better, they should gradually take on more responsibility for their own health. Ideally, this means that your teenager will eventually schedule appointments, take their medications and keep an ongoing health record all on their own. Starting early helps make this shift of responsibility easier for both the teenager and the parent.
