The 6 Cs
The 6 Cs are common concerns and questions that children have when they or someone they care about has a serious illness. They are:
- What is it CALLED?
- Can I CATCH it?
- Did I CAUSE it?
- Can I CURE it?
- Who will take CARE of me?
- How can I CONNECT to people I care about?
It is important to address these concerns even if your child has not brought them up. Many children wonder about these things but do not always share their thoughts and worries with others. These items can be addressed in any order and at any time. It can be helpful to check in with your children about the Cs at different times in their development and throughout the illness journey.
What is it CALLED?
It is important to name the condition, illness, or event that is causing the serious illness. Just calling the illness "sick" can be confusing and scary for young children. They might wonder if they or someone they care about could become seriously ill the next time they are "sick". Naming the condition allows for greater understanding and an opportunity for kids to ask questions. Providing children and youth with information that is honest, timely and appropriate to their age and stage of development can help them build trust and feel better able to cope with the situation.
Can I CATCH it?
Most children are familiar with colds and flu – which they know they can "catch". If your child is sick with an illness that is not contagious, reassure other children that they cannot catch it or spread it. It is also important to share this information directly with your child that is ill, as they might worry about making people around them sick. Clearly explain that they can safely touch and share space together.
Did I CAUSE it?
Children often believe their thoughts, behaviour and/or wishes can influence the world around them. While this belief is a natural part of their development, it can sometimes cause them to feel responsible for the illness. Most children wonder about what caused the illness. When they are not given information or an explanation that is appropriate for their development, they might imagine that they were somehow responsible. For example, an ill child might believe that if they behaved better, this would not have happened to them. If they did have an impact on the illness, reassure them that sometimes things can happen that we wish did not. It is important to allow them to talk about their feelings and concerns while ensuring that they know they are loved unconditionally.
Can I CURE it?
Children often feel that it is part of their job to make things better. For example, they might feel responsible for ensuring a younger sibling recovers. Or an ill child might think that they are not trying hard enough to make themselves better if the treatment is not working. Reassure them that there are many health-care providers who are part of the team and trying their best to help. Giving kids jobs can help them feel included. For example, they can give hugs, take their medicine, draw a picture, pray, share their feelings. Ensure that kids know that they can be helpful but that it is not their responsibility to make it all better.
Who will take CARE of me?
When a child is ill, they often worry about who will take care of them and their family. It is natural to worry about their own safety and the safety of important people in their lives. An ill child might worry that at some point they may become too sick to be cared for. Reassure your child(ren) that they will always be looked after. Help your child(ren) identify adults who care about them and will help support them through this time. These people could include family, friends, health-care providers, teachers, religious leaders, and community members. Let your child(ren) know they are also welcome to talk to these people, to ask questions and share their feelings with them.
How can I CONNECT to people I care about?
Remind children that they will always be connected to the people they care about. Even if children are separated from their family members due to illness, remind them that they remain connected through photos, connection items (each person having the same item, such as matching stuffed animals or bracelets), letters, storytelling, video chats, etc.
For a child who is seriously ill, share with them ways that they will always be part of the family, even if their illness changes things.
Wonders, worries and wishes: The 3 W’s
For children living with a serious illness and for their siblings it can be a stressful and confusing time. A lot of change and uncertainty can occur. Each child will have their own unique needs and way of processing and asking for support. The 3 W’s can be used to help enhance opportunities to talk with children about their feelings and thoughts, while providing space to listen, validate and feel together.
Take time to check in often about your children’s wonders, worries, and wishes. Avoid judgement or trying to minimize difficult topics or concerns. It’s natural for a parent to want to say something like “you don’t need to worry about that” when a child shares that they’ve been thinking about something hard or scary. If your child is bringing up a topic it means that it is on their mind and something that they want to talk about. Telling them not to worry does not usually make the worry go away. However, it can unintentionally lead a child to believe that this is something they should not openly talk about.
You do not need to have all the answers. It is ok to wonder about things together, to wish for things that may or may not be possible and to worry about difficult things. Often as caregivers, we try to minimize stress and worry by saying things like "everything is fine" or "you’re strong, don’t cry". Children can feel when things are not "fine", and they know that life is not always perfect. Take these opportunities to include and support your children in what is going on. Including them can help them gain control, build trust, develop coping skills and increase resiliency.
Spending time talking about wonders, worries, and wishes can help children feel connected to their caregivers, so they do not need to deal with all their big thoughts and feelings alone.
You are not alone
As a parent, you know your child best. Learning how to include and support your child(ren) through illness can be new and feel overwhelming at times. Your health-care team is available to help partner with you as you continue to support your child(ren) on this journey.
