What to tell toddler about sick Grandmother?

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Ken - 21 Feb 2005 13:17 GMT

Hi. My Mother-in-Law is starting treatment for anaplastic thyroid
cancer. She is 80, not in great health as is, and the mass is already
about 7cm. The prognosis is not good. I have a two year old (just
about three) who knows and loves his bubby (that's what he calls my
Mother-in-Law). He used to see her once every few weeks or so, but now
that will most likely stop at least for a long while, and may never
happen again if she dies.

My wife has been trying hard not to show our son that she is upset, but
it's getting tough. He is very observant, and I think he senses
something is wrong. Just yesterday he was telling us that one of his
dolls was very sad. That night when we were in bed together, he said
his doll was sad, and then he started to cry.

So we are just wondering how/when to talk to him about what is going
on, and when we do, what to say. We've had some people tell us not to
mention that bubby is "sick," because he may equate getting sick with
what bubby is going through. However, I'm not sure how else to say it.
My instinct says to tell him that bubby is sick, and that is why Mommy
is sad, and to just leave it at that for now. But then I think that if
she dies, he may equate dying with being sick. Should I say that bubby
is very old and has a sickness you can get when you are very old? Of
course then I wonder if he will equate it with my parents who are both
old, but alive and well.

Any advice or resource recommendations would be appreciated. I've
heard there is a good book about this for toddlers called Nana
Upstairs, Nana Downstairs, so I may check that out. Of course, my
mother is Nana, and she is not sick, so I wonder if he will equate it
with her.

Thanks again for any advice,

Ken

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Steph - 21 Feb 2005 16:35 GMT

> Hi. My Mother-in-Law is starting treatment for anaplastic thyroid
> cancer. She is 80, not in great health as is, and the mass is already
[quoted text clipped - 12 lines]
> So we are just wondering how/when to talk to him about what is going
> on, and when we do, what to say.

The truth is always best, as early as possible, in terms he will understand

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J - 21 Feb 2005 16:57 GMT

> Hi. My Mother-in-Law is starting treatment for anaplastic thyroid
> cancer. She is 80, not in great health as is, and the mass is already
[quoted text clipped - 9 lines]
> dolls was very sad. That night when we were in bed together, he said
> his doll was sad, and then he started to cry.

Ken,
My aunt and one grandfather both died when we were very young. We're still
left with questions because our parents chose to not tell us or involve us
at all.

Tell the child that "bubby first name" (show photo) has cancer, a type that
is not curable.
Go see her, as much as possible, while she's possibly at her best. At that
age, IMO the child should be sleeping on his own. You could help him draw
pictures or make cards to say "I love you and care about you" and take them
and let him give them to "bubby first name".
Call the others' "bubby their first name" (show photo) and say that they
are well.

Rehnquist was diagnosed in Oct/04, underwent a tracheostomy. He immediately
began external-beam radiation, then began chemotherapy treatments. He's
"down for the count" again, according to Washington Post - 18 Feb 2005
Rehnquist to Miss 2 Weeks on Bench. I don't know what his health was like
before the diagnosis, but this webpage indicates less than two months.
http://cpmcnet.columbia.edu/dept/thyroid/anaplastic.html
"Tragically, the five year survival from this type of cancer is less than
5%, with most patients dying within just a few months of the diagnosis.
Treatment with radiation therapy or chemotherapy may shrink the tumor
slightly and make breathing more easy in those patients who are suffering
from shortness of breath."

Steph would have to comment, but it appears to me (non doctor) that the
only reason to undergo treatment would probably be radiation therapy, if an
expert says that it might help the breathing.
So given that your MIL is in not good health, you may wish to get a second
opinion, from "hospice" (specialized care at home, if that's possible - if
she's home or transferrable to a hospice wing) to see how they can relieve
symptoms/keep comfortable someone with such a cancer. They can also be
there for you and the whole family and help with such questions.

Personally, I think viewing, a funeral and enterment can be too traumatic
for a child that age (mostly because there's too many adults and upset), so
you might consider a babysitter. (you'll have to see what hospice thinks
about that)

Later (regardless of whether he attends the funeral or not), teach him
about life and death by observing mice and birds (while they're alive and
happy) and if you find one that has died, have a mock funeral, with a box,
bury it and make a cross of sticks. Then say prayers (for the
bird/mouse/bubby first name) and tell him that's how peaceful things went
for "bubby first name". That IMO would help the child find closure. Also
a photo album, with more about her type of cancer, just for him, so if/when
he wants to think and read about her, he has it for the rest of his life.
Best wishes,
J

http://www.endocrineweb.com/caana.html
Characteristics of Anaplastic Thyroid Cancer
Typically presents as rapidly growing neck mass
Spread to lymph nodes of the neck present in more than 90% of cases
Distant spread (to lungs or bones) is very common even when first diagnosed

Overall cure rate very low
Often requires the patient to get a tracheostomy to maintain their airway.
Many patients, especially those who have advanced cancer and cannot undergo
surgical resection, will benefit from external-beam radiation

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