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Section 11
Track #11 - Breaking the News

Question 11 found at the bottom of this page
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On the last track we discussed making plans for the future as a technique for restoring hope. 

On this track we will discuss breaking the news.  Techniques for breaking the news will include timing, delegation and methods for telling children.  As you listen to this track, consider your Harriet.  Harriet, age 43, was diagnosed with lymphoma.  The cancer was in her lung.  Harriet stated, “I have children and friends that will be devastated.”

#1  Timing
I stated to Harriet, “Telling other people that you have cancer can be a difficult thing to do.  It is also a very personal and individual act.  It has been said that there are as many ways to break the news as there are clients with cancer multiplied by the number of people they need to tell.”  Think of your client.  Was a spouse, significant other, or family member with the client at the time of discovery?  After the moment of discovery, could your client find it helpful to put a little time between the discovery and breaking the news?  I find that the time buffer allows clients to put on their game faces and to determine just how much they want to reveal and to whom.  The time buffer also gives clients the time to figure out how these people can best help in the initial stages of treatment and recovery process.

#2  Delegation
One of the first steps that Harriet took was to assign a close friend and colleague to tell others.  As you know, the act of telling can be emotional and draining because while a client may have dealt with his or her own grief, breaking the news means he or she now needs to deal with another person’s grief.  I stated to Harriet, “If you do choose to delegate the informing of those close to you, you might consider having the person assigned explain that you weren’t feeling ready to talk about your diagnosis yet.  Later, you can explain that although you wanted to tell everyone personally, you needed to build your emotional reserves for the task ahead.  For those you do talk to, you probably want to set both a realistic and optimistic tone.  It might be productive to have a list of reasons ready for why you feel optimistic.  That way you can forestall morbid dwelling on your situation which you will probably find counterproductive.”

#3  Methods for Telling Children
Harriet asked, “Ok.  But I can’t delegate someone to tell my kids.  How do I do that?”  Would you agree that telling children is an even more delicate matter?  I stated to Harriet, “How to tell  your children about your diagnosis depends on their age and developmental stage.  Children under five are at a point developmentally where they’re more focused on their own needs, so what’s most important is to continually communicate that they are going to be cared for.  Be explicit about how their needs are going to be met.”  For example, prior to treatment, Harriet stated to her children, “While mommy’s at the cancer center having treatment, Grandma’s going to cook your breakfast, and Grandpa’s going to take you to day care.”  I find that children’s equilibrium is thrown off if things at home aren’t normal.  Therefore, would you agree that it can be beneficial for parents to maintain a child’s routine as much as possible?

In addition to maintaining routine, I find that it can also be productive for parents to use words that children can understand.  For example, a five year old may not understand the word ‘cancer,’ but may understand  ‘mommy doesn’t feel well’ or ‘mommy needs medicine.’  I stated to Harriet, “Present the situation in a hopeful but not unrealistic way.  You certainly don’t want to lay a foundation of distrust with the child.”

Also, I find that children under the age of ten are very attuned to physical changes that a parent might go through.  Explain before the changes occur what might happen.  For example, ‘mommy’s getting treatment and may lose her hair, but it will grow back.’  Some parents want to protect their children by not giving them details, but it ends up making it more difficult for the child when the changes occur.

One method for making the news easier on children is to bring them to the cancer center at least once.  They can look around, see where their parent is going to get treatment, they can meet the nursing staff, and see what an IV looks like.  Would you agree that can help take the sense of mystery away?  As you probably know, when children aren’t given information, they have to use their imaginations and in their minds the situation is usually a lot worse. 

On this track we discussed breaking the news.  Techniques for breaking the news include timing, delegation and methods for telling children. 

On the next track we will discuss hospital strategies.  Three strategies included on this track are decorating with things from home, requesting what you want, and saying no. 

QUESTION 11
What are three techniques for breaking the news of cancer? To select and enter your answer go to Answer Booklet.