Are my children’s symptoms due to anticipatory grief?

Question

Hello doctor,

My father is 58 and was diagnosed with stage 4 non-small cell lung cancer about five months ago. He is currently on Pembrolizumab, and his PD-L1 level is 72 percent.

I have two children, aged nine and 12, who are very close to their grandfather. Recently, I have noticed some changes in their behavior. My 12-year-old has not been eating well, and my nine-year-old has started bedwetting again, which had stopped years ago.

The school counselor mentioned anticipatory grief and said it can happen in children when a loved one is seriously ill. I am not fully clear on what this means medically or psychologically. I want to know the following:

How does anticipatory grief affect children compared to adults?
Should I consider taking them to a child psychologist at this stage, or is it okay to wait and observe?
Also, how can I explain their grandfather’s condition to my nine-year-old in a way that is honest but not frightening?

I am unsure how much to share with them and how to support them while protecting their emotional well-being.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for reaching out.

Children at this age do understand more than we think, but they may express their emotions differently because their thinking and understanding are still developing.

My honest opinion is not to hide things from them. It is better to explain clearly and avoid vague words.

You can approach the conversation like this:

Sit with them when you are free and can give them enough time. Talk in a calm and gentle tone.
You can say that your grandfather is very sick. The doctors are trying their best, but he is not getting much better. This means he may leave us soon.
I know you both love him very much, and I do too. It is normal for us to feel sad and worried. This is a part of life, and every person will pass away someday.
Let them spend time with their grandfather if possible. Be available for them and encourage them to ask questions about their worries, confusion, or fears.
Tell them that I have noticed some changes in you. Talk to them about their feelings and also encourage activities they enjoy, including their favorite foods and hobbies.

In my opinion, you and your family are the best support system for them right now. Be present, show love, and reassure them.

I hope this helps.

Please revert in case of further queries.

Thank you.