A Resource for Caregivers and Loved Ones

By Shaindy Alexander, Certified Child Life Specialist PACT (Paediatric Advanced Care Team) at the Hospital for Sick Children

Having an illness, condition, injury, or event that impacts a child's health can be a challenging, stressful, and often a confusing time. It is important to create a safe space for children to openly discuss their thoughts and emotions. Remember to be present, listen, validate, and feel together.

The 6C’s and 3W’s are common concerns and questions that children may have while in hospital and it is important to address these at different stages in their healthcare journey, even if your child has not brought them up themselves.

6 C’s

What is it CALLED? 

It is important to name the condition, illness, or injury that is causing the child to be “sick.” Giving the condition a name allows the child to have a greater sense of understanding and an opportunity to ask questions. Providing children with information that is honest, timely, and appropriate for their age and stage of development can help them better cope with their situation.

Can I CATCH it? 

If your child is sick with an illness that isn’t contagious, reassure your child so that they do not worry about getting others sick, and share this information with other children to reassure them that they won’t catch it if they share the space with the child that is ill.

Did I CAUSE it? 

Children often believe that their thoughts, behaviour, and/or wishes can influence the world around them. Although 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 and when they’re not given the information or an explanation that is appropriate for their development and circumstance, they may feel as though they were somehow responsible. If they did have an impact on their illness or condition, remind them that sometimes things can happen that we wish didn’t. It is important to allow them to talk about their feelings and concerns and feel supported and loved.

Can I CURE it? 

Children often feel a sense of responsibility to make their illness, condition, or injury better. They may feel like they aren’t doing enough or trying hard enough to get better if the treatment isn’t working. Reassure them that although they can be helpful to their own treatment and/or recovery, they are not responsible for making it all better. There are a team of healthcare providers who are doing their best to help. Instead, give the child a job to help them feel included in their own healthcare journey, like reminding them to take their medicine, draw pictures, or share their feelings.

Who will take CARE of me? 

When a child is in hospital, it is often common for them to worry about who will care for them and those important to them. At some point, they may believe that they are too ill to be cared for. Help your children identify adults who care about them and will help support them through this challenging time and encourage them to ask questions and share their feelings with these people.

How can I CONNECT to people I care about?  

If children are away from their support systems and/or loved ones, remind them that there are ways to stay connected to them, including through photos, letters, phone calls, storytelling, and connection items that they share with their loved ones. For a child who is seriously ill, share with them ways that they will always be a part of the family, even if their illness changes things.

3W’s

WONDER, WORRIES, & WISHES

When a child shares that they have been thinking about something challenging or scary, you may want to tell them not to WORRY and that everything will be fine, or to not cry and just stay strong. But doing so does not necessarily make the worries go away. 

Instead, explore this thought further and discuss ways to focus on what can be controlled. Remind your child that it is okay to feel as though things are not okay, to cry, and to express their sadness or frustration. You don’t need to have all the answers.  

It is okay to WONDER about things, to WISH for things that may or may not be possible, and to worry about difficult things together. Including them in these discussions can help children gain a sense of control, develop healthy coping skills, build trust in those around them, and increase resiliency. ✨