Teenager With a Seriously Ill Parent: Adolescence When Serious Illness Is at Home

What does a teenager with a sick parent feel? The young person's emotions, changing roles and how a family can offer support when serious illness is at home.

The first thing she does when she gets home from school is look at her mother's face: Is she tired today, is she in pain, or is it a good day? While his friends talk about weekend plans, he is thinking about which day his father's check-up is. A teenager with a sick parent sits in the same classroom as their peers and prepares for the same exams, but one corner of their mind is always at home. When cancer, heart disease, kidney failure, a neurological illness or another long-term health problem affects a mother or father, it changes not only the person who is ill but everyone in the house. Adolescence is already a time when identity, independence and emotions are being intensely reorganised; when the uncertainty of a serious illness is added to that, the young person often carries a great burden in silence. In this article we look at what these young people may go through and how the family and those around them can support them.

What Does a Teenager With a Sick Parent Feel?

The feelings of young people facing a parent's illness are many-layered and change over time. In the first days after the diagnosis, shock and disbelief may be in the foreground; as treatment goes on, tiredness, anger and uncertainty may weigh more heavily.

Common feelings include:

• Fear and anxiety: Questions such as "Is Mum going to die?" or "Will Dad get better?" occupy the mind. This fear is sometimes not put into words but shows itself as sleeplessness at night, stomach aches or difficulty concentrating.
• Anger: Anger directed at the illness, at life, and sometimes at the ill parent themselves. Young people usually feel guilty after this anger.
• Guilt: Irrational but common thoughts such as "Did they get ill because I upset them?"; the feeling, while having fun with friends, of "I'm laughing here while Mum is suffering at home."
• Loneliness: The problems their friends talk about seem small to them; yet they may find no one to tell about what they are going through.
• Embarrassment and feeling different: Changes in the parent's appearance, a wheelchair or hair loss after treatment may lead the young person to avoid inviting friends home.
• Suppressing their own needs: Not sharing their own problems, joys or even exam anxiety, telling themselves "My troubles don't matter right now."

These feelings can change even within a single day. A young person who is saddened by their mother's weakness in the morning may be angry with her in the afternoon and go to bed blaming themselves in the evening. None of these feelings is "wrong". But when a young person finds no space to express them, they can grow heavier as they build up.

Why Do Young People So Often Hide What They Are Going Through?

A large proportion of young people with an ill parent do not talk openly about their experience either at home or at school. There are several reasons for this.

The first is trying to protect the family. The young person does not want to be an extra burden with their own sadness on parents who are already in a difficult situation. Telling themselves "I have to be strong", they keep their feelings inside. The second is the worry of looking "different" among peers. They shy away from pitying looks, questions or being treated differently. The third is that the illness is often not talked about openly at home either. In many families, the seriousness of the illness is hidden or downplayed in order to protect the young people. Yet teenagers read the atmosphere at home, the whispered phone calls and the worry on adults' faces very well. When they are not given information, they often fill the gap with scenarios more frightening than the reality. What is more, when they realise they are not being told anything, they may conclude that asking is forbidden too and fall completely silent. In this way, everyone in the house lives with the same fear, but each person carries it alone.

How Should You Explain the Illness to Your Teenager?

When talking with teenagers about illness, honesty, age-appropriateness and a balance of hope are important.

Be honest but measured

It is necessary to explain in clear language the name of the illness, what the treatment will broadly involve and what may change in daily life. On matters you don't know, saying "We don't know this yet; the doctors are waiting for these results" is healthier than giving made-up reassurance. If there are children of different ages in the family, our article on explaining a parent's illness to a child, which looks at how illness can be explained to younger children, may offer guidance.

Let them ask questions

Sometimes a young person asks nothing in the first conversation; questions may come days or even weeks later. Saying "If anything is on your mind, you can ask whenever you like" keeps the door open. Some young people find it easier to ask by written message than to talk face to face.

Think together about how they access information

Teenagers tend to research illness on the internet, and the information they come across can be out of context and frightening. Saying to your teenager "If you read something you're wondering about, talk to us first", or, where appropriate, including them in a conversation with the doctor, can reduce anxiety caused by misinformation.

Hold hope and reality together

Saying "Everything is going to be wonderful" and describing the worst-case scenario in detail both put pressure on young people. A framework such as "We're going through a difficult time; the doctors are doing everything they can, and we'll support each other" is both realistic and supportive.

Changing Roles: Should a Teenager With a Sick Parent Become a Carer?

A serious illness changes roles in the family. The healthy parent both cares for the ill one and takes on the running of the household; they are often tired and tense. In this gap, new responsibilities fall on the young person: looking after younger siblings, preparing meals, going along to hospital appointments, reminding the parent when it is time for their medication, even helping with the ill parent's personal care.

A certain amount of contribution can help the young person feel useful and connected to the family. But when the responsibilities do not suit their age and strength, or they are expected to shoulder them alone, the ordinary developmental tasks of adolescence are disrupted. There is no time left for studying, spending time with friends, sleeping or building their own life.

Let us say a seventeen-year-old girl, during the year her father is being treated, rushes home from school every day, keeps her father company while her mother is at work and can only find a few hours at night to study. While those around her praise her as "so mature", she is steadily burning out and cannot tell anyone. This picture plays out in many families where the burden of care remains invisible. In such a situation, her mother saying "This week your aunt will stay with Dad for two evenings, and you go and meet your friends" may look small, but it is a step that opens up space in the young person's life again.

When the family shares the burden of care among adults as far as possible and asks for help from relatives, neighbours and formal sources of support, the pressure on the young person is reduced. Our article on the psychology of chronic illness can also help in understanding the family's overall situation, including the carer's own tiredness.

School, Friends and Daily Life

A parent's illness can affect a young person's school life in various ways: difficulty concentrating, homework slipping, absences, falling grades, or, on the contrary, burying themselves in lessons in an attempt to control everything. For a young person preparing for an important exam such as the LGS or YKS (Turkey's national high-school and university entrance exams), this load can become even heavier.

The following can help during this period:

• Informing the school: With the young person's consent, telling the school counsellor and form teacher about the situation allows the school to be understanding and to offer support when needed. Asking the young person who should be told lets them feel their privacy is respected.
• Protecting normal life: It is important that the ordinary activities in the young person's life, such as sport, courses and meeting friends, continue as far as possible. Having fun is not betraying their parent.
• Easing guilt: The ill parent themselves saying "Go out with your friends; seeing that makes me happy" can lift an invisible weight from the young person.
• Recognising their own space: A place, a hobby or a trusted adult that lets them step away briefly from the intense atmosphere at home helps the young person breathe.

For a young person growing up beside an ill parent, the most valuable support is not being convinced that everything is fine; it is knowing they are not alone while carrying difficult feelings.

Family Routines During Long Periods of Treatment

Serious illnesses are often not a single moment of crisis but a process lasting months or even years. Hospital stays, check-ups, and the good and bad days of treatment make family life rise and fall like a wave. In this long process, one of the things the young person needs most is predictability.

Some families find that a short weekly family meeting helps. At this meeting they talk about which days of the week are hospital days, who will take on which tasks and which evenings belong to the young person. That way, each evening the young person comes home not to the uncertainty of "What will happen today?" but at least to the existence of a plan.

Relatives, neighbours and family friends often want to help during this period but don't know what to do. Defining concrete tasks such as bringing a meal, collecting a younger sibling from school or sharing hospital shifts prevents the burden from shifting onto the young person. Where extended family ties are strong, as in many parts of Turkey, this solidarity is a very valuable resource; but care is also needed so that crowded visits do not disrupt the young person's rest and study routine.

There is good news too in the course of an illness: a treatment that brings a positive result, a day of discharge from hospital, a week without pain. Noticing these moments as a family and sharing them, however small, helps the young person connect not only with anxiety but with hope as well.

When Should You Seek Professional Support?

Feeling sadness, anxiety and anger in the face of a parent's illness is ordinary. However, the following signs may show that the young person needs extra support:

• Intense unhappiness, hopelessness or being unable to enjoy anything, lasting for weeks
• A marked disruption of sleep patterns, constant tiredness or a marked change in appetite
• Withdrawing completely from friends and activities they used to enjoy
• A sudden and lasting drop in school performance, refusing to go to school
• A marked increase in angry outbursts, risky behaviour or substance use
• Putting their own life entirely on hold because of the burden of care, and signs of burnout
• Statements that life is meaningless, or thoughts or acts of self-harm

If the young person talks about harming themselves or ending their life, take it seriously and, in an emergency, call 112 (emergency services) without delay.

If the parent's illness worsens or they are lost, the young person may also need support through grief. Our article on grief in teenagers offers detailed information on this.

How Can Therapy Support a Teenager With a Seriously Ill Parent?

For a young person living with a parent's serious illness, therapy can be a space where they can set their burden down for a while and do not have to protect anyone. In counselling for teenagers, the following approaches can be used when working with these young people:

Recognising and expressing feelings: The focus is on the idea that fear, anger, guilt and sadness can exist at the same time, and that none of them lessens the young person's love.

Cognitive work: From a Cognitive Behavioural Therapy perspective, thoughts such as "I caused the illness" or "If I have fun, I'm a bad son/daughter" are examined, and a more realistic and compassionate perspective is developed.

Living with uncertainty: Skills for coping with anxiety in the face of a situation that cannot be controlled, relaxation and bringing attention back to the present moment can be worked on.

Boundaries and self-care: The young person is supported in recognising their share of the burden of care, learning to ask for help and being able to look after their own needs as well.

Working with the family: Where needed, meetings with the parents are used to plan how the illness will be talked about at home, how responsibilities will be shared and how the young person's needs will be looked after.

Frequently Asked Questions

Should I hide how serious the illness is from my teenager?

Teenagers notice most of the changes at home. When information is hidden, the young person often imagines scenarios worse than the reality, and their trust is damaged. Age-appropriate, honest and supportive openness is usually more protective.

My teenager avoids spending time with their ill parent; what should I do?

Avoidance is often the result of fear, helplessness or not knowing what to say. Rather than forcing the young person, creating small, pressure-free opportunities for contact, such as watching a film together or having a short chat, makes it easier for them to come closer.

As the ill parent, how can I talk to my teenager?

Telling the young person that they can share their feelings, that you are not angry with them and that you want them to carry on with their life is very valuable. Sharing your own feelings in a measured way also makes it easier for them to express theirs.

How can a teenager with a sick parent be supported at school?

With the young person's consent, informing the school counsellor, allowing flexibility around homework and exam periods, and arranging regular short conversations with a teacher they trust can lighten the load in their school life.

• #chronic illness
• #family
• #adolescent psychology
• #caregiving burden

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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