Pay attention to how the child is responding to the conversation, Ingman said. They might be emotional if it's very difficult news, and that's normal. There's no formula for how to conduct this conversation and no guarantees about how it will go, so it's customary to take breaks and to allow time for follow-up questions.

A part of the conversation is how the illness will affect the whole family, which includes telling the child how this might change their routine.

Let the child know if a different family member will pick them up from school, or if a relative will stay with them at night should the adult need to go to the hospital. Telling them about these changes but working to keep as much of their routine going is reassuring to them, Ingman said.

Signs of distress

A child's reactions to this conversation can run the gamut because each child is unique. It's normal for a child to not react, just as it's normal to be very distressed.

It becomes a concern when the child has prolonged signs of distress that don't go away. These include getting worse grades at school, being withdrawn or not being able to engage in activities the child typically enjoyed.

Other signs, Schneider said, include not wanting to be separated from the adult who's sick, not sleeping independently or not wanting to go to school.

In this scenario, Schneider advises guardians to ask the child what's causing them to act this way, what's worrying them or what's bothering them, because the adult and child can then talk about it.

"Their behavior is their way of showing their pain, and that's something that parents need to remember because [children] can't come right out and say it," she said.

Get the child involved

Along with being brought into a conversation that's appropriate for their age, children can also be given a hands-on role.

Ingman said giving the child tasks such as drawing a picture, taking a photo or writing a note for the ill family member gives them some sense of agency in the situation.

What happens if the illness becomes terminal

It's extremely important that kids have an opportunity to prepare if a parent or sibling is not going to survive, because the family can collectively make choices about how to spend those final days and how to say goodbye, Schneider said.

"If they're not given the information," she said, "the fear of the unknown is much worse for them."

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