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Back-to-School Delivers Extra Stress to Parents with Cancer, other Serious Illness

Aug. 26, 2020

Re-entry to the 2020 school year in the midst of the coronavirus pandemic is tricky for everyone. For parents or grandparents who are sick and need to stay safe, it’s even more daunting.

We asked four URMC medical experts to discuss what they’re hearing from families in these difficult situations, and to offer suggestions about sending children back to school based on their experience and knowledge. They are: Wally Johnson, M.D., director of the UR Medicine Primary Care Network; Natercia Rodrigues, M.D., a physician at Manhattan Square Family Medicine in downtown Rochester; Meg Blaney, R.N., outpatient nurse manager and quality manager at the Wilmot Cancer Institute’s Blood & Marrow Transplantation (BMT) service, which requires strict infection control measures with or without a pandemic; and Beth Wensel, R.N., nurse coordinator for the BMT unit.

Talk to Your Care Team

Unfortunately, the experts said, there is no definitive answer at this time to one key question: Should people with serious illnesses such as cancer or heart disease send their children back to school for in-person classes? Each family must consider their own medical status, work schedules, child care options, and other factors.

“No perfect solution exists and the back-to-school decisions are very personal and will be different for each family,” said Wensel, who has discussed the issue with patients and families at the Cancer Center. “My biggest piece of advice is to have open dialogue with your care team about every question and concern you might have. It’s important for people to know they will be supported, and that we can advise them with up-to-date information.”

It’s All About Masks

Masking and constant handwashing is important — even though masking is not welcome by all people, and even when kids object because their peers are not wearing masks.

“Ask children to think about it this way: You’re wearing a mask for your Mom or your Dad, or your grandparent who has cancer,” Blaney said. “Tell them: This is not about you. Many things are about you, but this is something that’s about protecting grandma, even if it’s a hardship for you.”

Start training children immediately, before school starts. Most area school systems are opening in September with in-person sessions or a hybrid model, which includes some in-person classes. Practice with everyone in the family wearing masks together, said Rodrigues, of the Manhattan Square office. Explore what it’s like to wear masks in groups, such as during outdoor play while taking a break from screen time. “Make masking a part of your routine — like putting on shoes and socks,” she said.

Dr. Elizabeth Murray, UR Medicine Golisano Children's Hospital Pediatrician

Seek Reliable Sources

The experts warned patients and families to avoid “Internet gurus,” and instead use valid sources of information such as Monroe County Department of Public Health, New York state, and Centers for Disease Control (CDC) resources, which are all available here: https://www2.monroecounty.gov/health-COVID-19#schools.

Understand and discuss risks versus benefits, and seek counsel only from professionals, they added.

Additional Back-to-School Tips:

Get a flu shot. And get a COVID-19 vaccine when it becomes available. Urge extended family, friends, neighbors, and anyone else in your life to do the same. Talk to your doctor about all vaccines and, if you are an older adult, discuss what else is available for protection from infectious diseases. We are all at risk when vaccines are deferred, Johnson said.
Wash your hands. A lot. And use hand sanitizer when you cannot wash with soap and water. As above, practice this with children and teens before school starts.
Avoid being around anyone who is sick, especially with symptoms of coronavirus. This is problematic, as parents and guardians are used to their children coming down with routine sniffles once school starts. But if you have a serious illness, or are in a high-risk group for coronavirus, do not allow anyone near you who might be feeling under the weather. People with cancer, especially those undergoing treatment, “should adhere to the highest standards of protection available to themselves and loved ones,” Blaney said.
Be a good role model. This is the best thing any adult or child can do when they have a loved one with a compromised immune system or a serious illness. Children are more likely to stand up to peer pressure against masking if they see their parents and other adult role models wearing masks, washing their hands, and practicing social distancing, Wensel said. “We shouldn’t underestimate how much our children can understand,” she said. “We can use this as an opportunity to have them take an active role in their loved one’s treatment plan.”
Ask questions. If an ill or at-risk parent or grandparent is living with children who will attend school in person, the adults in the household, and other close relatives, should knowdetails of the school’s plan to handle meal times, social distancing and masking enforcement, and access to soap/water and hand sanitizers, for example.
Have a plan if coronavirus occurs. Every family should discuss this. Blaney noted that even with the best care possible and with good prevention tactics in place, transmission can occur. Knowing the practical steps your family can take will reduce anxiety. For people with cancer, it’s important to be able to immediately separate from the family upon any potential coronavirus exposure, and speak to the medical team about further recommendations, she said.
Take care of your mental health. It’s natural to feel overwhelmed. But it’s important to take care of yourself and your family members by finding healthy ways to cope with stress. Connect with others, adhere to healthy eating and sleep patterns, seek help when you need it, and arm yourself with reliable knowledge, Blaney said. “I feel so badly for our patients,” she said. “In many ways, this has been the year of disappointments. All of our families have really had to balance what’s best for the children and what’s best for their health, and navigate many difficult decisions.”