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Mike and Mary,
Like Mike, I think it is a a combination of all of this. My family has had to deal with quite a bit of significant health issues both with my husband and myself (fortunately we are both on the other side of all of it and healthy now) and with other family members (on going) from shortly after our 12 year old was born. As a parent I know my protective tendencies to shield my child from the pain and suffering this provides is strong, however the chaplain in me does wisely prevail and we do bring her on board when something is happening but this is what I do, these are the conversations I specialize in and my husband defers to me to handle these with our daughter. But I am uniquely equipped to do this. Most parents as Mike indicates are trying to do the best they can with their own stuff, I imagine it is overwhelming to even consider trying to explain to a child.