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Parents of sick children are extremely appreciative of gifts given their children by friends, families, and communities. The value of these supportive gestures is hard to overstate.

When people give children presents during the course of illness and treatment, these gifts are a mercy. They distract from uncomfortable treatments. They break up the monotony of a day.

Still more importantly, these gifts acknowledge the challenge of the courageous fight a child faces.

They honor a unique bravery these children are forced to call up and discover within themselves – far sooner than they should.

What these gifts do not call up are thank you notes.

 Most people, I believe, understand this when giving a present in such circumstances. I was surprised to find that parents of sick kids worry about this.

But the parents of sick kids do worry about a perception that these efforts aren’t appreciated.

Parents of sick children worry that their inability to respond to these gifts with a bread and butter note will be misconstrued.

These mothers and fathers want to say thank you.

These mothers and fathers don’t have time.

Know this:

Parents of children who are sick, discover the grace in every moment. They must also battle through heartbreak like tiny and sedated bodies in huge hospital machines. When they have a second, they must pay bills.

For those giving gifts, it is important to remember siblings. Siblings tend to be left out of the gift giving cycle. This can be very stressful for parents who are left to negotiate with a child who received a gift, and one (or more) who did not.

Young children cannot understand the complete medical situation. Therefore, the optics of a parade of gifts and attention heaped upon one hospitalized child over another non-hospitalized child are often confusing. This can cause tension between siblings.

If you are giving a gift, set a budget and divide it among the children. Or buy something they can use together. Write a little note that honors the sibling role in the family as courageous brother or sister. This is their battle too.

In giving a gift, go ahead and write on the card that you would prefer no thank you card, no acknowledgment.

The parents of sick children are warriors. Warriors choose their battles. A battle worth having is another dose of medicine a child hates, another needle. A battle not worth having is explaining that manners dictate a thank you note for the puzzle. Sick kids face many tedious, sick-making, uncomfortable treatments. A gift should arrive with no strings attached, no expectation of formal acknowledgment.

In addition, depending on the age of the child, writing may be difficult – they may not have learned to write yet. They may be too ill to do one more thing that feels like a chore. Kids can love a gift and still find thank you notes a bit oppressive.

For those in older generations, it may worth explaining that with more medical options comes more intense medical management.

Know that the gifts given sick children do a great deal to acknowledge the situation of the family. Importantly, this reduces their potential social and emotional isolation.

Who knew you could get all that out of a ream of Construction paper and some markers? All that, but still no thank you note.

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