Paula, hi again - just to ask if your daughter's school is aware of the difficult home situation, with two parents in poor health? Schools are 'usually' pretty good when it comes to children with home difficulties - my son's school was wonderful when my husband was diagnosed with cancer, very understanding and kind, and 'made allowances' etc (also gave us permission for a term time holiday -that very sadly turned out to be our last ever family holiday and therefore, as you can imagine, the most precious, precious memories...)

I know you will be wanting to 'shield' your daughter as much as possible, and rightly so, from the 'impact' of having two parents with care needs, but inevitably there will be an impact on her. She will want to help, and will probably worry. Allowing her to help 'a little' will, probably, actually be reassuring for her - she will feel she is contributing and that will make her feel better and more 'in control' (it's the being 'out of control' that may be the greatest potential source of stress for her.)

The school should be 'alert' to any fall out in terms of both her schoolwork, and her behaviour. I know you don't want her on any kind of 'at risk' register, but if her teachers are aware of the situation at home, and on the look out for any signs of stress that she may be hiding from you (children can be incredibly 'selfless'!), that may be coming out (eg, as an extreme, maybe something like self-harming or whatever)(not suggesting that will happen, but it's the kind of 'intense reaction' that a highly stressed teen may resort to to relieve that stress). The school will be 'on your side', as well as on your daughter's side.

At 13 (year 9 now, is that it?) her school work will start to intensify, in preparation for her GCSE years, so it would be good to think ahead to how she will handle that when that time comes. The last thing you'd want is for any stress to 'build up' now, and then 'burst out' just when it will be most important for her to be able to give sufficient attention to her exam work. Again, the school really should be supportive at this stage, which I very much hope they will be. (Remember, they have 'seen it all before', and in the great scheme ofthings, having two parents with physical illnesses who are otherwise stable and loving is very 'good' compared with some of the utterly miserable home lives some poor children have, with chaotic families, warring parents, indifferent and emotionally neglectful! Your situation is 'light' in comparison to that and the school will know that you are very, very willing to do what you are capable of to see your daughter gets a good, low-stress school experience.

By the same token, I wonder whether getting in touch with a local 'Young Carers' support group would be good, because one thing that may affect your daughter is a sense of isolation and 'being different' (I always knew I was 'different' because I had a mum with mental health problems!). If she is part of a young carers support group then she will know that lots and lots of children (alas) have 'non-ideal' home lives, in terms of parents with care needs (even if she is not a major caregiver).

Finally, I do think, speaking personally, that talking to your daughter about the home situation is a good idea. children 'know' when things are difficult, and trying to put on a good front, or minimising problems and saying 'it's all fine darling!' won't reassure her. As she starts her journey to adulthood, it's important, I think personally, to start to 'open up' to her WITHOUT making her 'part of'' the illnesses affecting you and your husband, but to be honest with her....but 'carefully'. Again, when my husband was diagnosed, I turned to a friend whose own husband had had lymphoma for decades 'what to tell our son', and she said 'the truth - otherwise they will fear that you are simply lying to them.' So we did - but 'carefully', and also 'not all at once' (eg, Dad needs an operation, that was the first thing we said, only afterwards did we say that the reason was cancer, and so on) (my son was 14 at the time, so not much older than your daughter.)

Anyway, all this is only my own personal take, so please only read it in that light!

Wishing you all the best possible, kind regards, Jenny