Learn Hardcore Indonesian: Nenek saya cemas karena anaknya demam dan batuk. - My grandmother is anxious because her child has a fever and a cough.

Indonesian doesn’t use a verb like “to be” before adjectives. The adjective itself is the predicate, so Nenek saya cemas literally reads “My grandmother anxious.” Do not add adalah before adjectives; adalah is mainly used to link two nouns, e.g., Nenek saya adalah dokter.

What does cemas mean exactly? How does it differ from khawatir or gelisah?

cemas: anxious, uneasy, tense (often felt physically).
khawatir: worried/concerned (very common, neutral).
gelisah: restless/fidgety (more about agitation than worry). In this sentence, cemas and khawatir are both natural. Nenek saya khawatir … is just as idiomatic.

How does karena work, and can I change the word order?

Karena introduces the reason clause (“because”). Default order: [main clause] + karena + [reason clause], as in the sentence. You can front the reason for emphasis: Karena anaknya demam dan batuk, nenek saya cemas. When fronted, use a comma. Synonyms:

sebab (formal-ish “because”)
gara-gara (informal, often with a negative/blaming nuance)

Who does the -nya in anaknya refer to?

-nya is a third-person possessive clitic meaning “his/her/its/their,” and it often refers to the most salient third person in context. Here, the most natural reading is “her child,” i.e., the grandmother’s child (which, from the speaker’s perspective, is likely their mother or father). However, without context it’s ambiguous (see next question).

Could anaknya mean “the child” rather than “her child”?

Yes. -nya can also act like a definite marker (“the/that”). So anaknya can mean “the child (previously mentioned).” To avoid ambiguity:

To clearly say “my grandmother’s child”: anak nenek saya (or specify: ibuku/ayahku).
To say “her grandchild”: cucunya.

Does -nya indicate gender or number?

No. -nya is gender-neutral and number-neutral. Anaknya can mean “his/her child” or “their child(ren)” depending on context. To make plural explicit, use anak-anaknya (“his/her/their children”).

Are demam and batuk nouns or verbs here?

Indonesian is flexible. In predicate position, demam and batuk read as stative/intransitive predicates:

Anaknya demam = “Her child has a fever / is feverish.”
Anaknya batuk = “Her child is coughing / has a cough.” Both words can also function as nouns (“a fever,” “a cough”) in other contexts.

Do I need sedang or lagi to show it’s happening now?

Not required, but you can add them for emphasis on “currently”:

Anaknya sedang demam dan batuk. (neutral)
Anaknya lagi demam dan batuk. (informal/colloquial) The original sentence is already understood as present unless context says otherwise.

Is it okay to say Nenek saya cemas karena dia demam dan batuk? Who would dia refer to?

That’s risky because dia could be taken to refer to the nearest or most salient third person—often the grandmother—yielding “My grandmother is anxious because she is feverish and coughing.” To avoid ambiguity, keep anaknya, use a name, or specify ibuku/ayahku or cucunya.

Should there be a comma before karena?

Not when karena is in the middle: Nenek saya cemas karena … (no comma). If you front the reason, use a comma: Karena anaknya demam dan batuk, nenek saya cemas.

How do I negate this—“not anxious,” or “not because …”?

Negate the adjective with tidak: Nenek saya tidak cemas.
Negate the cause with bukan karena: Nenek saya cemas, bukan karena anaknya demam, tetapi karena …
Use bukan to negate noun phrases or to correct a specific assertion; tidak negates verbs/adjectives.

Pronunciation tips for words in the sentence?

c as in cemas is “ch” (IPA [tʃ]).
ny in nya is like “ny” in “canyon” (IPA [ɲ]).
u in batuk is like “oo” in “book.”
Final k in batuk is often a glottal stop [ʔ] in casual speech: [batuʔ].
The first e in karena and cemas is the schwa [ə].

Are there register/formality choices for “my grandmother” and “her child”?

“My grandmother”: nenek saya (neutral/polite), nenekku (informal/affectionate), nenek gue (very informal, Jakarta).
“Her child”: anaknya (neutral), anak nenek saya (explicit), anak beliau (respectful; beliau is a respectful 3rd-person pronoun).

How do I say “grandchild” instead of “child,” and how do I intensify “anxious”?

“Grandchild”: cucu. Example: Nenek saya cemas karena cucunya demam dan batuk.
Intensifiers: sangat cemas, cemas sekali (both neutral), cemas banget (informal). You can also use sangat khawatir.