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Parents dying of cancer and their children

Published online by Cambridge University Press:  19 July 2005

ESTELA A. BEALE
Affiliation:
The Department of Neuro-Oncology, Psychiatry Section, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
DEBRA SIVESIND
Affiliation:
The Department of Neuro-Oncology, Psychiatry Section, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
EDUARDO BRUERA
Affiliation:
Department of Palliative Care & Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

Abstract

Objective: We reviewed our experience with 28 consecutive children referred for assessment and intervention. These were the children of patients with terminal cancer referred to the Palliative Care and Symptom Control Service. In all cases the dying parent was a biological parent.

Methods: Eleven parameters were assessed in each of 29 children and their incidence was calculated. The children and their parents were seen in a semistructured interview, together as well as separately. The parameters were: seeking reassurance (82), becoming a caretaker (79), inability to separate from parent (79), anger about feeling abandoned (68), despair (57), guilt (54), discipline problems, aggressive behavior (46), denial (39), blame of others (21), and fear for the child's own health (18).

Results: Our results suggest that children with dying parents manifest significant distress as well as a greater understanding of their parent's illness than is usually suspected.

Significance of results: Timely intervention by a child psychiatrist or other mental health professional with proven competence in working with children can help children to better cope with the death and dying of their parent and ameliorate the process of bereavement following the parent's death.

Because of our small sample, we cannot generalize about all of the findings. Further research is required to characterize the level of distress in the children and the long-term impact in their overall adjustment to life.

Type
Research Article
Copyright
© 2004 Cambridge University Press

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References

REFERENCES

Bluebond-Langner, M. (1989). Worlds of dying children and their well siblings. Death Studies, 116.Google Scholar
Bowlby, J. (1980). Attachment and Loss: Sadness and Depression, Vol. 3. London: Hogarth Press.
Breier, A., Kelsoe, J.R., Jr., Kirwin, P.D., et al. (1988). Early parental loss and development of adult psychopathology. Archives of General Psychiatry, 45, 987993.Google Scholar
Buckman, R. (1984). Breaking bad news: Why is it still so difficult? British Medical Journal (Clinical Research Edition), 288, 15971599.Google Scholar
Butow, P.N., Brown, R.F., Cogar, S., et al. (2002). Oncologists' reactions to cancer patients' verbal cues. Psycho-Oncology, 11, 4758.Google Scholar
Claflin, C.J. & Barbarin, O.A. (1991). Does “telling” less protect more? Relationships among age, information disclosure, and what children with cancer see and feel. Journal of Pediatric Psychology, 16, 169191.Google Scholar
Chesterfield, P. (1992). Communicating with dying children. Nursing Standard, 6, 3032.Google Scholar
Christ, G.H., Siegel, K., & Christ, A.E. (2002). Adolescent grief: “It never really hit me … until it actually happened.” Journal of the American Medical Association, 288, 12691278.Google Scholar
Elizur, E. & Kaffman, M. (1983). Factors influencing the severity of childhood bereavement reactions. American Journal of Orthopsychiatry, 53, 688676.Google Scholar
Ellis, R. & Leventhal, B. (1993). Information needs and decision-making preferences of children with cancer. Psycho-Oncology, Vol. 2, 277284.Google Scholar
Fallowfield, L. & Jenkins, V. (1999). Effective communication skills are the key to good cancer care. European Journal of Cancer, 35, 15921597.Google Scholar
Furman, E. (1974). A Child's Parent Dies. New Haven, CT: Yale University Press.
Harris, T., Brown, G.W., & Bifulco, A. (1986). Loss of parent in childhood and adult psychiatric disorder: The role of lack of adequate parental care. Psychology Medicine, 16, 641659.Google Scholar
Hilden, J.M., Watterson, J., & Chrastek, J. (2000). Tell the children. Journal of Clinical Oncology, 18, 31933195.Google Scholar
Kastenbaum, R. (1967). The child's understanding of death: How does it develop? In Explaining Death to Children. E. Grollman (ed.), pp. 89108. Boston: Beacon Press.
Kranzler, E.M., Shaffer, D., Wasserman, G., et al. (1990). Early childhood bereavement. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 513520.Google Scholar
Kroll, L., Barnes, J., Jones, A.L., et al. (1998). Cancer in parents: Telling children. British Medical Journal, 316, 880.Google Scholar
Maguire, P. (1999). Improving communication with cancer patients. European Journal of Cancer, 35, 20582065.Google Scholar
Matthews, G.B. (1989). Children's conceptions of illness and death. In Children and Health Care: Moral and Social Issues, L.M. Kopelman, J.C. Moskop (eds.), pp. 133146. Boston: Kluwer Academic Publishers.
Nitschke, R., Humphrey, G.B., Sexauer, C.L., et al. (1982). Therapeutic choices made by patients with end-stage cancer. Journal of Pediatrics, 101, 471476.Google Scholar
Pettle, S.A. & Britten, C.M. (1995). Talking with children about death and dying. Child: care, health and development, 21, 395404.Google Scholar
Pfeffer, C.R., Karus, D., Siegel, K., et al. (2000). Child survivors of parental death from cancer or suicide: Depressive and behavioral outcomes. Psycho-Oncology, 9, 110.Google Scholar
Piaget, J. (1929). The Child's Conception of the World. London: Routledge & Kegan Paul.
Sourkes, B. (1987). Views of the deepening shade: psychological aspects of life-threatening illness. American Journal of Hospice Care, 4, 2229.Google Scholar
Sourkes, B.M. (1992). The child with a life-threatening illness. In Countertransference in Psychotherapy with Children and Adolescents, J. Brandell, (ed.), pp. 267284. New York: Jason Aronson.
Sourkes, B.M. (1996). The broken heart: anticipatory grief in the child facing death. Journal of Palliative Care, 12, 5659.Google Scholar
Spinetta, J.J. (1974). The dying child's awareness of death: A review. Psychological Bulletin, 81, 256260.Google Scholar
Spinetta, J.J., Rigler, D., & Karon, M. (1974). Personal space as a measure of a dying child's sense of isolation. Journal of Consulting and Clinical Psychology, 42, 751756.Google Scholar
Stambrook, M. & Parker, K.C.H. (1987). The development of the concept of death in childhood Vol. 33: A review of the literature. Merrill-Palmer Quarterly, 133157.Google Scholar
Waechter, E.H. (1971). Children's awareness of fatal illness. American Journal of Nursing, 7, 11681172.Google Scholar