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Two worlds: Adolescents' strategies for managing life with a parent in hospice

Published online by Cambridge University Press:  01 July 2015

Denice Kopchak Sheehan ,
M. Murray Mayo ,
Grace H. Christ ,
Kim Heim ,
Stephanie Parish ,
Ghada Shahrour  and
Claire Burke Draucker
Denice Kopchak Sheehan*
Affiliation:
Kent State University College of Nursing, Kent, Ohio
M. Murray Mayo
Affiliation:
Ursuline College, The Breen School of Nursing, Pepper Pike, Ohio
Grace H. Christ
Affiliation:
Columbia University School of Social Work, New York, New York
Kim Heim
Affiliation:
Department of Hematology/Oncology, Akron General Medical Center Physicians Partner Group, Akron, Ohio
Stephanie Parish
Affiliation:
Kent State University College of Nursing, Kent, Ohio
Ghada Shahrour
Affiliation:
Kent State University College of Nursing, Kent, Ohio
Claire Burke Draucker
Affiliation:
Indiana University School of Nursing, Indianapolis, Indiana
*
Address correspondence and reprint requests to: Denice Kopchak Sheehan, Kent State University, College of Nursing, Henderson Hall, P.O Box 5190, Kent, Ohio 44242-0001. E-mail: [email protected]
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Abstract

Objective:

This study aimed to generate an explanatory model of the coping strategies that adolescents employ to manage the stressors they experience in the final months of their ill parent's life and shortly after their death.

Method:

The sample included 26 families of adolescents with a parent receiving care in a large hospice program in northeastern Ohio. A semistructured interview was conducted with 14 ill parents, 17 well parents/guardians, and 30 of their adolescent children before the parent's death and, additionally, with 6 of these families after the death. The interviews were audiotaped, transcribed verbatim, and analyzed using a grounded-theory approach.

Results:

The participants described two worlds that constituted the lives of the adolescents: the well world of normal adolescence and the ill world of having a parent near the end of life. The adolescents experienced a common challenge of living in two worlds and responded to the challenge with a process we labeled “managing two worlds.” Five stages through which adolescents manage their worlds were identified: keeping the ill world and the well world separate; having the ill world intrude into the well world; moving between the ill world and the well world; being immersed in the ill world; and returning to the well world having been changed by the ill world.

Significance of results:

The explanatory model of “managing two worlds” outlines a complex and nuanced process that changes over time. The model can be used by health professionals who seek to help adolescents navigate this critical time when their parents are dying or have recently died. These results can also be used to inform the development of interventions that assist families with strategies tailored to an adolescent's specific needs. Future research should investigate associations among the process of “managing two worlds” and outcomes related to adolescent bereavement.

Keywords

Adolescents/youthHospiceParental deathAdvanced cancerQualitative research
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 3 , June 2016 , pp. 177 - 186
Copyright
Copyright © Cambridge University Press 2015 

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