Supporting children and young people before a death: selected references

BEALE, E. A., and SIVESIND, D. (2004) Parents dying of cancer and their children. Palliative & Supportive Care, vol.2, no.4, p403-408. (The authors reviewed their 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. 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). The 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. 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 the small sample, the authors cannot generalize about all of the findings and suggest that further research is required to characterise the level of distress in the children and the long-term impact in their overall adjustment to life).