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
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.