Wednesday, August 31, 2005
Beale EA, Sivesind D, Bruera E
Parents dying of cancer and their children
Palliative and Supportive Care 2004 v2 no4 p387-393
This article reviews 28 children who had been referred to a palliative care centre for assessment by their parents. The purpose was for assessment and intervention because one of their parents was terminally ill. The article commences with a literature review and various references to other studies on bereaved children are made at a number of points in the text.
The method involved interviews by either a child psychiatrist or a nurse specialist with each child. The children were asked a series of questions to provide an indication of their emotional state – eg the extent to which they needed reassurance, anger about abandonment, aggressive behaviour. Of 11 emotional domains the highest was for seeking reassurance (82%) and the lowest was fear for own health (18%). Only 14 had more than one interview which largely involved support, exploring emotions and reframing their perceptions. Three case studies are described with descriptions of drawings the children completed during the interview. The youngest child was 3 and showed a great understanding of her mother’s condition.
From the literature , the authors suggest six themes relevant both to the short and long term care of children with a parent with terminal cancer, the last of which would be probably be contested by health professionals. The authors suggest that meeting with a mental health professional provides an avenue for supportive discussions, which can model for the family how discussion can be conducted to clarify issues, dispel fears, bring people together, or plan for the future. The question is whether this has to be a mental health professional?
The conclusions, based as much on the literature review as on the work with these particular children, seem appropriate. It is not an easy task to recommend how to talk about terminal cancer – but discussions among parents, children and other caretakers are important. Ideally they should begin when the parens is first aware of his or her terminal condition eg at time of referral to a palliative care team. Assessment of both parents and children is necessary to ascertain the parents’ adaptation to the illness and the children’s developmental age, and understanding of the facts. Any work also needs to take place when there is enough motivation to accomplish a higher level of communication and possibly resolution of the conflicts, before death is imminent.
Parents dying of cancer and their children
Palliative and Supportive Care 2004 v2 no4 p387-393
This article reviews 28 children who had been referred to a palliative care centre for assessment by their parents. The purpose was for assessment and intervention because one of their parents was terminally ill. The article commences with a literature review and various references to other studies on bereaved children are made at a number of points in the text.
The method involved interviews by either a child psychiatrist or a nurse specialist with each child. The children were asked a series of questions to provide an indication of their emotional state – eg the extent to which they needed reassurance, anger about abandonment, aggressive behaviour. Of 11 emotional domains the highest was for seeking reassurance (82%) and the lowest was fear for own health (18%). Only 14 had more than one interview which largely involved support, exploring emotions and reframing their perceptions. Three case studies are described with descriptions of drawings the children completed during the interview. The youngest child was 3 and showed a great understanding of her mother’s condition.
From the literature , the authors suggest six themes relevant both to the short and long term care of children with a parent with terminal cancer, the last of which would be probably be contested by health professionals. The authors suggest that meeting with a mental health professional provides an avenue for supportive discussions, which can model for the family how discussion can be conducted to clarify issues, dispel fears, bring people together, or plan for the future. The question is whether this has to be a mental health professional?
The conclusions, based as much on the literature review as on the work with these particular children, seem appropriate. It is not an easy task to recommend how to talk about terminal cancer – but discussions among parents, children and other caretakers are important. Ideally they should begin when the parens is first aware of his or her terminal condition eg at time of referral to a palliative care team. Assessment of both parents and children is necessary to ascertain the parents’ adaptation to the illness and the children’s developmental age, and understanding of the facts. Any work also needs to take place when there is enough motivation to accomplish a higher level of communication and possibly resolution of the conflicts, before death is imminent.
