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 While all families may struggle when a loved one is dying, parenting
duties can create an added layer of emotional stress and complicate
efforts to comfort patients at the end of life, researchers note in
the journal BMJ Supportive and Palliative Care.
“What is unique about patients with young children is the
extraordinary psychological suffering related to parenting,” said
lead study author Dr. Eliza Park, a psychiatry researcher at the
University of North Carolina at Chapel Hill.
These parents may worry about how their illness negatively impacts
their children’s lives, how their death will impact their kids, and
how to explain their prognosis to their children in an
age-appropriate way. They may also experience anticipatory grief
about their inability to raise their children into adulthood, Park
added by email.
“The patient in these situations truly is the entire family unit,”
Park said.
To understand the unique issues faced by terminally ill parents,
Park and colleagues surveyed 344 widowed fathers who had lost a
spouse to cancer and were raising young children.
Their late wives had been about 44 years old on average. The
families typically had two kids under 18 years old, with the
youngest child around 8 years old.
About 43 percent of the women had cancer that had spread to other
parts of the body at the time tumors were diagnosed.
Roughly two thirds of the women received hospice services, and 41
percent of them died at home. Almost half of them died at the
location of their choice.
According to the fathers, 38 percent of mothers had not said goodbye
to their children before death, and 26 percent were not at peace
with the prospect of dying.
Nine in 10 widowed fathers reported that their spouse was worried
about the strain on their children at the end of life, the survey
found.
Fathers who reported clearer communication between doctors and their
spouse about the prognosis also reported fewer indications of
depression or grief in their survey responses.
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One shortcoming of the study, the authors note, is that it was done
online and men were recruited through an open-access educational
website, so researchers couldn’t verify that the men were indeed
widowed fathers who lost spouses to cancer. The participants also
tended to be white and married, with more income and education than
a typical widow might have, which could limit how much the results
apply to a broader population of parents and families.
Still, the findings suggest a need to better understand how
parenting influences choices in treatment at the end of life, and
what support families and children may need to cope with terminal
illness, the authors conclude.
This may be particularly true for mothers who haven’t experienced
the death of a loved one before, said Denice Sheehan, a researcher
at Kent State University College of Nursing and director of clinical
research at Hospice of the Western Reserve in Cleveland, Ohio.
These women may be uncertain about what to do for themselves, their
children and their spouse, Sheehan, who wasn’t involved in the
study, said by email.
“Having more time with their children without being a burden to
their family is often their primary goal,” Sheehan added. “Mothers
tend to worry about how their children will live without them, who
will take care of them and nurture them throughout their lives.”
SOURCE: http://bit.ly/1YTFgWh BMJ Supportive and Palliative Care,
online December 18, 2015.
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