title: Parents dying of cancer and their children.
abstract: 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 parent.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neuro-Oncology, Psychiatry Section, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030-4095, USA. ebeale@mdanderson.org
authors.forename: Estela A
authors.initials: EA
authors.lastname: Beale
authors.forename: Debra
authors.initials: D
authors.lastname: Sivesind
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002653:Child Behavior Disorders / Q000209:etiology; D002675:Child, Preschool; D032882:Comprehension; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010166:Palliative Care; D010287:Parent-Child Relations; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D014342:Truth Disclosure