title: Tightrope walkers suffering in silence: A qualitative study into the experiences of older parents who have an adult child with cancer.
abstract: BACKGROUND
  Given the worldwide ageing of the population and the changes in the structure of society and family, the likelihood increases that older parents face a serious illness in an adult child and will even outlive their child.
  
  
  OBJECTIVE
  To gain insight into older parents' experiences, concerns, and dilemmas regarding their position and role as a parent of an adult child with cancer.
  
  
  METHODS
  Qualitative interview design.
  
  
  METHODS
  A geriatric ward and four oncology wards of a university hospital, several nursing homes, local health service agencies.
  
  
  METHODS
  Twenty-five parents (age range 65-91 years) of 22 adult children with cancer (age range 33-66 years) of differing stages and types (with a preponderance of breast cancer).
  
  
  METHODS
  Using a qualitative research methodology underpinned by grounded theory, we conducted semi-structured interviews with a fairly open framework.
  
  
  RESULTS
  Suffering in silence emerged as the core category encapsulating three interrelated balancing acts: (1) shielding their child while being shielded by their child, (2) being involved while keeping an adequate distance, and (3) shifting attentional priorities between their child, themselves, and others. The emotional interconnectedness between older parents and their adult child with cancer becomes tangible in the transformational process of their parental role and position described in the three balancing acts.
  
  
  CONCLUSIONS
  Faced with their child's illness and possible death, older parents experience overwhelming feelings often underestimated by their (close) environment. Nurses need to be susceptible for the needs and experiences of these older parents. For care by nurses to make a difference, their attention must be directed to how older parents can be invigorated in their parenthood while respecting the child's autonomy.
authors.affiliation: Department of Geriatric Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: liesbeth.vanhumbeeck@uzgent.be.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Van Humbeeck
authors.affiliation: Oncology Centre and Department of Geriatric Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: let.dillen@uzgent.be.
authors.forename: Let
authors.initials: L
authors.lastname: Dillen
authors.affiliation: Department of Geriatric Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: ruth.piers@uzgent.be.
authors.forename: Ruth
authors.initials: R
authors.lastname: Piers
authors.affiliation: Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium. Electronic address: myriam.deveugele@ugent.be.
authors.forename: Myriam
authors.initials: M
authors.lastname: Deveugele
authors.affiliation: University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium. Electronic address: maria.grypdonck@ugent.be.
authors.forename: Mieke
authors.initials: M
authors.lastname: Grypdonck
authors.affiliation: University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium. Electronic address: sofie.verhaeghe@ugent.be.
authors.forename: Sofie
authors.initials: S
authors.lastname: Verhaeghe
authors.affiliation: Department of Geriatric Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: nele.vandennoortgate@uzgent.be.
authors.forename: Nele
authors.initials: N
authors.lastname: Van Den Noortgate
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*
keywords: Adult children; Cancer; Caregiver stress; Family relationships; Grounded theory; Older adults; Parenthood; Qualitative research; Role