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Watching a parent die of a terminal disease is traumatic for any child, but families can take steps to help them through it, according to researchers.
Age, they say, makes a substantial difference in how children understand and react to a parent's illness, and a 4-, 7- and 9-year-old all need very different types of support.
Writing in CA: A Cancer Journal for Clinicians, Drs. Grace H. Christ and Adolph E. Christ describe what they learned in interviews with 87 families of children who'd lost a parent to cancer.
With 3- to 5-year-olds, one of the most important things is to consistently reassure them during their parent's illness that they will be taken care of, according to the researchers, who are based at Columbia University and SUNY Health Science Center in New York.
Children this age can make short visits to the hospital, they say, but they should be structured visits; children should have toys to play with, and some activity they can do with their ill parent. Families should also try to control their emotions around children this young, the researchers advise, because crying may frighten them.
It's difficult for preschoolers to understand the meaning of illness, or that death is permanent, the authors point out. Families should expect that in the weeks after a parent dies, the child will repeatedly ask where their mother or father is.
Children between the ages of 6 and 8, on the other hand, understand death. But they may be highly emotional and even blame themselves for their parent's illness, according to the researchers.
They recommend that families repeatedly explain the basic nature of the parent's illness to children this age, and assure them that any "withdrawal" from them is because of the disease, and not because their parent doesn't love them.
With 9- to 11-year-old children, the researchers advise families to give detailed information about the parent's illness and treatment so they will know what to expect. Children this age even benefit from being able to help in their parent's care, the authors note, but they should not have any major responsibility.
After a parent's death, the researchers say, it's best for children in all these age groups to get back to school and their normal activities as soon as they can, to maintain a sense of stability in their lives.
And all children, they add, need to feel free to express their thoughts and feelings about their parent. There are bereavement groups, even for preschoolers, that can help them with this.
SOURCE: CA: A Cancer Journal for Clinicians, July/August 2006
