Rauch et al listed a number of steps for working with children who have a parent with terminal cancer. The loss of a parent can be devastating for a child, but the permanent harm can be reduced by appropriate interventions. The authors are from Massachusetts General Hospital and Harvard Medical School.


General tasks:

(1) Identify the children and try to understand their needs.

(2) Optimize the available support system for them and other family members.

(3) Answer common questions and provide open communication.

(4) Support hospital visits if possible or alternative forms of communication if not.


Communicate about the illness:

(1) Avoid euphemisms.

(2) Inform the children directly and honestly. A child should not find out the situation first by overhearing it.

(3) Listen to questions and try to understand what each child is concerned about.

(4) Find family members or friends that the child can talk with. Encourage the child not to worry alone.

(5) Let them know that what they are feeling is normal.


Preparing for death and grief:

(1) Make sure that child knows that she or he is loved.

(2) Encourage the child to say goodbye.

(3) Facilitate internalization and remembrance of the parent.

(4) Help the child to understand the process of grief.

(5) Provide support that continues after the death of the parent.


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