Supporting a Teenager Through the Loss of a Parent

Teenagers and Dying Parents

Although literature related to support of children of terminally ill parents has increased of late, much of the focus has been on younger children. A new study by Punziano and colleagues^[1] is a welcome addition, contributing to our understanding of teenagers who have survived the death of a parent.

This study was conducted through seven focus groups, totaling 62 participants who included nurses (n = 39), physicians (n = 13), physical therapists (n = 6), social workers (n = 2), and psychologists (n = 2). Although the report focuses on the perspectives of these healthcare professionals rather than that of the teenagers themselves, the findings offer insight into and describe the distinct needs of the adolescent population.

The experiences of the focus group participants in supporting teenagers who had lost a parent were analyzed and grouped into themes, each of which can provide practical direction for clinicians.

The first theme was that the reality of the loss was unthinkable to the teens. Another theme was that the loss generates negative emotions, including aggression, loneliness, uncertainty, and depression. Focus group participants described how teenagers often hid from these emotions and isolated themselves. As one participant said, "It seems that they are living in a world apart."

Study participants also discussed "the loss as a catalyst for change," recognizing that dealing with a terminally ill parent often forced the teen to mature and assume adult responsibilities. This highlighted the importance of clinicians "having the right language" to communicate effectively with teenagers.

Another theme was the idea of an "authentic relationship," which is viewed as a requirement for offering support to a teen who has lost a parent. The clinicians offered specific advice such as the need to provide honest information to teens and avoid false hope. These clinicians did emphasize, however, that every teenager is different and no standard protocol can be applied to supporting all teenagers.

Other themes focused on the actual death of the parent and subsequent grief. An important observation reported by these professionals was that we do not always understand the stages of adolescent development. They also recognized the intense emotional burden on clinicians who care for these families and the importance of self-care to sustain the work.

Viewpoint

This study adds to a growing body of work that has identified the unique needs of the older children of dying parents.^{[2,3,4,5,6,7]} This qualitative study provides a very thoughtful analysis of the experiences of a population in need of support.

The theme related to the loss and need for resources specific to teenagers is a reminder of the distinct developmental stage of teens. Even without a serious illness in the family, adolescence is often a challenging time for families, with intense emotion. Unlike other younger children, who may be somewhat protected from the reality of an ill parent, teenagers are often able to understand the circumstances of their ill parents. Even further, they may assume major responsibilities for their parents' care, such as bathing, medications, or assisting with treatments at home. These experiences in caregiving during a parent's terminal illness have a profound impact on the teenager's bereavement after the death.

The clinicians in this study acknowledged that it takes time to develop a trusting relationship with a teen, which is necessary to provide support. Clinicians should also consider the benefit of peer support, because teens may relate best to other teens.

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