Double bereavement, mental health consequences and support needs of children and young adults—When a divorced parent dies

Abstract

Aims and objectives To explore how children and young adults from divorced families experience double bereavement when they lose a divorced parent with cancer and how the double bereavement influences their mental health consequences and need of support. Background Children and young people who are confronted with the cancer and death of a parent is a highly stressful life event, which is associated with an increased risk of mental health problems, especially when children experience divorced parental cancer and death. Design Participant observations and interviews with a phenomenological‐hermeneutic approach and COREQ standards for reporting qualitative research. Methods We conducted 340 hr of participant observations within nine different support groups totalling 27 children and young adults from divorced families and included 28 interviews with participants and relatives. Analyses are based on Ricoeur's theory of interpretation: naïve reading, structural analysis, interpretation and discussion. Results The experiences with double bereavement identified three main themes: 1. navigating through multiple transitions and disruptions within two family worlds; 2. consequences for mental health including stress overload and disruptions to well‐being; and 3. need for accessible support derived from close relationships and professionals within and in‐between family worlds. Conclusion Children and young adult's double bereavement includes multiple transitions and disruptions often related to stress overload and mental health problems. Support from close relationships and professionals is experienced as helpful in the prevention and mitigation of mental health problems. Relevance to clinical practice There is a need for targeted accessible support availability to children, young adults and their families when a divorced parent is dying of cancer in clinical practice. Our findings suggest that specific health policies for health professionals should be developed to target improved support for these families.

Consequences of serious parental health events on child mental health and educational outcomes

“…This could suggest that living with both parents at the time of the health event could be a mitigating factor for mental health problems. This is in line with Danish studies that find that children in divorced families who experience parental death have an increased risk of developing mental health problems and suffering from worse well-being (Marcussen et al, 2019(Marcussen et al, , 2020. Marcussen et al (2020) explains that this might be caused that living with a sick or dying single parent can increase the child's responsibility and may amplify conflict between the parents.…”

Nursing care and nurses’ understandings of grief and bereavement among patients and families during cancer illness and death – A scoping review

“…Children experiencing parental cancer, are challenged in the lack of parents, well-being and the loss of daily routines (Elmose, 2011;Hauken et al, 2018;Lundberg et al, 2018). Also, double bereavement has been identified among children when a divorced parent dies (Marcussen et al, 2020). Both children and young adults losing a parent are found to be at risk for mental health problems, such as depression and distressing symptoms (Bugge et al, 2008;Marcussen et al, 2020).…”

Children and adolescents’ preferences for support when living with a dying parent – An integrative review

“…Results of this study indicate that it can be challenging for parents to balance caring for their children and being ill, which is also supported by previous research (Elmberger et al., 2008). It is also worth mentioning that the definition of the nuclear family is changing, and that the family perspective should also be extended to deal with, among other things, children and adolescents of divorced parents and the challenges they may entail (Marcussen et al., 2020). Our results indicate that it can be difficult for children and adolescents to be honest about their feelings and preferences when other family members are present.…”