End-of-life parental communication priorities among bereaved fathers due to cancer

Abstract

Objectives To elicit widowed fathers’ perspectives on which domains of parenting-related communication they consider most important for dying parents to discuss at the end of life (EOL). Methods Two hundred seventy nine fathers widowed by cancer completed a survey about their own depression and bereavement symptoms, their wife’s illness, and EOL parental communication priorities. Chi square and Fisher’s exact tests and logistic regression were used to evaluate relationships between maternal EOL characteristics and fathers’ responses to parenting-related EOL communication priorities. Results Fathers identified raising children in a manner that reflected maternal wishes, whether/how to talk with children about their mother’s death, and how the mother wanted to be remembered as the most important EOL communication domains. Fathers who reported that their dying wives were worried about the children were more likely to prioritize raising children in ways that reflect her wishes (p=0.01). Other EOL characteristics were not associated with communication domains. Conclusions Communicating with children and maintaining emotional connection with the deceased parent are important priorities for bereaved fathers who lost a spouse to cancer. Practice Implications Health care providers working with seriously ill parents may improve family outcomes by supporting communication at the EOL between co-parents.

Understanding Dying Concerns in Parents With Advanced Cancer With Dependent Children for Their Coparent

“…Several studies support that the parental status of being a PWAC with dependents impacts their end-of-life decisions, which also increases their worries and concerns. 4,17,18 However, this study acknowledged the PWACs' concern about the uncertainty in their coparent's abilities to make end-of-life decisions for them.…”

“…[1][2][3] When a patient has advanced cancer and is a parent to dependents (PWAC), the patient's concerns are increased, thereby impacting the patient's quality of life, psychological well-being, and perceived family functioning. 1,4,5 Yet, the literature on the approaching death of PWAC has often been limited to the term "parental concerns," [5][6][7][8][9] rather than the broader concept of dying concerns. Plus, the extant literature has mainly focused on concerns related to the PWAC's children, with limited focus on the concerns for the coparent.…”

“…5 It measures concerns on a Likert scale about the practical and emotional impact of their illness on the children and concerns about their coparent. 7 Patients with advanced cancer and parents to dependents scored their concerns for their coparent including the emotional impact of cancer, coparent coping, and quality of parenting as high, [4][5][6][7] but limited research has been conducted to identify, qualitatively, the specific concerns for the coparent from the PWACs' perceptions. The aim of this hermeneutic study was to gain a shared understanding of the perspectives of the PWAC about the dying concerns and the factors that may mediate these concerns with a focus on the impact of advanced cancer for the coparent.…”

A child after the death of a parent or another important person

“…W przypadku, gdy partnerzy nie mieli okazji ustalić wspólnej strategii dalszej opieki nad dzieckiem przez pozostającego przy życiu rodzica, późniejsza samotna już rola opiekuna może nastręczać wiele problemów, co jest z reguły znacznie trudniejsze dla ojców. Doświadczając choroby i następnie śmierci partnerki-matki, wielu mężczyzn żywi przekonanie, że nie otrzymało od niej właściwej "instrukcji", jak postępować z dzieckiem (dziećmi), zarówno w odniesieniu do sytuacji przeżywania straty, jak i w innych kwestiach życiowych [16].…”

End‐of‐life experiences of family caregivers of deceased patients with cancer: A nation‐wide survey

“…Little research has explored experiences of single parents with minor children . For example, one study indicated that healthy parents were keen to reassure and protect children, but that they failed to provide sufficient cancer‐related information.…”