Care of the Family of the Child with Cancer

EACH parent of a fatally ill child must adjust, in his own way, first to the threatened loss and then to the actual death of his child. The nature of this adjustment reflects, to varying degrees, the parent's mode of coping with past crises, his previous experiences with illness and death, and the idiosyncratic meaning this particular child may have to him. Thus, the physician can be of most help to the parents if he is aware of important landmarks in the history of the family and problems that they have had to face. His knowledge of previous patterns of family behavior in times of stress can aid him in encouraging parents along lines that have been successful in the past and in supporting attempts to adapt to the present situation. For many parents, this may be their first personal experience with death, and this may place additional demands and requests upon the physician. Unfortunately, such family history is usually not available to the physician who ultimately assumes the care of a fatally ill child. Furthermore, it is often difficult, and inadvisable, to obtain such information in detail at the time parents are preoccupied with an acute crisis. It therefore is useful for physicians to realize that there are many problems these parents face in common, and a number of studies have described more or less characteristic ways of reacting to them. This does not imply that stereotype behavior will be observed in parents sharing this common experience. However, if the physician is consciously aware of common modes of adjustment used by parents, he will be in the position of anticipating some of their needs, problems, and sources of anxiety.