Understanding Bereavement

Open research on bereavement, gathered with care

Research · for Cancer, stroke & family-support organisations

A parent's sudden serious illness: the children services rarely count

Published 2026-10-16

When a parent has a sudden serious illness, the children and the other parent are affected too, yet most health services do not record that those children exist. Families living with a parent's cancer have been counted in a handful of countries. For a parent's stroke, heart attack or cardiac arrest, no population count of the children was found anywhere.

A stroke, a cardiac arrest or a cancer diagnosis can change a household within a day. One parent is in hospital or in treatment. The other is suddenly running the home alone, visiting the ward, keeping a job going and deciding what to tell the children. The children are trying to make sense of what has happened, often with less information than anyone else in the family. This study gathers the published evidence, from any country, on how many families this affects, what it means for children and partners, and how far services see the whole family rather than the patient alone.

2.85 millionchildren in the United States were estimated to live with a parent who had had cancer, from national survey data for 2000–2007. This is a weighted survey estimate, not a count[1]
6.6%of all children born in Finland in 1987 had a parent with cancer at some point in their first 21 years, according to national registers[2]
40.2%of family caregivers of stroke survivors had depressive symptoms, pooled across 12 studies of 1,756 caregivers[3]

Only cancer has been counted, and only in a few countries

Two of the best estimates come from the United States and Finland. Researchers used the US National Health Interview Survey (2000–2007) to estimate how many people with a history of cancer live with their own children under 18. Among people diagnosed in the previous two years, 18.3% did, and 14.0% of all cancer survivors did. Weighted to the national population, that came to an estimated 1.58 million survivors living with 2.85 million children, including about 562,000 children whose parent was in the early phases of treatment and recovery[1]. A 2021 systematic review of 18 population-based publications found a similar picture elsewhere: between 14% and 24.7% of cancer patients had children, depending on how the sample was drawn, and between 1.6% and 8.4% of children or young adults had a parent with a history of cancer[4].

Registers give firmer numbers. In Finland, all 60,069 children born in 1987 were followed through national registers, and 3,909 of them (6.6%) had a parent with cancer within 21 years[2]. In Western Australia, linked records show that 15,938 parents were diagnosed with a malignant cancer between 1982 and 2015, affecting 25,901 children aged 0–11. In 2015 alone, 0.28% of the state's children aged 0–11 saw a parent diagnosed. The number of children affected rose over time, but only in step with population growth[5]. These figures measure different things (a single year, a whole childhood, or everyone living with a survivor), so they cannot be compared or combined.

For stroke, heart attack and cardiac arrest, this study found no population estimate, in any country, of how many children have a parent affected. Part of the reason is that hospitals rarely record it. A 2026 report from one US cancer centre describes adding a single screening question asking whether a patient is a parent or carer of children under 22, and its authors note that “parenthood status is rarely captured in oncology workflows”. Once asked, 20.6% of the 2,172 patients screened said they were parents[6].

Most children cope, but the first year carries extra risk

The research on children whose parent has cancer is larger than for any other illness, and its main message is steadier than many people expect. A 2007 systematic review concluded that children and adolescents “do not generally experience elevated levels of serious psychosocial difficulties compared to reference groups, but they are at a slightly increased risk for internalising type problems”, meaning worry, low mood and withdrawal rather than disruptive behaviour. Adolescent daughters appeared the most affected. The factor most consistently linked with how children were doing was family communication[7].

Whole-population registers point the same way. In the Finnish 1987 birth cohort, children whose parent had cancer used more specialised psychiatric care than their peers[2]. Yet the overall rate of psychiatric diagnoses among them “does not seem to differ” from other children's, although some specific diagnoses were more common[8]. In Sweden, children had a higher rate of hospital contact for an injury than other children in the first year after a parent's cancer diagnosis (a hazard ratio of 1.27), and more so when the parent also had a psychiatric disorder after diagnosis (1.41). The excess fell in the second and third years and disappeared after that[9]. The pattern suggests that the months around diagnosis and treatment, when adults' attention is stretched, are when practical help for the household matters most.

Children's hospital contact for injury after a parent's cancer diagnosis, Sweden, compared with children whose parent did not have cancerSwedish nationwide register study. Hazard ratio for hospital contact for injury: 1.27 in the first year after a parent's cancer diagnosis, 1.10 in the second and third years, and 1.01 after that (no difference).00.20.40.60.811.21.41.27First year1.10Years 2-31.01After year 3
Hazard ratios; 1.00 would mean the same rate as children whose parent did not have cancer. Register study: it adjusts for some differences between families, not all, and shows an association, not a cause. Source: Chen et al., eLife 2015.

Older children feel it differently. A 2018 review of 54 studies of adolescents and young adults whose parent had cancer found that 29 reported negative impacts, eight reported positive outcomes described as post-traumatic growth, and five had null or mixed findings. Communication and information mattered greatly to young people, “though these needs were often unmet and parents wanted guidance regarding discussions with their children”[10]. Where a parent dies, the evidence on children's grief is covered in the bereaved children library, for example on mental health after a parent's death.

Stroke and cardiac arrest arrive without warning, and children's research is thin

Cancer usually comes with a diagnosis, a treatment plan and some time to prepare. A stroke or a cardiac arrest does not. Yet almost all of the research on children has been done on parental cancer, and the evidence for the most sudden illnesses comes from small clinical studies.

The clearest study of children after a parent's stroke followed 82 children aged 4 to 18, and their parents, in the Netherlands. At the start of the stroke patient's rehabilitation, 54% of the children had at least one subclinical or clinical problem with mood, behaviour or health. One year after the stroke, that had fallen to 29%. The best predictor of how a child was doing at one year was how they had been doing at the start, followed by the depressive symptoms of the parent who had not had the stroke and how that parent saw the couple's relationship. The authors concluded that this “demonstrates the need for a family-centered approach in stroke rehabilitation”[11].

Children with at least one emotional, behavioural or health problem after a parent's stroke, Netherlands82 children aged 4 to 18 whose parent was in stroke rehabilitation in the Netherlands. 54% had at least one subclinical or clinical problem at the start of the parent's rehabilitation, falling to 29% one year after the stroke.0%20%40%60%54%Start ofrehabilitation29%One year afterstroke
Small clinical sample (82 children, 55 parents) from rehabilitation centres; "problems" includes subclinical scores. Not a population estimate. Source: Visser-Meily et al., Stroke 2005.

For some families, a sudden illness begins in intensive care. In interviews with 16 adolescents whose relative was critically ill in one of three Norwegian intensive care units, young people described significant uncertainty and distress, found the unit intimidating, and “frequently feel overlooked”. They wanted to be prepared before visiting and to be kept informed[12].

For children whose parent has a heart attack or survives a cardiac arrest, this study found no outcome data at all. The closest evidence is about adult relatives. In a Danish cohort of 146 relatives, 84% of them women, of people who had survived an out-of-hospital cardiac arrest, 25% had clinical-level symptoms of post-traumatic stress, 27% of anxiety and 14% of depression three months later[13]. A 2025 review noted that, unlike other heart conditions, “no clinical practice guidelines exist for assessing or treating the psychological consequences” of cardiac arrest[14]. The sibling study on working-age adults after a sudden serious illness covers survival and recovery for the person who was ill.

Relatives with clinical-level symptoms three months after a family member survived a cardiac arrest, Denmark146 relatives, 84% of them women, of people who survived an out-of-hospital cardiac arrest, recruited at three Danish cardiac arrest centres, 2018 to 2022. At three months: clinical symptoms of post-traumatic stress 25%, anxiety 27%, depression 14%.0%10%20%30%Anxiety27%Post-traumatic stress25%Depression14%
Questionnaire screening scores, not diagnoses; relatives who took part may differ from those who did not. Source: Dichman et al., Resuscitation Plus 2025 (REVIVAL cohort).

The other parent carries the household, often with little support

In most of these families, the other parent becomes carer, sole parent and often the main earner at once. The evidence on how partners fare is better than the evidence on children, though it rarely separates partners who are raising children from those who are not.

A meta-analysis of 12 studies, covering 1,756 family caregivers of stroke survivors, found a pooled prevalence of depressive symptoms of 40.2% and of anxiety symptoms of 21.4%. These are symptom scores on screening questionnaires, not diagnoses, and the studies varied widely. Depressive symptoms were more common where the caregiver or the stroke survivor was a woman[3]. The Danish cardiac arrest cohort above found clinical-level symptoms of anxiety or post-traumatic stress in about a quarter of relatives[13]. The ill parent carries strain too: among patients with cancer at one US centre, those raising children reported more distress (1.35 times the odds) and more anxiety (1.28 times the odds) than matched patients who were not parents[6]. The Dutch stroke study shows why this matters for children: the other parent's depressive symptoms were one of the things that predicted how children were doing a year later[11].

Money and work are part of the strain. In Swedish national registers for 2005–2016, spouses aged 60 or under whose partner had a stroke were compared with four matched people each. Overall, the change in their earnings from paid work was small and not statistically significant. But younger women whose partner had a stroke saw their income from paid work fall by an average of 1,614 euros[15]. In Norway, a review of 23 studies of children whose parent had a serious illness, injury, mental illness or substance dependence found that some children took on practical tasks at home and, occasionally, jobs to help maintain the family economy[16]. The sibling study on carers after caring covers the longer arc of family caregiving.

Services rarely ask about the children, even where the law requires it

Across countries, the same gap recurs: health services are organised around the patient, and the children at home are often invisible to them. The 2021 review of population studies concluded that cancer care should routinely include questions on patients' parental role and on how their children are coping[4]. The Norwegian review of 23 studies found that what helped children was at least one adult who recognised them, time with friends and leisure activities, and talking with peers in a similar position. What got in the way was “lack of information and recognition as well as silence and lack of dialogue within the family and/or health professional”[16].

Norway is one of the few countries to have written this into law. Since 2010, health personnel there must assess whether patients have children under 18 and make sure the children's needs for support are met[17]. A law is not the same as practice, though. In interviews with six partners of people with motor neurone disease (ALS) who had children at home, partners felt alone and “caught between the needs of their children and partner”, and said the health system did not see the whole family[17]. A decade after the law came in, 61.9% of 2,811 Norwegian health, social care and teacher education students who answered a survey (response rates 26–36%) said their own course had not taught them about such children[18].

Support designed for these children is still being built. A 2019 review found only eight studies evaluating six interventions for children of parents with cancer, of low quality overall, and concluded that interventions “do not yet adequately support cancer patients' children”[19]. Peer-group programmes, where children meet others in the same situation, have more encouraging results: a 2023 review of ten articles on seven programmes reported “high acceptance, feasibility and positive effects”[20]. For stroke and cardiac arrest, no comparable reviews of support for children were found.

What the evidence asks of us

The figures point to a small number of practical changes that services, funders and policymakers could make.

  • Ask, and record it. Hospitals, stroke units, cardiac and cancer services can routinely ask adult patients whether they have children at home, as Norway's law requires and as the cancer review recommends[4][17]. One US centre showed this can be done with a single question in the electronic record[6].
  • Support the other parent. The other parent's mental health is linked to how children are doing[11], and depressive and anxiety symptoms are common among stroke caregivers[3] and relatives after cardiac arrest[13]. Family-centred rehabilitation and routine screening of partners would follow the evidence.
  • Front-load help. The Swedish injury data suggest the first year after diagnosis is when the household is most stretched[9]. Practical help with childcare, transport and contact with school is likely to count most then.
  • Help families talk. Family communication is the factor most consistently linked to how children cope[7], and parents want guidance on talking with their children[10]. Information written for children, and for teenagers visiting intensive care[12], is part of that.
  • Train the workforce, and fund the research. Professional training on children of seriously ill parents is patchy even where it is required[18]. Funders could close the largest gap of all: there is no count, anywhere, of children whose parent has had a stroke or cardiac arrest, and almost no research on how they fare.

Language: this piece uses plain words such as “died” rather than euphemisms, because they are clearer. It describes people as “people who have had a stroke” or “people living with cancer”, and their partners and children as family members, not as patients or cases.

Why we're publishing this

Children and partners of people with a sudden serious illness are rarely counted, rarely asked about and rarely the subject of research, especially after a stroke or cardiac arrest. The organisations that work with these families, including cancer, stroke and heart charities and family-support services, already know this. We have gathered the published evidence from every country we could find so that they can point to it, cite it and use it to make the case for support that sees the whole family. Where the evidence is missing, we say so, because that gap is itself part of the case.

How to read this data

The figures come from several kinds of source, and they are not interchangeable. The US figure of 2.85 million children is a weighted estimate from a national household survey (2000–2007), not a count[1]. The Finnish and Western Australian figures come from population registers, which count everyone but measure different things: a whole childhood in Finland, a single year in Western Australia[2][5]. Register studies such as the Swedish injury study show associations; they adjust for some differences between families, but not all, and cannot prove cause[9]. The stroke and cardiac arrest studies of children and relatives are small clinical samples from one country each (the Netherlands and Denmark) and use screening questionnaires, not diagnoses[11][13]. The stroke caregiver figures are pooled from 12 studies of varying design[3], and do not separate partners raising children from other carers. Odds ratios (the US distress figures) and hazard ratios (the Swedish injury figures) are different measures and should be quoted as such. Almost all the evidence comes from high-income countries in Europe, North America and Australia; for most of the world, there are no data.

Use this data

Free to cite with attribution to Understanding Bereavement. Charities, schools, services and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Suggested citation: Understanding Bereavement (2026). A parent’s sudden serious illness: the children services rarely count. https://understandingbereavement.org/research/parent-sudden-serious-illness

Important: This study summarises published research about groups of people for general information. It is not medical advice or bereavement support, and it cannot describe or predict anything about an individual or family. If you are worried about yourself or someone close to you, please speak to a GP or another qualified professional.

Sources

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